77 FR 19657 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

... Power Company. Description: Local Service Agreement with Templeton Municipal Light Plant to be effective... Numbers: ER12-726-001. Applicants: Spring Valley Wind LLC. Description: Supplement to Amended Application for Market-Based Rate Authority of Spring Valley Wind LLC. Filed Date: 3/21/12. Accession Number...

Qualitative and quantitative aspects of drinking water supply in Sardinia, Italy. A descriptive analysis of the ordinances and public notices issued during the years 2010-2015.

PubMed

Dettori, M; Piana, A; Castiglia, P; Loria, E; Azara, A

2016-01-01

The aim of the study is to analyze the regional district ordinances and the warnings regarding qualitative and quantitavive drinking water abnormalities discovered by the Sardinian Municipalities and the Water Managing Authority between 2010 and 2015 in order to describe and identify the causes leading to an interruption or a limitation of the drinking water supply. We carefully reviewed all ordinances and warnings of non-potable water and service interruption published between 2010 and 2015 by the websites of 377 Sardinian Municipalities and by the main regional newspapers, the Water Managing Authority and the Regional Health Trusts. From 2010 to 2015, 738 warnings/ordinances regarding drinking water supply limitation or interruption were issued. The warnings involved more than half (n. 191, 50.7%) of the 377 Sardinian Municipalities. Considering that these Municipalities included the main Sardinian cities we estimated that 80.3% of the population was affected by the issue. During the 6 years we observed a progressive increase of Municipalities involved beginning with 25 and reaching up 110 in 2014. The initial 29 warnings rose to 256 in 2014 along with an increased number of abnormal values, parameters and standards of the drinking water. Regarding the ordinances issued by the 191 Mayors we noticed that the legal limits were exceeded in 23 cases. Among those, we underline the abnormal levels of chlorites and trihalomethanes (22% of cases), the turbidity, the abnormal concentration of total chemical substances and the abnormal level of coliforms, Escherichia coli, manganese, aluminum, nitrites and iron. According to our observations, the Sardinian drinking water supply system is affected by a major inconvenience and the data suggest that qualitative abnormalities are mainly due to water purification treatments used in addition to the poor water supply network in existence. Considering these results, a cooperation between all Authorities involved would be desirable in order to analyze official data and provide a careful evaluation of population exposure and real risks related to the level of every parameter considered.

Promoting Peace Education for Behaviourial Changes in Public Secondary Schools in Calabar Municipality Council Area, Cross River State, Nigeria

ERIC Educational Resources Information Center

Uko, E. S.; Igbineweka, P. O.; Odigwe, F. N.

2015-01-01

This study aimed at investigating the promotion of peace education for behavioural changes in public secondary schools in Calabar Municipal Council Area of Cross River State. A descriptive survey design was adopted for the study. A set of questionnaire items were validated and used for the collection of data involving 310 respondents, selected…

[Municipal public health spending in the state of Pernambuco, Brazil, from 2000 to 2007].

PubMed

Espírito Santo, Antônio Carlos Gomes do; Fernando, Virgínia Conceição Nascimento; Bezerra, Adriana Falangola Benjamin

2012-04-01

In order to assess the impact of macro-political measures implemented in the latter half of the 1990s on the increase in public spending on health and the possible reduction in allocation inequity, a descriptive, quantitative, cross-sectional study was carried out involving 184 municipalities in the state of Pernambuco, Brazil. Data from the Public Health Budget Information System was used, with the selected indicator being spending on health per inhabitant under the responsibility of the municipality. The correlations of this variable with the municipal Human Development Index, population size and value of the municipal budget per capita were analyzed. It was seen that, although the mean increase in municipal spending on health is 190.76%, the value per capita has remained relatively low - at around R$183.79 - which is below the national and macro-regional averages. Both spending on health per capita and growth percentages are distributed irregularly among health regions as well as among municipalities within a single region. In conclusion, there is marked allocation inequity among municipalities with regard to the distribution of public resources for health, despite the macro-political measures adopted to reduce this inequity.

Designing Adult Education Activities: A Case of Civic Education Programmes by National Commission for Civic Education in the Ashaiman Municipality in Ghana

ERIC Educational Resources Information Center

Afriyie, Sally Adwoa

2015-01-01

This article discusses the efficiency of the design of educational activities of the National Commission for Civic Education (NCCE) in Ashaiman municipality in Ghana. Using a descriptive case study design, data was collected from seven (7) Community Based Groups in Ashaiman. The results of the study indicated that to a large extent, there was…

[Work-related stress in nursery school educators in the Venice and Marghera districts].

PubMed

Camerino, Donatella; Fichera, G P; Punzi, Silvia; Campanini, P; Conway, P M; Prevedello, Laura; Costa, G

2011-01-01

Based on an investigation on organizational well-being in the Municipality of Venice (2009), we examined 110 public nursery school and preschool teachers working in the Venice and Marghera districts. The aim of this study was to develop and implement a procedure for work-related stress assessment and management in Municipality of Venice, in the light of Law 81/2008. Occupational stress and its impact on teachers' well-being and health were assessed by means of self-administered questionnaires and semi-structured interviews. Descriptive analyses were conducted to compare teachers' data with those concerning employees operating in other services in the Venice and Marghera districts. According to the results, while nursery school and preschool teachers work with considerable commitment, vigor, dedication and involvement, problems were observed related to: assignment of administrative tasks without appropriate support from the district offices; difficult access to support services; shortage of temporary teachers and auxiliary personnel and, limited to some facilities, lack of adequate physical space devoted to teaching activities. Such adverse conditions result in an increase in vigilance levels required to ensure children's safety. Personnel also suffer from a lack of career prospects, with scarce opportunities for contact with other facilities in the area and inadequate involvement in the decisional processes at Municipality level. Improving such adverse conditions could solve the current marginalization of public nursery school and preschool teachers and encourage mutual exchange of information, which would in turn favour more appropriate methods of managing each single facility.

Enhancing the Standard of Teaching and Learning in the 21st Century via Qualitative School-Based Supervision in Secondary Schools in Abuja Municipal Area Council (AMAC)

ERIC Educational Resources Information Center

Ebele, Uju F.; Olofu, Paul A.

2017-01-01

The study focused on enhancing the standard of teaching and learning in the 21st century via qualitative school-based supervision in secondary schools in Abuja municipal area council. To guide the study, two null hypotheses were formulated. A descriptive survey research design was adopted. The sample of the study constituted of 270 secondary…

[Relevance and validity of a new French composite index to measure poverty on a geographical level].

PubMed

Challier, B; Viel, J F

2001-02-01

A number of disease conditions are influenced by deprivation. Geographical measurement of deprivation can provide an independent contribution to individual measures by accounting for the social context. Such a geographical approach, based on deprivation indices, is classical in Great Britain but scarcely used in France. The objective of this work was to build and validate an index readily usable in French municipalities and cantons. Socioeconomic data (unemployment, occupations, housing specifications, income, etc.) were derived from the 1990 census of municipalities and cantons in the Doubs departement. A new index was built by principal components analysis on the municipality data. The validity of the new index was checked and tested for correlations with British deprivation indices. Principal components analysis on municipality data identified four components (explaining 76% of the variance). Only the first component (CP1 explaining 42% of the variance) was retained. Content validity (wide choice of potential deprivation items, correlation between items and CP1: 0.52 to 0.96) and construct validity (CP1 socially relevant; Cronbach's alpha=0.91; correlation between CP1 and three out of four British indices ranging from 0.73 to 0.88) were sufficient. Analysis on canton data supported that on municipality data. The validation of the new index being satisfactory, the user will have to make a choice. The new index, CP1, is closer to the local background and was derived from data from a French departement. It is therefore better adapted to more descriptive approaches such as health care planning. To examine the relationship between deprivation and health with a more etiological approach, the British indices (anteriority, international comparisons) would be more appropriate, but CP1, once validated in various health problem situations, should be most useful for French studies.

Public health agendas addressing violence against rural women - an analysis of local level health services in the State of Rio Grande do Sul, Brazil.

PubMed

da Costa, Marta Cocco; Lopes, Marta Julia Marques; Soares, Joannie dos Santos Fachinelli

2015-05-01

This study analyses health managers' perceptions of local public health agendas addressing violence against rural women in municipalities in the southern part of the State Rio Grande do Sul in Brazil. It consists of an exploratory descriptive study utilizing a qualitative approach. Municipal health managers responsible for planning actions directed at women's health and primary health care were interviewed. The analysis sought to explore elements of programmatic vulnerability related to violence in the interviewees' narratives based on the following dimensions of programmatic vulnerability: expression of commitment, transformation of commitment into action, and planning and coordination. It was found that local health agendas directed at violence against rural women do not exist. Health managers are therefore faced with the challenge of defining lines of action in accordance with the guidelines and principles of the SUS. The repercussions of this situation are expressed in fragile comprehensive services for these women and programmatic vulnerability.

[Clinical and socio-medical factors related to anemia in pregnant women: prevalence study in Mara Township, Venezuela, 2013].

PubMed

Avila, Ayari Guadalupe; García, Lenis; Gómez, María; Villanueva, Nixon; Benítez, Betty; Fuentes, Belkis

2014-07-11

Anemia during pregnancy is a frequent finding and can increase morbidity and mortality in both mother and child. This paper aims to identify clinical, social and healthcare-related factors that affect the incidence of anemia in pregnant patients in a primary care prenatal clinic in Mara municipality. This is a descriptive field study that took place between November and December, 2013. Sixty-two patients were selected through non-probability sampling among four primary care clinics in the municipality of Mara. A high prevalence of anemia (76%) was found, with normal MCV (mean corpuscular volume), normal MCH (mean corpuscular hemoglobin), and normal MCHC (mean corpuscular hemoglobin concentration). In only 36% of cases serum iron levels fell below 50 ug/dl. Some clinical factors found to be related to anemia in pregnancy are multiparity (69.9%), infections before or during pregnancy (77.5%), low protein intake (91.8%), less than a year birth interval (63.3%), and gestational age (89.8%). The main socioeconomic factor related to anemia is poverty (89.8%). Prenatal checkup schedule needs to be adjusted in primary care clinics in the municipality of Mara taking into consideration clinical and socioeconomic factors in order to lower the prevalence of anemia during pregnancy in this population.

Geographic information systems for mapping the National Exam Result of Junior High School in 2014 at West Java Province

NASA Astrophysics Data System (ADS)

Setiawan Abdullah, Atje; Nurani Ruchjana, Budi; Rejito, Juli; Rosadi, Rudi; Candra Permana, Fahmi

2017-10-01

National Exam level of schooling is implemented by the Ministry of Education and Culture for the development of education in Indonesia. The national examinations are centrally evaluated by the National Education Standards Agency, and the expected implementation of the national exams can describe the successful implementation of education at the district, municipal, provincial, or national level. In this study, we evaluate, analyze, and explore the implementation of the national exam database of the results of the Junior High School in 2014, with the Junior High School (SMP/MTs) as the smallest unit of analysis at the district level. The method used in this study is a data mining approach using the methodology of Knowledge Discovery in Databases (KDD) using descriptive analysis and spatial mapping of national examinations. The results of the classification of the data mining process to national exams of Junior High School in 2014 using data 6,878 SMP/MTs in West Java showed that 81.01 % were at moderate levels. While the results of the spatial mapping for SMP/MTs in West Java can be explained 36,99 % at the unfavorable level. The evaluation results visualization in graphic is done using ArcGIS to provide position information quality of education in municipal, provincial or national level. The results of this study can be used by management to make decision to improve educational services based on the national exam database in West Java. Keywords: KDD, spatial mapping, national exam.

The impact of outmigration of men on fertility and marriage in the migrant-sending states of Mexico, 1995–2000

PubMed Central

White, Kari; Potter, Joseph E.

2015-01-01

Using the 2000 Mexican Census, we examined whether the level of migration was associated with total fertility and the proportion of women married in 314 municipalities from seven traditional sending states. Across these municipalities, we observe lower fertility in higher-migration areas. Municipalities in the quartile with the highest levels of migration have total fertility more than half a child lower than municipalities in the lowest migration quartile. However, there are no differences in marital fertility by level of migration, indicating that lower proportions of women married account for lower total fertility in high-migration municipalities. In municipal-level regression models, lower sex ratios are associated with a lower proportion of women married, while there is an inverse association between education and marriage. The level of migration also has an independent association with marriage, suggesting that there may be changing ideas surrounding family formation in high-migration areas. PMID:23009347

Municipalities' Preparedness for Weather Hazards and Response to Weather Warnings.

PubMed

Mehiriz, Kaddour; Gosselin, Pierre

2016-01-01

The study of the management of weather-related disaster risks by municipalities has attracted little attention even though these organizations play a key role in protecting the population from extreme meteorological conditions. This article contributes to filling this gap with new evidence on the level and determinants of Quebec municipalities' preparedness for weather hazards and response to related weather warnings. Using survey data from municipal emergency management coordinators and secondary data on the financial and demographic characteristics of municipalities, the study shows that most Quebec municipalities are sufficiently prepared for weather hazards and undertake measures to protect the population when informed of imminent extreme weather events. Significant differences between municipalities were noted though. Specifically, the level of preparedness was positively correlated with the municipalities' capacity and population support for weather-related disaster management policies. In addition, the risk of weather-related disasters increases the preparedness level through its effect on population support. We also found that the response to weather warnings depended on the risk of weather-related disasters, the preparedness level and the quality of weather warnings. These results highlight areas for improvement in the context of increasing frequency and/or severity of such events with current climate change.

Municipal water consumption forecast accuracy

NASA Astrophysics Data System (ADS)

Fullerton, Thomas M.; Molina, Angel L.

2010-06-01

Municipal water consumption planning is an active area of research because of infrastructure construction and maintenance costs, supply constraints, and water quality assurance. In spite of that, relatively few water forecast accuracy assessments have been completed to date, although some internal documentation may exist as part of the proprietary "grey literature." This study utilizes a data set of previously published municipal consumption forecasts to partially fill that gap in the empirical water economics literature. Previously published municipal water econometric forecasts for three public utilities are examined for predictive accuracy against two random walk benchmarks commonly used in regional analyses. Descriptive metrics used to quantify forecast accuracy include root-mean-square error and Theil inequality statistics. Formal statistical assessments are completed using four-pronged error differential regression F tests. Similar to studies for other metropolitan econometric forecasts in areas with similar demographic and labor market characteristics, model predictive performances for the municipal water aggregates in this effort are mixed for each of the municipalities included in the sample. Given the competitiveness of the benchmarks, analysts should employ care when utilizing econometric forecasts of municipal water consumption for planning purposes, comparing them to recent historical observations and trends to insure reliability. Comparative results using data from other markets, including regions facing differing labor and demographic conditions, would also be helpful.

Local government units initiatives on coastal resource management in adjacent municipalities in Camarines Sur, Philippines

NASA Astrophysics Data System (ADS)

Faustino, A. Z.; Madela, H. L.

2018-03-01

This research was conducted to determine the local government units (LGUs) initiatives on coastal resource management (CRM) in adjacent municipalities in Camarines Sur, Philippines. The respondents of this study are 100 fisherfolk leaders in the municipalities of Calabanga, Tinambac and Siruma. Descriptive, comparative and evaluative methods of research were employed and a survey questionnaire was used as the primary tool in data gathering. On the test of difference, the computed F-value of 12.038 and p-value of .001 revealed a very high difference in the implementation of CRM initiatives in the adjacent municipalities. The respondents in this study live below the poverty threshold. The intrusion of commercial fishers and the use of active fishing gears inside the 15-km municipal waters significantly affect the marine habitat while fishpond conversion kills the natural cycle in the mangrove forests. However, the FOs membership in the Municipal Fisheries and Aquatic Resources Management Council empower them to engage in governance which can be a venue for them to recommend policies related to CRM. As a result of this study, a CRM monitoring and evaluation model was crafted to guide the LGUs in the review, revision and crafting of CRM programs.

Impact of the social agendas--Agenda 21 and Healthy Cities--upon Social Determinants of Health in Brazilian municipalities: measuring the effects of diffuse social policies through the dimensions of the Millennium Development Goals.

PubMed

do Nascimento, Paulo Roberto; Westphal, Marcia Faria; Moreira, Rafael da Silveira; Baltar, Valéria Troncoso; Moysés, Simone Tetu; Zioni, Fabiola; Minowa, Evelin

2014-01-01

In order to improve the quality of life and health of the population in recent years there have been several local social agendas, like Agenda 21 and Healthy Cities. To identify how social agendas are impacting on the living conditions and health in municipalities of the five regions of Brazil. Through an ecological longitudinal study, the social agendas' effects on the Social Determinants of Health were measured in 105 municipalities, using indicators related to the eight dimensions of the Millennium Development Goals (MDGs). Indicators were also calculated for other 175 non-exposed municipalities. Descriptive statistics were calculated for each group of municipalities at three different moments: in the year of the agenda implementation, then 3 and 6 years later. The models were adjusted by the method of GEE to assess the effects of the agendas, time and their interaction. Nonparametric analysis of variance was used for the ordinal data with repeated measures. Impacts of the agendas were detected for reduction of hunger and increase of universal access to education: 'percentage of children under one year with protein/caloric undernourishment' (interaction effect: p = 0.02) and 'Age-grade distortion in the 8th grade of fundamental education' (interaction effect: p < 0.001). The comparative discussion between model results and descriptive statistics recommends, at further research, extending the period of investigation, using compound indexes, improving the methodology for the apprehension of the impacts of the diffuse social policies for development, as well as using 'mixed methodologies', integrating quantitative and qualitative tools.

Improvement of economic security management system of municipalities with account of transportation system development: methods of assessment

NASA Astrophysics Data System (ADS)

Khe Sun, Pak; Vorona-Slivinskaya, Lubov; Voskresenskay, Elena

2017-10-01

The article highlights the necessity of a complex approach to assess economic security of municipalities, which would consider municipal management specifics. The approach allows comparing the economic security level of municipalities, but it does not describe parameter differences between compared municipalities. Therefore, there is a second method suggested: parameter rank order method. Applying these methods allowed to figure out the leaders and outsiders of the economic security among municipalities and rank all economic security parameters according to the significance level. Complex assessment of the economic security of municipalities, based on the combination of the two approaches, allowed to assess the security level more accurate. In order to assure economic security and equalize its threshold values, one should pay special attention to transportation system development in municipalities. Strategic aims of projects in the area of transportation infrastructure development in municipalities include the following issues: contribution into creating and elaborating transportation logistics and manufacture transport complexes, development of transportation infrastructure with account of internal and external functions of the region, public transport development, improvement of transport security and reducing its negative influence on the environment.

Work situation of registered nurses in municipal elderly care in Sweden: a questionnaire survey.

PubMed

Josefsson, Karin; Sonde, Lars; Winblad, Bengt; Robins Wahlin, Tarja-Brita

2007-01-01

Organizational changes have occurred in municipal elderly care in Sweden during the past decades. The 'Adel' reform transferred responsibility for the care of older persons from the county councils to the municipalities. Furthermore, the specialisation in dementia care divided elderly care into two groups: dementia and general care. This change has had a significant impact on the work situation of registered nurses (RNs). The main focus was to describe RNs' work situation and their characteristics in municipal elderly care. Another aim was to compare RNs working solely in dementia care with those working in general care of older persons with diverse diagnoses. A non-experimental, descriptive design with a survey research approach was used. Sixty special housing units with underlying units including those offering daytime activities in a large city in the middle of Sweden. The number of participating RNs was a total of 213, with a response rate of 62.3%. Of the 213 RNs, 95 (44.6%) worked in dementia care, and 118 (55.4%) in general care. A questionnaire survey. The results indicated high levels of time pressure in both groups. Greater knowledge and greater emotional and conflicting demands were found in dementia care. The majority perceived a greater opportunity to plan and perform daily work tasks than to influence the work situation in a wider context. Support at work was perceived as generally high from management and fellow workers and higher in dementia care. It is important to decrease RNs' time pressure and increase their influence on decisions made at work.

Anaerobic Treatment of Municipal Solid Waste and Sludge for Energy Production and Recycling of Nutrients

NASA Astrophysics Data System (ADS)

Leinonen, S.

This volume contains 18 papers presented at a Nordic workshop dealing with application of anaerobic decomposition processes on various types of organic wastes, held at the Siikasalmi Research and Experimental Station of the University of Joensuu on 1-2 Oct. 1992. Subject coverage of the presentations extends from the biochemical and microbiological principles of organic waste processing to descriptions and practical experiences of various types of treatment plants. The theoretical and experimental papers include studies on anaerobic and thermophilic degradation processes, methanogenesis, effects of hydrogen, treatment of chlorinated and phenolic compounds, and process modeling, while the practical examples range from treatment of various types of municipal, industrial, and mining wastes to agricultural and fish farm effluents. The papers provide technical descriptions of several biogas plants in operation. Geographically, the presentations span the Nordic and Baltic countries.

Investigating social inequalities in exposure to drinking water contaminants in rural areas.

PubMed

Delpla, Ianis; Benmarhnia, Tarik; Lebel, Alexandre; Levallois, Patrick; Rodriguez, Manuel J

2015-12-01

Few studies have assessed social inequalities in exposure to drinking water contaminants. This study explores this issue in 593 rural municipalities of Québec, Canada. Quartiles of an ecological composite deprivation index were used as a proxy of socioeconomic status. Total trihalomethanes (TTHMs) and lead were chosen as proxies of chemical drinking water quality. The results show that the majority of deprived rural municipalities apply no treatment to their water (26%) or use a basic treatment (51%), whereas a relative majority of the wealthiest municipalities (40%) use advanced treatment. The proportion of municipalities having important lead (>5 μg/L) levels is highest in most deprived municipalities. Moreover, most deprived municipalities have a higher risk of high tap lead levels (RR = 1.33; 95%CI: 1.30, 1.36). Conversely, most deprived municipalities have a lower risk of high TTHMs levels (RR = 0.78; 95%CI: 0.69, 0.86). These findings suggest an environmental inequality in drinking water contaminants distribution in rural municipalities. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Trend in inequalities in mortality due to external causes among the municipalities of Antioquia (Colombia)].

PubMed

Caicedo-Velásquez, Beatriz; Álvarez-Castaño, Luz Stella; Marí-Dell'Olmo, Marc; Borrell, Carme

2016-01-01

To analyse the trend in inequalities in mortality due to external causes among municipalities in Antioquia, department of Colombia, from 2000 to 2010, and its association with socioeconomic conditions. External causes included violent deaths, such as homicides, suicides and traffic accidents, among others. Ecological design of mortality trends, with the 125 municipalities of Antioquia as the unit of analysis. The age-adjusted smoothed standardized mortality ratio (SMR) was estimated for each of the municipalities by using an empirical Bayesian model. Differences in the SMR between the poorest and least poor municipalities were estimated by using a two-level hierarchical model (level-1: year, level-2: municipality). Mortality due to external causes showed a downward trend in the department in the period under review, although the situation was not similar in all municipalities. The findings showed that the risk of death from external causes significantly increased in poor and underdeveloped municipalities. Intervention is required through policies that take into account local differences in mortality due to external causes. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

People Participation Towards Opisthorchis viverrini Prevention and Control in Chaiyaphum Province, Northeastern Thailand.

PubMed

Phongsiripapat, Rutjirapat; Chimplee, Kanokporn; Rujirakul, Ratana; Kaewpitoon, Soraya; Keawpitoon, Natthawut

2016-01-01

This cross-sectional descriptive and qualitative study was aimed to study the people participation and their approaches toward the human carcinogenic liver fluke, Opisthorchis viverrini, prevention and control in Ban Chaun sub-district administrative organization (BCSAO) and Bamnet Narong sub-district municipality (BNSM), Bamnet Narong district, Chaiyaphum Province, Thailand between June 2013 and February 2014. Participants were purposive selected, included chiefs of sub-district administrative organizations, sub-district municipalities, sub-district health promotion hospitals (SHPHs), heads of village, and a further sample was selected with a multi- stage random sampling for public health volunteers, and villagers. The pre-designed questionnaire contained items for individualized status and the participatory steps of sharing ideas, decision-making, and planning, procession, evaluation, and mutual benefit, for the project O. viverrini prevention and control (POPC). In-depth interviews were used for collection of need approaches to POPC. With 375 participants who completed the questionnaire, it was found that people had a high level regarding to participate in the POPC, particularly in the process stage (X_ =3.78, S.D. = 0.56), but the lowest level was found in sharing ideas, decision making, and planning step (X_ =3.65, S.D. = 0.63). By comparison, participant status and organization did not significantly differ with people participation. In each step, Ban Chaun sub-district had a high level of participation in the step of sharing ideas, decision making, and planning toward POPC, more than Bamnet Narong sub-district municipality (t=2.20, p=0.028). Approaches for POPC in Ban Chaun sub-district and Bamnet Narong sub-district municipality included requirements for budget support, annual campaigns for liver fluke prevention and control, campaign promotion, risk group observation, home visiting, community rules regarding reducing raw fish consumption in their communities, and a professional public health officer for working in their communities, BCSAO, BNSM, and SHPH, for O. viverrini prevention and control. This study indicates that people realize that eradication of the liver fluke needs a continuous people participation for O. viverrini prevention and control in their communities.

Energy utilization: municipal waste incineration. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

LaBeck, M.F.

An assessment is made of the technical and economical feasibility of converting municipal waste into useful and useable energy. The concept presented involves retrofitting an existing municipal incinerator with the systems and equipment necessary to produce process steam and electric power. The concept is economically attractive since the cost of necessary waste heat recovery equipment is usually a comparatively small percentage of the cost of the original incinerator installation. Technical data obtained from presently operating incinerators designed specifically for generating energy, documents the technical feasibility and stipulates certain design constraints. The investigation includes a cost summary; description of process andmore » facilities; conceptual design; economic analysis; derivation of costs; itemized estimated costs; design and construction schedule; and some drawings.« less

Job involvement of primary healthcare employees: does a service provision model play a role?

PubMed

Koponen, Anne M; Laamanen, Ritva; Simonsen-Rehn, Nina; Sundell, Jari; Brommels, Mats; Suominen, Sakari

2010-05-01

To investigate whether the development of job involvement of primary healthcare (PHC) employees in Southern Municipality (SM), where PHC services were outsourced to an independent non-profit organisation, differed from that in the three comparison municipalities (M1, M2, M3) with municipal service providers. Also, the associations of job involvement with factors describing the psychosocial work environment were investigated. A panel mail survey 2000-02 in Finland (n=369, response rates 73% and 60%). The data were analysed by descriptive statistics and multivariate linear regression analysis. Despite the favourable development in the psychosocial work environment, job involvement decreased most in SM, which faced the biggest organisational changes. Job involvement decreased also in M3, where the psychosocial work environment deteriorated most. Job involvement in 2002 was best predicted by high baseline level of interactional justice and work control, positive change in interactional justice, and higher age. Also other factors, such as organisational stability, seemed to play a role; after controlling for the effect of the psychosocial work characteristics, job involvement was higher in M3 than in SM. Outsourcing of PHC services may decrease job involvement at least during the first years. A particular service provision model is better than the others only if it is superior in providing a favourable and stable psychosocial work environment.

Association between the level of education and knowledge, attitudes and practices regarding dengue in the Caribbean region of Colombia.

PubMed

Diaz-Quijano, Fredi Alexander; Martínez-Vega, Ruth Aralí; Rodriguez-Morales, Alfonso J; Rojas-Calero, Ronald Alexander; Luna-González, María Lucrecia; Díaz-Quijano, Ronald Giovanny

2018-01-16

Community integration in dengue control requires assessments of knowledge, attitudes and practices (KAPs), which can vary widely according to demographic and educational factors. We aimed to describe and compare the KAPs according to level of education in municipalities in the Caribbean region of Colombia. A survey was administered from October to December 2015, including families selected through probabilistic sampling in eleven municipalities. The analysis focused on the comparative description of the responses according to level of education. The KAP prevalence ratios (PR) according to education were estimated using Poisson regression (robust), including age and sex as adjustment variables. Out of 1057 participants, 1054 (99.7%) surveys were available for analysis, including 614 (58.3%) who had a high school level of education or higher and 440 (41.7%) who had a lower level of education (not high school graduates). The high school graduates showed a higher frequency of correct answers in relation to knowledge about dengue symptoms and transmission. On the other hand, graduates showed a higher probability of practices and attitudes that favor dengue control, including not storing water in containers (PR: 2.2; 95% Confidence Interval [CI]: 1.42-3.43), attend community meetings (PR: 1.33; 95% CI: 1.07-1.65), educate family members and neighbors in prevention measures (PR: 1.35; 95% CI: 1.15-1.59). Level of education could be a key determinant of knowledge of the disease and its transmission, as well as attitudes and practices, especially those that involve the integration of community efforts for dengue control.

40 CFR 60.56a - Standards for municipal waste combustor operating practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... large MWC plant shall develop and update on a yearly basis a sitespecific operating manual that shall... standards under this subpart; (2) Description of basic combustion theory applicable to an MWC unit; (3...

Testicular membrane lipid damage by complex mixture of leachate from municipal battery recycling site as indication of idiopathic male infertility in rat

PubMed Central

Oboh, Ganiyu; Akindahunsi, Akintunde A.

2013-01-01

Leachate from a municipal battery recycling site is a potent source of mixed-metal released into the environment. The present study investigated the degree at which mixed-metal exposure to the municipal auto-battery leachate (MABL) and to the Elewi Odo municipal auto-battery recycling site leachate (EOMABRL) affected the lipid membrane of the testes in in vitro experiment. The results showed elevated level of mixed-metals over the permissible levels in drinking water, as recommended by regulatory authorities. In the leachate samples, the levels of malondialdehyde (MDA), a biomarker of lipid damage, was significantly (p<0.05) increased in rat testes in a dose-dependent manner. MDA induced by the municipal auto-battery leachate (MABL) was significantly (p<0.05) higher than the leachate from Elewi Odo municipal auto-battery recycling site (EOMABRL). The testicular lipid membrane capacity was compromised following treatment with leachate from the municipal battery recycling site, implicating mixed-metal exposure as the causative agent of testicular damage and male infertility. PMID:24678257

Testicular membrane lipid damage by complex mixture of leachate from municipal battery recycling site as indication of idiopathic male infertility in rat.

PubMed

Akintunde, Jacob K; Oboh, Ganiyu; Akindahunsi, Akintunde A

2013-12-01

Leachate from a municipal battery recycling site is a potent source of mixed-metal released into the environment. The present study investigated the degree at which mixed-metal exposure to the municipal auto-battery leachate (MABL) and to the Elewi Odo municipal auto-battery recycling site leachate (EOMABRL) affected the lipid membrane of the testes in in vitro experiment. The results showed elevated level of mixed-metals over the permissible levels in drinking water, as recommended by regulatory authorities. In the leachate samples, the levels of malondialdehyde (MDA), a biomarker of lipid damage, was significantly (p<0.05) increased in rat testes in a dose-dependent manner. MDA induced by the municipal auto-battery leachate (MABL) was significantly (p<0.05) higher than the leachate from Elewi Odo municipal auto-battery recycling site (EOMABRL). The testicular lipid membrane capacity was compromised following treatment with leachate from the municipal battery recycling site, implicating mixed-metal exposure as the causative agent of testicular damage and male infertility.

The National Health Insurance Scheme (NHIS) in the Dormaa Municipality, Ghana: Why Some Residents Remain Uninsured?

PubMed Central

Amo, Thompson

2014-01-01

The paper presents a quantitative investigation on the National Health Insurance Scheme (NHIS) in the Dormaa Municipality, Ghana: Why some residents remain uninsured? Since its implementation a little over a decade now. The aim is to identify the obstacles of enrolment by the public, which would enable policy direction, to ensure that all residents are registered with the scheme. A descriptive and cross-sectional study was conducted between May and July, 2013. Both purposive and simple random sampling techniques were used to select 210 respondents and data obtained through self-administered, and face-to-face interviews guided by structured questionnaire. Chi square (χ2) test of independence was adopted to show the association between socioeconomic and demographic features as well as membership. Findings from the research suggest that residents’ decision to enrol is significantly associated with gender, education, number of children, place of residence, employment and income. It was also observed that membership is highly affected by premium level. The discussion of the findings and recommendations offered, if incorporated into the policy guideline of NHIS, could maintain, and at the same time increase enrolment level. This would guarantee quality and affordable basic health care protection for the good people of Ghana. PMID:24762349

The National Health Insurance Scheme (NHIS) in the Dormaa Municipality, Ghana: why some residents remain uninsured?

PubMed

Amo, Thompson

2014-02-21

The paper presents a quantitative investigation on the national health insurance scheme (nhis) in dormaa municipality, Ghana: why some residents remain uninsured? Since its implementation has been a little over a decade now. The aim is to identify the obstacles to enrollment by the public which would enable policy direction to ensure that all residents are registered with the scheme. A descriptive and cross-sectional study was conducted between May and July, 2013. Both purposive and simple random sampling technique were used to select 210 respondents and data obtained through self-administered and face-to-face interviews guided by structured questionnaire. chi square (X2) test of independence was adopted to show the association between socioeconomic and demographic features and membership. Findings from the research suggest that residents' decision to enrol have significant associated with gender, education, number of children, place of residence, employment and income. It was also observed that membership is highly affected by premium level. The discussion of the findings and recommendations offered, if incorporated into the policy guideline of NHIS could maintain and at the same time increase enrollment level which would guarantee quality, accessible and affordable basic health care protection for the good people of Ghana.

Pioneers and laggards - is the effect of gender equality on health dependent on context?

PubMed

Backhans, Mona Christina; Burström, Bo; Lindholm, Lars; Månsdotter, Anna

2009-04-01

This study combines data at individual and area level to examine interactions between equality within couples and gender equality in the municipality in which individuals live. The research question is whether the context impacts on the association between gender equality and health. The material consists of data on 37,423 men and 37,616 women in 279 Swedish municipalities, who had their first child in 1978. The couples were classified according to indicators of their level of gender equality in 1980 in the public sphere (occupation and income) and private sphere (child care leave and parental leave) compared to that of their municipality. The health outcome is compensated days from sickness insurance during 1986-1999 with a cut-off at the 85% percentile. Data were analysed using logistic regression with the overall odds as reference. The results concerning gender equality in the private sphere show that among fathers, those who are equal in an equal municipality have lower levels of sick leave than the average while laggards (less equal than their municipality) and modest laggards have higher levels. In the public sphere, pioneers (more equal t han their municipality) fare better than the average while laggards fare worse. For mothers, those who are traditional in their roles in the public sphere are protected from high levels of sick leave, while the reverse is true for those who are equal. Traditional mothers in a traditional municipality have the lowest level of sick leave and pioneers the highest. These results show that there are distinct benefits as well as disadvantages to being a gender pioneer and/or a laggard in comparison to your municipality. The associations are markedly different for men and women.

Prevalence of antibiotic prescription in southern Italian outpatients: real-world data analysis of socioeconomic and sociodemographic variables at a municipality level.

PubMed

Russo, Veronica; Monetti, Valeria Marina; Guerriero, Francesca; Trama, Ugo; Guida, Antonella; Menditto, Enrica; Orlando, Valentina

2018-01-01

The aim of this study was to analyze the geographic variation in systemic antibiotic prescription at a regional level and to explore the influence of socioeconomic and sociodemographic variables. This study was a retrospective analysis of reimbursement pharmacy records in the outpatient settings of Italy's Campania Region in 2016. Standardized antibiotic prescription rates were calculated at municipality and Local Health Unit (LHU) level. Antibiotic consumption was analyzed as defined daily doses (DDD)/1000 inhabitants per day (DID). Logistic regression was performed to evaluate the association between antibiotic prescription and sociodemographic and socioeconomic determinants at a municipality level. The average antibiotic prevalence rate was 46.8%. At LHU level, the age-adjusted prevalence rates ranged from 41.1% in Benevento to 51.0% in Naples2. Significant differences were found among municipalities, from 15.2% in Omignano (Salerno LHU [Sa-LHU]) to 61.9% in Moschiano (Avellino [Av-LHU]). The geographic distribution also showed significant differences in terms of antibiotic consumption, from 6.7 DID in Omignano to 41.6 in San Marcelino (Caserta [Ce-LHU]). Logistic regression showed that both municipality type and average annual income level were the main determinants of antibiotic prescription. Urban municipalities were more than eight times as likely to have antibiotic high prevalence rates compared to rural municipalities (adjusted odds ratio [OR]: 8.62; 95% confidence interval [CI]: 4.06-18.30, P <0.001). Low average annual income level municipalities were more than eight times as likely to have antibiotic high prevalence rates compared to high average annual income level municipalities (adjusted OR: 8.48; 95% CI: 3.45-20.81, P <0.001). We provide a snapshot of Campania's antibiotic consumption, evidencing the impact of both socioeconomic and sociodemographic factors on the prevalence of antibiotic prescription. The observed intraregional variability underlines the lack of shared therapeutic protocols and the need for careful monitoring. Our results can be useful for decision makers to plan educational interventions, thus optimizing health resources and improving rational drug use.

Influence of municipal- and individual-level socioeconomic conditions on mortality in Japan.

PubMed

Honjo, Kaori; Iso, Hiroyasu; Fukuda, Yoshiharu; Nishi, Nobuo; Nakaya, Tomoki; Fujino, Yoshihisa; Tanabe, Naohito; Suzuki, Sadao; Subramanian, S V; Tamakoshi, Akiko

2014-01-01

The health effect of area socioeconomic conditions has been evident especially in Western countries; however, limited research has focused on the effect of municipal-level socioeconomic conditions, especially in Asia. Multilevel research using data from the Japan Collaborative Cohort Study, a large cohort study followed from 1990 to 2006, was conducted to examine individual as well as municipal socioeconomic conditions on risk of death, adjusting for each other. We included 24,460 men and 32,649 women aged 40 to 65 years at baseline in 35 municipalities as our study population. Primary predictors were municipal socioeconomic conditions (proportion of college graduates, per capita income, unemployment rate, and proportion of households receiving public assistance) and individual socioeconomic conditions (education level and occupation). Among men, the multilevel logistic estimate (standard errors) of proportion of college graduates and unemployment rate for mortality from cardiovascular disease were -0.399 (0.094) and -0.343 (0.122), respectively. Among women, the multilevel logistic estimate (standard errors) of proportion of college graduates and per capita annual income for mortality from injuries were -0.386 (0.171) and -1.069 (0.407). Individual education level and occupation were associated with all-cause mortality, in particular, mortality from cardiovascular disease or injuries. Interactions between individual education level and indicators of municipal socioeconomic conditions were observed for mortality from cancer and cardiovascular disease among men and mortality from injuries among women. Municipal and individual socioeconomic conditions were independently and interactively associated with premature death; this suggests that reducing social inequalities in health demands a focus on municipal conditions in addition to those of individuals.

Possibilities of municipal solid waste incinerator fly ash utilisation.

PubMed

Hartmann, Silvie; Koval, Lukáš; Škrobánková, Hana; Matýsek, Dalibor; Winter, Franz; Purgar, Amon

2015-08-01

Properties of the waste treatment residual fly ash generated from municipal solid waste incinerator fly ash were investigated in this study. Six different mortar blends with the addition of the municipal solid waste incinerator fly ash were evaluated. The Portland cement replacement levels of the municipal solid waste incinerator fly ash used were 25%, 30% and 50%. Both, raw and washed municipal solid waste incinerator fly ash samples were examined. According to the mineralogical composition measurements, a 22.6% increase in the pozzolanic/hydraulic properties was observed for the washed municipal solid waste incinerator fly ash sample. The maximum replacement level of 25% for the washed municipal solid waste incinerator fly ash in mortar blends was established in order to preserve the compressive strength properties. Moreover, the leaching characteristics of the crushed mortar blend was analysed in order to examine the immobilisation of its hazardous contents. © The Author(s) 2015.

[The issues of legal support of municipal public health].

PubMed

2011-01-01

The issues of legal regulation of municipal health care system are discussed. It is demonstrated that the Federal legislation unjustifiably restricts the powers of municipal public health. This situation impacts the provision of accessible and qualified medical care to population and financing of municipal public health. The necessity of further development of legal regulation of health promotion on municipal level is postulated.

40 CFR 220.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... agents, radioactive materials, chemicals, biological and laboratory waste, wreck or discarded equipment, rock, sand, excavation debris, industrial, municipal, agricultural, and other waste, but such term does... matter of any kind or description, including, but not limited to, dredged material, solid waste...

Allocation of home care services by municipalities in Norway: a document analysis.

PubMed

Holm, Solrun G; Mathisen, Terje A; Sæterstrand, Torill M; Brinchmann, Berit S

2017-09-22

In Norway, elder care is primarily a municipal responsibility. Municipal health services strive to offer the 'lowest level of effective care,' and home healthcare services are defined as the lowest level of care in Norway. Municipalities determine the type(s) of service and the amount of care applicants require. The services granted are outlined in an individual decision letter, which serves as a contract between the municipality and the home healthcare recipient. The purpose of this study was to gain insight into the scope and duration of home healthcare services allocated by municipalities and to determine where home care recipients live in relation to home healthcare service offices. A document analysis was performed on data derived from 833 letters to individuals allocated home care services in two municipalities in Northern Norway (Municipality A = 500 recipients, Municipality B = 333 recipients). In Municipality A, 74% of service hours were allotted to home health nursing, 12% to practical assistance, and 14% to support contact; in Municipality B, the distribution was 73%, 19%, and 8%, respectively. Both municipalities allocated home health services with no service end date (41% and 85% of the total services, respectively). Among recipients of "expired" services, 25% in Municipality A and 7% in Municipality B continued to receive assistance. Our findings reveal that the municipalities adhered to the goal for home care recipients to remain at home as long as possible before moving into a nursing home. The findings also indicate that the system for allocating home healthcare services may not be fair, as the municipalities lacked procedures for revising individual decisions. Our findings indicate that local authorities should closely examine how they design individual decisions and increase their awareness of how long a service should be provided.

Knowledge and technology transfer to improve the municipal solid waste management system of Durango City, Mexico.

PubMed

Valencia-Vázquez, Roberto; Pérez-López, Maria E; Vicencio-de-la-Rosa, María G; Martínez-Prado, María A; Rubio-Hernández, Rubén

2014-09-01

As society evolves its welfare level increases, and as a consequence the amount of municipal solid waste increases, imposing great challenges to municipal authorities. In developed countries, municipalities have established integrated management schemes to handle, treat, and dispose of municipal solid waste in an economical and environmentally sound manner. Municipalities of developing and transition countries are not exempted from the challenges involving municipal solid waste handling, but their task is not easy to accomplish since they face budget deficits, lack of knowledge, and deficiencies in infrastructure and equipment. In the northern territory of Mexico, the municipality of Durango is facing the challenge of increased volumes of waste with a lack of adequate facilities and infrastructure. This article analyses the evolution of the municipal solid waste management of Durango city, which includes actions such as proper facilities construction, equipment acquisition, and the implementation of social programmes. The World Bank, offering courses to municipal managers on landfill operation and waste management, promoted the process of knowledge and technology transfer. Thereafter, municipal authorities attended regional and some international workshops on waste management. In addition they followed suggestions of international contractors and equipment dealers with the intention to improve the situation of the waste management of the city. After a 15-year period, transfer of knowledge and technology resulted in a modern municipal solid waste management system in Durango municipality. The actual system did not reach the standard levels of an integrated waste management system, nevertheless, a functional evaluation shows clear indications that municipality actions have put them on the right pathway. © The Author(s) 2014.

Municipalities' Preparedness for Weather Hazards and Response to Weather Warnings

PubMed Central

Mehiriz, Kaddour; Gosselin, Pierre

2016-01-01

The study of the management of weather-related disaster risks by municipalities has attracted little attention even though these organizations play a key role in protecting the population from extreme meteorological conditions. This article contributes to filling this gap with new evidence on the level and determinants of Quebec municipalities’ preparedness for weather hazards and response to related weather warnings. Using survey data from municipal emergency management coordinators and secondary data on the financial and demographic characteristics of municipalities, the study shows that most Quebec municipalities are sufficiently prepared for weather hazards and undertake measures to protect the population when informed of imminent extreme weather events. Significant differences between municipalities were noted though. Specifically, the level of preparedness was positively correlated with the municipalities’ capacity and population support for weather-related disaster management policies. In addition, the risk of weather-related disasters increases the preparedness level through its effect on population support. We also found that the response to weather warnings depended on the risk of weather-related disasters, the preparedness level and the quality of weather warnings. These results highlight areas for improvement in the context of increasing frequency and/or severity of such events with current climate change. PMID:27649547

Opening Public Administration: Exploring Open Innovation Archetypes and Business Model Impacts

NASA Astrophysics Data System (ADS)

Feller, Joseph; Finnegan, Patrick; Nilsson, Olof

This work-in-progress paper presents an exploration of a network of Swedish municipal authorities. Within this network, we have observed a move from isolated innovation to leveraging inflows and outflows of knowledge in a manner characteristic of the open innovation paradigm. This paper presents a characterization of these knowledge exchanges using an existing framework of open innovation archetypes, as well as an initial description of the business model impacts of this innovation approach on the participant municipalities, and the enabling role of information technology. The paper concludes by drawing preliminary conclusions and outlining ongoing research.

SANITARY SEWER OVERFLOW ANALYSIS AND PLANNING (SSOAP) TOOLBOX

EPA Science Inventory

Description: The Nation's sanitary-sewer infrastructure is aging, with some sewers dating back over 100 years. Nationwide, there are more than 19,500 municipal sanitary-sewer collection systems serving an estimated 150 million people and about 40,000 SSO events per year. Becau...

Educational status, social economic status and evaluation of some dimensions of octogenarians' quality of life.

PubMed

Inouye, Keika; Pedrazzani, Elisete Silva

2007-01-01

To describe the profile of a sample of octogenarians (n=80) attended at the municipal health network of a city in the interior of São Paulo, Brazil; evaluate their perception regarding quality of life dimensions (QoL); identify correlations between socio economic status, education level and QoL. It is an exploratory descriptive study with a quantitative analysis of data. The results revealed that this population is predominantly female, widowed, illiterate, sedentary and poor, who need health services and leisure opportunities, and whose main support is religion. The socio economic status did not interfere in the QoL perception, though, higher education and participation in physical activities result in higher satisfaction.

Determinants of health promotion action in primary health care: comparative study of health and home care personnel in four municipalities in Finland.

PubMed

Simonsen-Rehn, Nina; Laamanen, Ritva; Sundell, Jari; Brommels, Mats; Suominen, Sakari

2009-01-01

The purpose of this paper is to contribute to understanding which factors influence health promotion action in primary health care (PHC) on the municipal, i.e. local, level. A cross-sectional mail survey of all PHC personnel in four municipalities in Finland in 2002. The data were analysed by descriptive statistics, and univariate and multivariate logistic regression analyses. A total of 417 (response rate 57%) healthcare professionals participated in the study; 65% of the personnel working in ambulatory care, 52% working in home care and 44% working in inpatient care were engaged in health promotion action (=higher than median engagement). Factors independently associated with engagement in health promotion were organizational values, reflected in perceived skill discretion and social support from coworkers, and the personnel's competence, reflected in knowledge about the health and living conditions of the population served. Further, the opportunities, reflected in cooperation with partners outside the organization were strongly associated with engagement in health promotion action. The results suggest that working conditions such as possibilities for skill usage, reflection and development as well as collegial support enable higher engagement in health promotion action in PHC. However, access to data on the local population's health and living conditions, in addition to opportunities to cooperate with decision makers and partners in the community turned out to be as important. This should be taken into consideration when striving to reorient health services to health promotion.

Spatial patterns of leprosy in a hyperendemic state in Northern Brazil, 2001-2012

PubMed Central

Monteiro, Lorena Dias; Martins-Melo, Francisco Rogerlândio; Brito, Aline Lima; Alencar, Carlos Henrique; Heukelbach, Jorg

2015-01-01

ABSTRACT OBJECTIVE To describe the spatial patterns of leprosy in the Brazilian state of Tocantins. METHODS This study was based on morbidity data obtained from the Sistema de Informações de Agravos de Notificação (SINAN – Brazilian Notifiable Diseases Information System), of the Ministry of Health. All new leprosy cases in individuals residing in the state of Tocantins, between 2001 and 2012, were included. In addition to the description of general disease indicators, a descriptive spatial analysis, empirical Bayesian analysis and spatial dependence analysis were performed by means of global and local Moran’s indexes. RESULTS A total of 14,542 new cases were recorded during the period under study. Based on the annual case detection rate, 77.0% of the municipalities were classified as hyperendemic (> 40 cases/100,000 inhabitants). Regarding the annual case detection rate in < 15 years-olds, 65.4% of the municipalities were hyperendemic (10.0 to 19.9 cases/100,000 inhabitants); 26.6% had a detection rate of grade 2 disability cases between 5.0 and 9.9 cases/100,000 inhabitants. There was a geographical overlap of clusters of municipalities with high detection rates in hyperendemic areas. Clusters with high disease risk (global Moran’s index: 0.51; p < 0.001), ongoing transmission (0.47; p < 0.001) and late diagnosis (0.44; p < 0.001) were identified mainly in the central-north and southwestern regions of Tocantins. CONCLUSIONS We identified high-risk clusters for transmission and late diagnosis of leprosy in the Brazilian state of Tocantins. Surveillance and control measures should be prioritized in these high-risk municipalities. PMID:26603352

USEPA MUNICIPAL WASTEWATER TREATMENT BY CONSTRUCTED WETLANDS MANUAL

EPA Science Inventory

A description of the upcoming USEPA manual is presented along with discussion of salient points of the conceptual approach employed in its development. The manual is the first to recognize and identify the primary removal mechanisms in these systems when they are applied to preli...

Clinical-epidemiological description of live births with microcephaly in the state of Sergipe, Brazil, 2015.

PubMed

Cabral, Cibelle Mendes; Nóbrega, Martha Elizabeth Brasil da; Leite, Priscila Leal E; Souza, Mércia Simone Feitosa de; Teixeira, Daniela Cabral Pizzi; Cavalcante, Taíse Ferreira; Lima, Raulinna Gomes de Souza; Tavares, Lúcia Maria Sayde de Azevedo; Souza, Priscila Bochi de; Saad, Eduardo

2017-01-01

to describe the clinical and epidemiological characteristics of microcephaly cases in live births in Sergipe, Brazil, and to calculate the prevalence in its municipalities. this is a descriptive study on live births from September 1st to November 30th, 2015, with data from medical records and interviews with mothers. 83 cases of microcephaly were confirmed, with three deaths; prevalence in the 26 municipalities with confirmed cases ranged from 18 to 185/10,000 live births; the median of head circumference was 31 cm (range: 22.5-33.0); agenesis of corpus callosum (26/43), lissencephaly (12/43), absence of midline (10/43) and ventriculomegaly (8/43) were observed in the transfontanellar ultrasound; 40 mothers reported rash in pregnancy, 23 in the first trimester, with pruritus, arthralgia and headache; seven were positive for infections potentially causing malformations. there was a high occurrence of cases of microcephaly, and reports of signs and symptoms compatible with Zika virus infection during pregnancy.

Orientation to Municipal Wastewater Treatment. Training Manual.

ERIC Educational Resources Information Center

Office of Water Program Operations (EPA), Cincinnati, OH. National Training and Operational Technology Center.

Introductory-level material on municipal wastewater treatment facilities and processes is presented. Course topics include sources and characteristics of municipal wastewaters; objectives of wastewater treatment; design, operation, and maintenance factors; performance testing; plant staffing; and laboratory considerations. Chapter topics include…

Municipal policies and plans of action aiming to promote physical activity and healthy eating habits among schoolchildren in Stockholm, Sweden: a cross-sectional study.

PubMed

Guldbrandsson, Karin; Wennerstad, Karin Modig; Rasmussen, Finn

2009-08-03

Promoting physical activity and healthy eating habits by structural measures that reach most children in a society is presumably the most sustainable way of preventing development of overweight and obesity in childhood. The main purpose of the present study was to analyse whether policies and plans of action at the central level in municipalities increased the number of measures that aim to promote physical activity and healthy eating habits among schoolchildren aged six to 16. Another purpose was to analyse whether demographic and socio-economic characteristics were associated with the level of such measures. Questionnaires were used to collect data from 25 municipalities and 18 town districts in Stockholm County, Sweden. The questions were developed to capture municipal structural work and factors facilitating physical activity and the development of healthy eating habits for children. Local policy documents and plans of action were gathered. Information regarding municipal demographic and socio-economic characteristics was collected from public statistics. Policy documents and plans of action in municipalities and town districts did not seem to influence the number of measures aiming to promote physical activity and healthy eating habits among schoolchildren in Stockholm County. Municipal demographic and socio-economic characteristics were, however, shown to influence the number of measures. In town districts with a high total population size, and in municipalities and town districts with a high proportion of adults with more than 12 years of education, a higher level of health-promoting measures was found. In municipalities with a high annual population growth, the number of measures was lower than in municipalities with a lower annual population growth. Another key finding was the lack of agreement between what was reported in the questionnaires regarding existence and contents of local policies and plans of action and what was actually found when these documents were scrutinized. Policy documents and plans of action aiming to promote physical activity and healthy eating habits among schoolchildren aged six to 16 in municipalities and town districts in Stockholm County did not seem to have an impact on the local level of measures. Demographic and socio-economic characteristics of the municipalities and town districts were on the other hand associated with local health-promoting measures.

Does patients' choice of health centre doctor depend on the organization? A comparative study of four municipalities with different forms of service provision in Finland.

PubMed

Laamanen, Ritva; Simonsen-Rehn, Nina; Suominen, Sakari; Brommels, Mats

2010-11-01

The aim of the study was to examine the use of physician services and the willingness to choose an health centre (HC) doctor rather than an alternative (i.e. private, occupational healthcare, other doctor) by the working age population in four municipalities in Finland. In a Southern municipality primary health care was contracted out to a non-profit organization whereas Eastern, Western and South-Western municipalities mainly provided services themselves. A mail survey of a random sample of the 15-64-age population was conducted in 2002 (n = 2,000, response rate 62%). Data were analyzed using descriptive statistics as well as bi- and multivariate logistic regression analyses. Of the respondents, 69% had visited an HC doctor during the past year, and of these, more than 40% had also visited another doctor outside the HC. The willingness to choose an HC doctor varied from 40% to 54% and was highest in the Southern municipality. When significantly associated variables - age, working status, perceived stress in life situation, access to an appointment, perceived interpersonal quality, and visits to doctors - were controlled for, the willingness to choose an HC doctor was, compared with the Southern municipality, less popular only in the Western municipality. The tendency to choose an HC doctor rather than an alternative was quite low, probably reflecting lack of attractiveness of HC to patients. However, contracting out service production did not additionally decrease patients' willingness to choose an HC doctor. More attention should be paid to improving access, interpersonal quality and continuity of care.

Non linear relationship between change in awareness in municipal solid waste management and domestic wastewater management - A case of the Jodipan and Ksatrian village, Malang, East Java

NASA Astrophysics Data System (ADS)

Zakiyya, Nida Maisa; Sarli, Prasanti Widyasih; Soewondo, Prayatni

2017-11-01

In developing countries the awareness on the importance of sanitation facilities, whether it is for municipal solid waste or domestic wastewater treatment, is still very low. Jodipan and Ksatrian Village, in Malang, East Java, are two slum areas that have recently been improved visually by using simple colorful paints. The visual improvement was expected to increase the resident's awareness on the importance of keeping the area clean; adjacent to the project, a new municipal waste management system was also put in place, changing the president's behaviour towards municipal solid waste. This study focuses on the relationship between community awareness in municipal solid waste management and domestic wastewater management. The result is expected to be an input for the government to enhance wastewater infrastructure program and its sustainability, related to its awareness on municipal solid waste. A descriptive model through questionnaire to 48 households of Jodipan sub district in Kampung Warna-warni and 69 households of Ksatrian sub district in Kampung 3D by random sampling, with an error of 0.1, was used to conduct this research. A nonlinear relationship between the change in awareness in municipal solid waste management (MSW) and domestic wastewater management was observed, with only 0.1312 of determination coefficient. Weak Spearman correlation coefficient number was found, ranging from 0.284 to 0.39, indicating another parameter turned into a role on affecting the awareness of wastewater. Further study about another parameter (eg. social and economic parameter) intervension on sanitation awareness could be investigated.

[Inequalities in mortality by cardiovascular diseases in the Colombian Coffee Growing Region, 2009-2011].

PubMed

Cardona, Dora; Cerezo, María Del Pilar; Parra, Hernán; Quintero, Liliana; Muñoz, Liliana; Cifuentes, Olga Lucía; Vélez, Silvia Clemencia

2015-01-01

The impact of mortality from cardiovascular diseases requires the measurement of the relationship between the local socioeconomic conditions and these death causes. To determine the inequality in mortality from cardiovascular diseases in the municipalities of the Colombian Coffee Growing Region (2009-2011). We conducted an ecological study to compare the mortality from cardiovascular diseases (hypertensive, ischemic, cerebrovascular) in municipalities and their economic situation. Mortality rates and the index of unsatisfied basic needs were obtained from the Colombian Departamento Administrativo Nacional de Estadística (DANE) vital statistics, while the municipal gross domestic product per capita was estimated for this study. The inequality indices were calculated using regression models, and concentration and Theil indices with Epidat 3.1. The death risk resulting from ischemic or hypertensive diseases was greater in those municipalities with a higher index of unsatisfied basic needs. Mortality due to hypertensive disease tended to concentrate in municipalities with a higher level of unsatisfied basic needs. The municipalities with a lower gross domestic product showed a higher rate of deaths due to hypertensive disease in years 2009 and 2010, and due to ischemic disease in years 2010 and 2011. Nevertheless, this indicator does not measure the gap existing among poor communities. Disaggregated inequality indicators at municipal level are lacking. Suggested indicators are estimated only for country and provincial levels and they do not favor the characterization of health social inequalities at territorial level.

Implementation of health impact assessment in Danish municipal context.

PubMed

Kraemer, Stella Rebecca Johnsdatter; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

2014-12-01

Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health policy. Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used for implementation of HIA. No significant differences were found among analyzed municipalities by status of HIA inclusion into health policy. Among barriers; a lack of tools with general validity, a lack of intersectoral working culture, balance between centralized versus participatory way of working and organizational structure of a municipality, and a lack of capacities were enlisted as most relevant. The last one is a crucial factor of an internal social system of a municipality. With regards to communication channels, reporting and presentation skills of implementers and doers are of key importance. Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.

Copper Tube Pitting in Santa Fe Municipal Water Caused by Microbial Induced Corrosion.

PubMed

Burleigh, Thomas D; Gierke, Casey G; Fredj, Narjes; Boston, Penelope J

2014-06-05

Many copper water lines for municipal drinking water in Santa Fe, New Mexico USA, have developed pinhole leaks. The pitting matches the description of Type I pitting of copper, which has historically been attributed to water chemistry and to contaminants on the copper tubing surface. However, more recent studies attribute copper pitting to microbial induced corrosion (MIC). In order to test for microbes, the copper tubing was fixed in hexamethyldisilazane (HMDS), then the tops of the corrosion mounds were broken open, and the interior of the corrosion pits were examined with scanning electron microscopy (SEM). The analysis found that microbes resembling actinobacteria were deep inside the pits and wedged between the crystallographic planes of the corroded copper grains. The presence of actinobacteria confirms the possibility that the cause of this pitting corrosion was MIC. This observation provides better understanding and new methods for preventing the pitting of copper tubing in municipal water.

Copper Tube Pitting in Santa Fe Municipal Water Caused by Microbial Induced Corrosion

PubMed Central

Burleigh, Thomas D.; Gierke, Casey G.; Fredj, Narjes; Boston, Penelope J.

2014-01-01

Many copper water lines for municipal drinking water in Santa Fe, New Mexico USA, have developed pinhole leaks. The pitting matches the description of Type I pitting of copper, which has historically been attributed to water chemistry and to contaminants on the copper tubing surface. However, more recent studies attribute copper pitting to microbial induced corrosion (MIC). In order to test for microbes, the copper tubing was fixed in hexamethyldisilazane (HMDS), then the tops of the corrosion mounds were broken open, and the interior of the corrosion pits were examined with scanning electron microscopy (SEM). The analysis found that microbes resembling actinobacteria were deep inside the pits and wedged between the crystallographic planes of the corroded copper grains. The presence of actinobacteria confirms the possibility that the cause of this pitting corrosion was MIC. This observation provides better understanding and new methods for preventing the pitting of copper tubing in municipal water. PMID:28788679

Geographic and socioeconomic distribution of food vendors: a case study of a municipality in the Southern Brazil.

PubMed

Correa, Elizabeth Nappi; Padez, Cristina Maria Proença; Abreu, Ângelo Horta de; Vasconcelos, Francisco de Assis Guedes de

2017-03-30

The objective of this study was to identify the food vendor distribution profile of the city of Florianópolis, Santa Catarina State, Brazil, and investigate its association with the socioeconomic and demographic characteristics of different municipal regions. This descriptive, cross-sectional study obtained the location of food vendors from secondary data from different institutional sources. The density of different types of food vendors per 1,000 inhabitants in each municipal weighted area was calculated. The Kruskal-Wallis test compared the mean density of food vendors and the weighted income areas. The lowest-income regions had the lowest density of butchers, snack bars, supermarkets, bakeries/pastry shops, natural product stores, juice bars, and convenience stores. The identification of these areas may encourage the creation of public policies that facilitate healthy food startups and/or maintenance of healthy food vendors, especially in the lowest-income regions.

What implies the good work for registered nurses in municipal elderly care in Sweden?

PubMed

Josefsson, Karin; Aling, Jenny; Östin, Britt-Louise

2011-08-01

The aim was to describe registered nurses' perceptions of what the good work implies to them in municipal elderly care. A descriptive design and a structured questionnaire specifically designed for this study were used. Sixty housing units for older people and 213 nurses participated, with a response rate of 62%. The good work included the following aspects: intellectually stimulating without guilt feelings; freedom and independence with the possibility to influence; having appreciative and pleasant fellow workers and a fair and understanding manager; a good physical and risk-free environment; work security and a steady income with the possibility of improving salary through work effort; work effort should be beneficial to others; innovative thinking and initiative should be highly valued; and pride in work without compromising personal values. Employers must take this into consideration to retain those nurses already employed and recruit nurses to municipal elderly care.

[Implementation of the International Health Regulations in Cuba: evaluation of basic capacities of the health sector in selected provinces].

PubMed

Gala, Ángela; Toledo, María Eugenia; Arias, Yanisnubia; Díaz González, Manuel; Alvarez Valdez, Angel Manuel; Estévez, Gonzalo; Abreu, Rolando Miyar; Flores, Gustavo Kourí

2012-09-01

Obtain baseline information on the status of the basic capacities of the health sector at the local, municipal, and provincial levels in order to facilitate identification of priorities and guide public policies that aim to comply with the requirements and capacities established in Annex 1A of the International Health Regulations 2005 (IHR-2005). A descriptive cross-sectional study was conducted by application of an instrument of evaluation of basic capacities referring to legal and institutional autonomy, the surveillance and research process, and the response to health emergencies in 36 entities involved in international sanitary control at the local, municipal, and provincial levels in the provinces of Havana, Cienfuegos, and Santiago de Cuba. The polyclinics and provincial centers of health and epidemiology in the three provinces had more than 75% of the basic capacities required. Twelve out of 36 units had implemented 50% of the legal and institutional framework. There was variable availability of routine surveillance and research, whereas the entities in Havana had more than 40% of the basic capacities in the area of events response. The provinces evaluated have integrated the basic capacities that will allow implementation of IHR-2005 within the period established by the World Health Organization. It is necessary to develop and establish effective action plans to consolidate surveillance as an essential activity of national and international security in terms of public health.

Assessing the knowledge of expectant mothers on mother-to-child transmission of viral hepatitis B in Upper West region of Ghana.

PubMed

Dun-Dery, Frederick; Adokiya, Martin Nyaaba; Walana, Williams; Yirkyio, Ernestina; Ziem, Juventus B

2017-06-12

Viral Hepatitis B is of a major public health concern globally, especially in developing countries. Expectant mothers' knowledge of Mother-To-Child Transmission (MTCT) of the disease is significant in preventing the spread from an infected mother to her child. This study sought to assess the expectant mothers' knowledge of Mother-To-Child Transmission of viral hepatitis B in the Wa Municipality and Lawra District of Upper West Region, Ghana. A descriptive cross-sectional study with a multi-stage sampling technique was employed to select a total of 450 study respondents (expectant mothers), and a semi-structured questionnaire was used for the data collection. Respondents were interviewed using face-to-face interview technique. Majority (54.0%) of the respondents were aged between 25 and 35 years and the results were similar in both districts. Overall, 62.4% (281/450) of the respondents had at least Junior High level education, and 76.2% (343/450) were multigravida. Educational levels among respondents in the two areas were above 50.0% and considered relatively high. Respondents' general knowledge of hepatitis B infection and disease was 46.0% (208/450). However, there was a slight difference between the two districts (40.1% in Lawra District and 51.6% in Wa Municipality). The overall knowledge level on MTCT of viral hepatitis B among the respondents was 34.7% (156/450): the Wa Municipality recorded higher knowledge (43.3%) compared to 24.8% in Lawra District. The knowledge level of the expectant mothers on MTCT of viral hepatitis B is relatively low in Upper West Region, Ghana. Majority of the respondents had some form of formal education. The age, marital status, education, occupation, gravity and family setup were found to be associated with knowledge of Hepatitis B infection and MTCT. Thus, there is urgent need to intensify efforts of health staff to educate expectant mothers. In addition, home education and outreach activities should be intensified on HBV infection as well as MTCT. Consequently, planning, implementation and execution of preventive activities, especially in the antenatal clinics should critically consider the social and demographic variations of mothers.

The Answer Van in Rural New Jersey

ERIC Educational Resources Information Center

Milich, Patricia S.

1978-01-01

Description of a mobile information center that provides public information on local events, municipal ordinances, employment, taxes, social security, planned parenthood, welfare, adoption laws, and other topics. The project has been deemed successful because it offers the public an opportunity to communicate face to face in a nonthreatening…

Watch It

ERIC Educational Resources Information Center

Bolch, Matt

2008-01-01

For the school chief information officer (CIO), safeguarding students and facilities is as much a part of the job description as keeping the data networks running and the servers protected from hackers. This article describes how two districts, Miami-Dade County Public Schools and Taos Municipal Schools, secured their surveillance systems. The…

Factors associated with implementation of a multicomponent responsible beverage service program – results from two surveys in 290 Swedish municipalities

PubMed Central

2013-01-01

Background The purpose of this study was to investigate which factors affected the implementation of a multicomponent Responsible Beverage Service (RBS) program in 290 Swedish municipalities and whether the amount of such factors influenced the level of implementation of the program. Methods This study used variation in the presence of implementation-promoting factors to predict the level of implementation of the RBS program in municipalities throughout Sweden. The presence of such factors and the level of implementation of the program were studied by means of two surveys in all Swedish municipalities (N=290). Logistic regression and Spearman’s correlation analyses were used to analyze the relationship between implementation-promoting factors and the level of implementation of the RBS program. Results The response rates of the two surveys were 96% and 98%, respectively. One main finding was that program fidelity was low. Only 13% of the municipalities surveyed had implemented the RBS program as a whole, as stated in the specification of requirements. In municipalities reporting a higher amount of implementation-promoting factors, a significantly higher level of implementation of the program was shown. Evaluation and feedback was the only factor that correlated significantly with the level of implementation of the RBS program as a whole. Conclusion Evaluation and feedback constitutes an important implementation-promoting factor also in complex programs like the RBS program. Program fidelity is significant for the outcome of an intervention and must be a major focus of the implementation processes. PMID:23497692

Unemployment at municipality level is associated with an increased risk of small for gestational age births--a multilevel analysis of all singleton births during 2005-2010 in Finland.

PubMed

Räisänen, Sari; Kramer, Michael R; Gissler, Mika; Saari, Juho; Heinonen, Seppo

2014-10-18

Neighbourhood level deprivation has been shown to influence adverse perinatal outcomes independent of individual level socioeconomic status (SES) in countries with high income inequality, such as the United States. The present study evaluates whether municipality level deprivation defined based on education (proportion of inhabitants with university level education), income (mean income per capita) and unemployment were associated with the prevalence of preterm birth (<37 weeks) and small for gestational age (SGA, birth weight <2 standard deviations) after adjustment for individual level socio-demographics (age, parity, prior preterm births, smoking during pregnancy and SES defined based on maternal occupation at birth) in Finland. The study design was cross-sectional. The data gathered from the Medical Birth Register included all singleton births (n = 345,952) in 2005-2010. We fitted Generalized Estimating Equations (GEE) models to account for correlation of preterm birth and SGA clustering within municipality. Of all the women with singleton pregnancies, 4.5% (n = 15,615) gave birth preterm and 3.8% (n = 13,111) of their newborns were classified as SGA. Individual level SES and smoking were important risk factors for each outcome in adjusted models. Controlling for individual level factors, women living in intermediate and high unemployment class municipalities were 6.0% (adjusted odds ratio (aOR) = 1.06; 95% confidence interval (CI) 1.01-1.12) and 13.0% (aOR = 1.13; 95% CI 1.06-1.20), respectively, more likely to give birth to an SGA newborn than women living in low unemployment class municipalities. After adjustment for individual level socio-demographics, the prevalence of SGA was around 6-13% higher in municipalities with an intermediate or high unemployment rate than municipalities with the lowest unemployment rate. The results suggested that the unemployment rate has an important public health effect with clinical implications since SGA is associated with a higher risk of adverse long-term health outcomes.

Assessment of municipal infrastructure development and its critical influencing factors in urban China: A FA and STIRPAT approach.

PubMed

Li, Yu; Zheng, Ji; Li, Fei; Jin, Xueting; Xu, Chen

2017-01-01

Municipal infrastructure is a fundamental facility for the normal operation and development of an urban city and is of significance for the stable progress of sustainable urbanization around the world, especially in developing countries. Based on the municipal infrastructure data of the prefecture-level cities in China, municipal infrastructure development is assessed comprehensively using a FA (factor analysis) model, and then the stochastic model STIRPAT (stochastic impacts by regression on population, affluence and technology) is examined to investigate key factors that influence municipal infrastructure of cities in various stages of urbanization and economy. This study indicates that the municipal infrastructure development in urban China demonstrates typical characteristics of regional differentiation, in line with the economic development pattern. Municipal infrastructure development in cities is primarily influenced by income, industrialization and investment. For China and similar developing countries under transformation, national public investment remains the primary driving force of economy as well as the key influencing factor of municipal infrastructure. Contribution from urbanization and the relative consumption level, and the tertiary industry is still scanty, which is a crux issue for many developing countries under transformation. With economic growth and the transformation requirements, the influence of the conventional factors such as public investment and industrialization on municipal infrastructure development would be expected to decline, meanwhile, other factors like the consumption and tertiary industry driven model and the innovation society can become key contributors to municipal infrastructure sustainability.

Assessment of municipal infrastructure development and its critical influencing factors in urban China: A FA and STIRPAT approach

PubMed Central

Li, Yu; Zheng, Ji; Li, Fei; Jin, Xueting; Xu, Chen

2017-01-01

Municipal infrastructure is a fundamental facility for the normal operation and development of an urban city and is of significance for the stable progress of sustainable urbanization around the world, especially in developing countries. Based on the municipal infrastructure data of the prefecture-level cities in China, municipal infrastructure development is assessed comprehensively using a FA (factor analysis) model, and then the stochastic model STIRPAT (stochastic impacts by regression on population, affluence and technology) is examined to investigate key factors that influence municipal infrastructure of cities in various stages of urbanization and economy. This study indicates that the municipal infrastructure development in urban China demonstrates typical characteristics of regional differentiation, in line with the economic development pattern. Municipal infrastructure development in cities is primarily influenced by income, industrialization and investment. For China and similar developing countries under transformation, national public investment remains the primary driving force of economy as well as the key influencing factor of municipal infrastructure. Contribution from urbanization and the relative consumption level, and the tertiary industry is still scanty, which is a crux issue for many developing countries under transformation. With economic growth and the transformation requirements, the influence of the conventional factors such as public investment and industrialization on municipal infrastructure development would be expected to decline, meanwhile, other factors like the consumption and tertiary industry driven model and the innovation society can become key contributors to municipal infrastructure sustainability. PMID:28787031

76 FR 20783 - Self-Regulatory Organizations; Municipal Securities Rulemaking Board; Order Granting Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... rates and descriptive information about Auction Rate Securities (``ARS'') and Variable Rate Demand... interest rate setting mechanisms for ARS and liquidity facilities for VDROs, information about orders submitted for an ARS auction, and additional information about VRDOs.\\5\\ To provide subscribers with access...

76 FR 11547 - Self-Regulatory Organizations; Municipal Securities Rulemaking Board; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-02

... interest rates and descriptive information about Auction Rate Securities (``ARS'') and Variable Rate Demand... interest rate setting mechanisms for ARS and liquidity facilities for VRDOs, information about orders submitted for an ARS auction, and additional information about VRDOs.\\4\\ To provide subscribers with access...

77 FR 13114 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-05

... following electric securities filings: Docket Numbers: ES12-23-000 Applicants: Wolverine Power Supply... and the Issuance of Securities under Section 204 of the Federal Power Act of Wolverine Power Supply... Power Pool, Inc. Description: 1166R15 Oklahoma Municipal Power Authority NITSA NOA to be effective 2/1...

Individual and contextual determinants of self-reported poor psychological health: a population-based multilevel analysis in southern Sweden.

PubMed

Lindström, Martin; Moghaddassi, Mahnaz; Merlo, Juan

2006-01-01

To investigate the influence of contextual and individual factors on self-reported psychological health. The 2000 public health survey in Scania is a cross-sectional postal questionnaire study with a 59% participation rate. A total of 13,715 persons aged 18-80 answered the questionnaire. A multilevel logistic regression model, with individuals at the first level and municipalities/city quarters at the second, was performed. The effect (intra-class correlation, cross-level modification, and odds ratios) of individual and municipality/city quarter factors on self-reported psychological health was analysed. The crude variance between municipalities/city quarters was small but significant. It was particularly affected and lowered by individual civil status, country of origin, economic stress, and social participation. The inclusion of all individual factors age, sex, civil status, country of origin, education, economic stress, and social participation lowered the between municipality variance to not-significant levels, which is the reason why no contextual variables were included in the calculations. The results of this study suggest that poor self-reported psychological health is affected mainly by individual characteristics of the population and not by contextual factors at the municipality/city quarter level.

Greenhouse gas emissions control in integrated municipal solid waste management through mixed integer bilevel decision-making.

PubMed

He, Li; Huang, G H; Lu, Hongwei

2011-10-15

Recent studies indicated that municipal solid waste (MSW) is a major contributor to global warming due to extensive emissions of greenhouse gases (GHGs). However, most of them focused on investigating impacts of MSW on GHG emission amounts. This study presents two mixed integer bilevel decision-making models for integrated municipal solid waste management and GHG emissions control: MGU-MCL and MCU-MGL. The MGU-MCL model represents a top-down decision process, with the environmental sectors at the national level dominating the upper-level objective and the waste management sectors at the municipal level providing the lower-level objective. The MCU-MGL model implies a bottom-up decision process where municipality plays a leading role. Results from the models indicate that: the top-down decisions would reduce metric tonne carbon emissions (MTCEs) by about 59% yet increase about 8% of the total management cost; the bottom-up decisions would reduce MTCE emissions by about 13% but increase the total management cost very slightly; on-site monitoring and downscaled laboratory experiments are still required for reducing uncertainty in GHG emission rate from the landfill facility. Copyright © 2011 Elsevier B.V. All rights reserved.

On the (In)Consistency of Citizen and Municipal Level Indicators of Social Capital and Local Government Performance.

PubMed

Kampen, Jarl K

2010-06-01

We study the empirical consistency of survey based (micro level) indicators of social capital and local government performance on the one, and municipality based (aggregate level) measures of these two concepts on the other hand. Knowledge about the behavior of these indicators is helpful for evaluating the value of studies carried out in isolated contexts, that is, with access to data on either, but not both, levels. The method is by comparing data collected by Statistics Belgium on Flemish municipalities, to data collected at citizen level by means of a face-to-face survey. The available evidence supplies at best a meager basis for presupposing a shared component of the indicators under study.

On the (In)Consistency of Citizen and Municipal Level Indicators of Social Capital and Local Government Performance

PubMed Central

2009-01-01

We study the empirical consistency of survey based (micro level) indicators of social capital and local government performance on the one, and municipality based (aggregate level) measures of these two concepts on the other hand. Knowledge about the behavior of these indicators is helpful for evaluating the value of studies carried out in isolated contexts, that is, with access to data on either, but not both, levels. The method is by comparing data collected by Statistics Belgium on Flemish municipalities, to data collected at citizen level by means of a face-to-face survey. The available evidence supplies at best a meager basis for presupposing a shared component of the indicators under study. PMID:20461124

40 CFR 60.1175 - What information must I include in the plant-specific operating manual?

Code of Federal Regulations, 2010 CFR

2010-07-01

... waste combustion unit. (e) Procedures for maintaining a proper level of combustion air supply. (f... Standards of Performance for Small Municipal Waste Combustion Units for Which Construction is Commenced... municipal waste combustion units. (c) Procedures for receiving, handling, and feeding municipal solid waste...

An exploration into municipal waste charges for environmental management at local level: The case of Spain.

PubMed

Puig-Ventosa, Ignasi; Sastre Sanz, Sergio

2017-11-01

Municipal waste charges have been widely acknowledged as a crucial tool for waste management at the local level. This is because they contribute to financing the costly provision of waste collection and treatment services and they can be designed to provide an economic stimulus to encourage citizens and local businesses to improve separate collection and recycling. This work presents a methodology to evaluate a sample of 125 municipal waste charges in Spain for the year 2015, covering 33.91% of the Spanish population. The qualitative benchmarking of municipal waste charges shows that flat fees are frequent, whereas variable fees are set according to criteria that are weakly related to waste generation. The average fee per household is €82.2 per year, which does not provide full cost recovery. The current configuration of municipal waste charges penalises taxpayers contributing to source separation of waste, while subsidising less environmentally friendly behaviours. In this sense, municipal waste charges in Spain are far from applying the polluter pays principle. Furthermore, it is argued that municipal waste charges are ineffective for promoting the proper application of the so-called 'waste hierarchy'.

The Study on Mental Health at Work: Design and sampling.

PubMed

Rose, Uwe; Schiel, Stefan; Schröder, Helmut; Kleudgen, Martin; Tophoven, Silke; Rauch, Angela; Freude, Gabriele; Müller, Grit

2017-08-01

The Study on Mental Health at Work (S-MGA) generates the first nationwide representative survey enabling the exploration of the relationship between working conditions, mental health and functioning. This paper describes the study design, sampling procedures and data collection, and presents a summary of the sample characteristics. S-MGA is a representative study of German employees aged 31-60 years subject to social security contributions. The sample was drawn from the employment register based on a two-stage cluster sampling procedure. Firstly, 206 municipalities were randomly selected from a pool of 12,227 municipalities in Germany. Secondly, 13,590 addresses were drawn from the selected municipalities for the purpose of conducting 4500 face-to-face interviews. The questionnaire covers psychosocial working and employment conditions, measures of mental health, work ability and functioning. Data from personal interviews were combined with employment histories from register data. Descriptive statistics of socio-demographic characteristics and logistic regressions analyses were used for comparing population, gross sample and respondents. In total, 4511 face-to-face interviews were conducted. A test for sampling bias revealed that individuals in older cohorts participated more often, while individuals with an unknown educational level, residing in major cities or with a non-German ethnic background were slightly underrepresented. There is no indication of major deviations in characteristics between the basic population and the sample of respondents. Hence, S-MGA provides representative data for research on work and health, designed as a cohort study with plans to rerun the survey 5 years after the first assessment.

Prevalence and awareness of obesity among people of different age groups in educational institutions in Morogoro, Tanzania.

PubMed

Nyaruhucha, C N M; Achen, J H; Msuya, J M; Shayo, N B; Kulwa, K B M

2003-02-01

To determine the prevalence rates and level of awareness of obesity among people of different age groups in Morogoro Municipality, Tanzania. A cross-sectional, descriptive study. One hundred adults aged 19-50 years old and 40 pupils aged 14-18 years old. Four educational institutions in Morogoro Municipality were included in the study. The four institutions included a primary and a secondary school, a teacher's training college and a university. The prevalence of obesity among the sampled subjects in Morogoro Municipality was 25 %, whereby 15.7% had a Body Mass Index (BMI) of between 25 and 30, and 9.3% had a BMI of more than 30. Age and occupation of all the subjects, together with marital status of adult subjects, were significantly related with obesity status. Prevalence of obesity increased with the increased age whereby subjects in the 41-50 years had the highest rate (45.4%). Employed subjects had higher rate of obesity (22.2%) than pupils or students. Similarly, married adults had higher rate of obesity (27.8%) than the single ones (4.7%). Unlike the old age group (41-50 years), 70% of the youngest subjects were not aware about the harmful effects of obesity. On the other hand, more than two thirds of all the subjects could not associate excess body weight with chronic non-communicable diseases such as coronary heart disease, high blood pressure and breathing problems. Results of the current study indicate that obesity is increasingly becoming a public health problem in Morogoro Municipality, and probably in many other places in Tanzania. There is need for more public awareness on the effect of obesity on people's health through information, education and communication. It would be of great importance if such interventions were introduced at early age of life, for example by inclusion in school curricula.

Environmental quality and sustainability in the province of Reggio Emilia (Italy): using multi-criteria analysis to assess and compare municipal performance.

PubMed

Ferrarini, A; Bodini, A; Becchi, M

2001-10-01

Sustainability has become an increasingly significant issue, although practical implementation remains difficult. In Italy, promoting sustainability is particularly problematic at the provincial and municipal level, where the lack of resources and expertise, and the effects of uncoordinated policies make it difficult to achieve minimum requirements to make sustainable policies operational. One essential requirement is knowledge of baseline environmental conditions in each municipality. In the province of Reggio Emilia (Northern Italy) Legambiente, an environmental association, launched an initiative called 'Ecopaese' aimed at gathering data on environmental conditions and stimulating local administrations to implement sustainable policies. To this end, the state of the environment in the 45 municipalities within the province has been monitored using 25 indicators. Their values have been used to rank the municipalities by multiple criteria analysis (MCA). The results of this comparative approach provide information about the level of sustainability attained in the province as a whole as well as in the single municipalities. It is hoped that it will provide the basis for direct action plans at the provincial level by identifying areas for remedial action, as recommended by Agenda 21, the declaration adopted by many countries attending the Rio Summit in 1992.

RCRA Sustainable Materials Management Information

EPA Pesticide Factsheets

This asset includes a broad variety of documents, descriptive data, technical analyses and guidance materials relative to voluntary improvements in resource conservation, the beneficial use of sustainable materials and the management of non-hazardous wastes and materials. Included in this asset are participant information and outreach materials of various voluntary programs relating to better materials and waste management programs. An example is the WasteWise program and Sustainable Materials Management (SMM) Challenges, which help organizations and businesses apply sustainable materials management practices to reduce municipal and select industrial wastes. Also included in this asset are guidance materials to assist municipalities in recycling and reuse of municipal solid waste, including diverting materials to composting, and the use of conversion methods such as anaerobic digestion. Another component are the data necessary to compile reports on the characterization of municipal solid waste (including such waste streams as food waste, yard and wood waste, discarded electronics, and household non-hazardous waste), the recycled content of manufactured goods, and other analyses performed using such tools as the Waste Assessment Reduction Model (WARM).For industrial non-hazardous waste, this asset includes guidance and outreach materials on industrial materials recycling and waste minimization. Finally, this asset includes research analyses on sustainable materia

Breast developmental anomalies in dormaa municipality of ghana: prevalence and impact on the life of the individual.

PubMed

Agbenorku, P; Otupiri, E; Fugar, S

2013-01-01

Background. Breast developmental anomalies (BDAs) are abnormalities of breast tissue that arise during breast development. Some of the anomalies can have negative impact on the person's life. This study seeks to assess the prevalence of BDA in the Dormaa Municipality in Ghana and its impact on the life of the individual. Materials and Methods. A descriptive study involving 500 female respondents aged between 11 and 25 years from selected schools in the Dormaa Municipality using self-administered questionnaires and interviews. Results. From the study, it was found that the prevalence of BDA in the municipality was 12.8%. The commonest BDA was bilateral hypoplasia which accounted for 31.3% of the BDAs found in the study. Nine (14.1%) complained of the BDA affecting their lives with most being teased in school. Twenty-two (34.4%) girls out of the 64 with BDAs had a family member with a BDA. Conclusion. BDA is a worry; therefore, comprehensive educational programs for health workers and the general public are needed to increase awareness. Also, work should be done to include education on BDA when awareness is being raised about breast cancer and on the importance of breast self-Examination (BSE).

[Knowledge and perception about tuberculosis in Habana Vieja municipality].

PubMed

Arroyo Rojas, Lellanis; Sánchez Valdés, C Lizet; Bonne Carcassés, Miriam Albertina; Pérez Pérez, Haydée Roberta; Armas Pérez, Luisa

2012-01-01

the studies on population's knowledge and perceptions of infectious diseases contribute to develop more effective communication processes. to evaluate the knowledge and the perception of the residents in Habana Vieja municipality about tuberculosis, and to identify the ways for obtaining information about aspects of this disease. a cross-sectional study was carried out. A questionnaire was applied on a sample of 86 persons from five health areas of the municipality. A descriptive analysis was made. Odds ratios were calculated to determine association between ways for obtaining information and knowledge on the existence of the disease, symptoms and transmission forms. the respondents know about tuberculosis as a disease, its symptoms, and its presence in Cuba, but the percentages corresponding to the truly significant symptoms are low, including incorrect identifications of towel, comb and mosquitoes as transmission ways of the disease. Television, radio and friends were the most mentioned sources of information. the population from Habana Vieja municipality knows about the existence of TB. However, specific knowledge about symptoms of the disease and ways of transmissions are insufficient. Changing this situation requires the strengthening of the role of the mass media role and the development of local communication strategies suited to local characteristics.

Effects of urbanization on the magnitude and frequency of floods on small streams in Tennessee; basic data report no. 2

USGS Publications Warehouse

Robbins, Clarence H.

1982-01-01

Peak stages, discharges, and rainfall recorded at 22 gaging stations on streams draining small (less than 25 mi super 2) urbanized basins across Tennessee are presented. The gaged basins are in 17 different municipalities with populations ranging between 5,000 and 100,000. The report gives a description of each gaged site along with a data sheet on which peak stages, discharges, and corresponding rainfall are listed. The description gives the station location, type of gage, basin characteristics, and general remarks. (USGS)

Description of Trichophoromyia ruifreitasi, a new phlebotomine species (Diptera, Psychodidae) from Acre State, Brazilian Amazon

PubMed Central

de Oliveira, Arley Faria José; Teles, Carolina Bioni Garcia; Medeiros, Jansen Fernandes; Camargo, Luís Marcelo Aranha; Pessoa, Felipe Arley Costa

2015-01-01

Abstract Trichophoromyia ruifreitasi sp. n. is described as a new species of sand fly from the genus Trichophoromyia Barretto. This description is supported with illustrations and photographs that detail the morphological characteristics of male specimens collected in the municipality of Assis Brasil, Acre State, Brazilian Amazon. This species is similar to Trichophoromyia auraensis (Mangabeira), but the two species can be easily differentiated by the distribution of setae on their parameres, and by the presence of a dorsal lobe in the parameres of the new species. PMID:26487825

Description of Trichophoromyia ruifreitasi, a new phlebotomine species (Diptera, Psychodidae) from Acre State, Brazilian Amazon.

PubMed

de Oliveira, Arley Faria José; Teles, Carolina Bioni Garcia; Medeiros, Jansen Fernandes; Camargo, Luís Marcelo Aranha; Pessoa, Felipe Arley Costa

2015-01-01

Trichophoromyia ruifreitasi sp. n. is described as a new species of sand fly from the genus Trichophoromyia Barretto. This description is supported with illustrations and photographs that detail the morphological characteristics of male specimens collected in the municipality of Assis Brasil, Acre State, Brazilian Amazon. This species is similar to Trichophoromyia auraensis (Mangabeira), but the two species can be easily differentiated by the distribution of setae on their parameres, and by the presence of a dorsal lobe in the parameres of the new species.

[Multiple aspects of the use of fluorine in public health from the viewpoint of healthcare leaders].

PubMed

Ferreira, Regina Glaucia Lucena Aguiar; Marques, Regina Auxiliadora de Amorim; Menezes, Léa Maria Bezerra de; Narvai, Paulo Capel

2013-07-01

The article describes the perceptions of health care leaders on issues relating to the use of fluorine in public health. This is a descriptive study with a qualitative approach, using Collective Subject Discourse (DCS) as technique for processing the statements. The study population was comprised of delegates to the 13th National Health Conference; the sample was defined by convenience and consisted of 310 delegates: 56 at municipal level in Fortaleza (CE), 143 at state level (Ceará) and 111 at national level. Data were collected by semi-structured questionnaires. There were gaps in knowledge about various aspects of the use of fluorine in public health, which indicates the need to improve the level of information of society on issues relating to fluoridation. The lack of knowledge of delegates, together with the data found in the literature about the shortcomings in the monitoring and control of fluorine levels in water, are indicative of the need to reassess the role of social actors and the mechanisms used in social control.

Sound pressure level in a municipal preschool

PubMed Central

Kemp, Adriana Aparecida Tahara; Delecrode, Camila Ribas; Guida, Heraldo Lorena; Ribeiro, André Knap; Cardoso, Ana Claúdia Vieira

2013-01-01

Summary Aim: To evaluate the sound pressure level to which preschool students are exposed. Method: This was a prospective, quantitative, nonexperimental, and descriptive study. To achieve the aim of the study we used an audio dosimeter. The sound pressure level (SPL) measurements were obtained for 2 age based classrooms. Preschool I and II. The measurements were obtained over 4 days in 8-hour sessions, totaling 1920 minutes. Results: Compared with established standards, the SPL measured ranged from 40.6 dB (A) to 105.8 dB (A). The frequency spectrum of the SPL was concentrated in the frequency range between 500 Hz and 4000 Hz. The older children produced higher SPLs than the younger ones, and the levels varied according to the activity performed. Painting and writing were the quietest activities, while free activities period and games were the noisiest. Conclusion: The SPLs measured at the preschool were higher and exceeded the maximum permitted level according to the reference standards. Therefore, the implementation of actions that aim to minimize the negative impact of noise in this environment is essential. PMID:25992013

DOE Office of Scientific and Technical Information (OSTI.GOV)

Medrano, Ma Jose, E-mail: pmedrano@isciii.es; Boix, Raquel; Pastor-Barriuso, Roberto

Background: High-chronic arsenic exposure in drinking water is associated with increased cardiovascular disease risk. At low-chronic levels, as those present in Spain, evidence is scarce. In this ecological study, we evaluated the association of municipal drinking water arsenic concentrations during the period 1998-2002 with cardiovascular mortality in the population of Spain. Methods: Arsenic concentrations in drinking water were available for 1721 municipalities, covering 24.8 million people. Standardized mortality ratios (SMRs) for cardiovascular (361,750 deaths), coronary (113,000 deaths), and cerebrovascular (103,590 deaths) disease were analyzed for the period 1999-2003. Two-level hierarchical Poisson models were used to evaluate the association of municipalmore » drinking water arsenic concentrations with mortality adjusting for social determinants, cardiovascular risk factors, diet, and water characteristics at municipal or provincial level in 651 municipalities (200,376 cardiovascular deaths) with complete covariate information. Results: Mean municipal drinking water arsenic concentrations ranged from <1 to 118 {mu}g/L. Compared to the overall Spanish population, sex- and age-adjusted mortality rates for cardiovascular (SMR 1.10), coronary (SMR 1.18), and cerebrovascular (SMR 1.04) disease were increased in municipalities with arsenic concentrations in drinking water >10 {mu}g/L. Compared to municipalities with arsenic concentrations <1 {mu}g/L, fully adjusted cardiovascular mortality rates were increased by 2.2% (-0.9% to 5.5%) and 2.6% (-2.0% to 7.5%) in municipalities with arsenic concentrations between 1-10 and>10 {mu}g/L, respectively (P-value for trend 0.032). The corresponding figures were 5.2% (0.8% to 9.8%) and 1.5% (-4.5% to 7.9%) for coronary heart disease mortality, and 0.3% (-4.1% to 4.9%) and 1.7% (-4.9% to 8.8%) for cerebrovascular disease mortality. Conclusions: In this ecological study, elevated low-to-moderate arsenic concentrations in drinking water were associated with increased cardiovascular mortality at the municipal level. Prospective cohort studies with individual measures of arsenic exposure, standardized cardiovascular outcomes, and adequate adjustment for confounders are needed to confirm these ecological findings. Our study, however, reinforces the need to implement arsenic remediation treatments in water supply systems above the World Health Organization safety standard of 10 {mu}g/L.« less

Non-completion of secondary education and early disability in Norway: geographic patterns, individual and community risks.

PubMed

Myhr, Arnhild; Haugan, Tommy; Lillefjell, Monica; Halvorsen, Thomas

2018-05-31

School non-completion and early work disability is a great public health challenge in Norway, as in most western countries. This study aims to investigate how medically based disability pension (DP) among young adults varies geographically and how municipal socioeconomic conditions interact with non-completion of secondary education in determining DP risk. The study includes a nationally representative sample of 30% of all Norwegians (N = 350,699) aged 21-40 in 2010 from Statistic Norway's population registries. Multilevel models incorporating factors at the individual, neighbourhood and municipal levels were applied to estimate the neighbourhood and municipality general contextual effects in DP receipt, and detect possible differences in the impact of municipal socioeconomic conditions on DP risk between completers and non-completers of secondary education. A pattern of spatial clustering at the neighbourhood (ICC = 0.124) and municipality (ICC = 0.021) levels are clearly evident, indicating that the underlying causes of DP receipt have a systematic neighbourhood and municipality variation in Norway. Non-completion of secondary education is strongly correlated with DP receipt among those younger than 40. Socioeconomic characteristics of the municipality are also significantly correlated with DP risk, but these associations are conditioned by the completion of secondary education. Living in a socioeconomically advantageous municipality (i.e. high income, high education levels and low unemployment and social security payment rates) is associated with a higher risk of DP, but only among those who do not complete their secondary education. Although the proportion of DPs was equal in rural and urban areas, it is evident that young people living in urban settings are more at risk of early DP than their counterparts living in rural parts of the country when controlling for other risk factors. The association between school non-completion and DP risk varies between municipalities and local socioeconomic environments. The interplay between personal characteristics and the local community is important in DP risk among young adults, implying that preventive measures should be directed not only at the individual level, but also include the educational system and the local community.

Quality in transitional care of the elderly: Key challenges and relevant improvement measures

PubMed Central

Storm, Marianne; Siemsen, Inger Margrete D.; Laugaland, Kristin; Dyrstad, Dagrunn Nåden; Aase, Karina

2014-01-01

Introduction Elderly people aged over 75 years with multifaceted care needs are often in need of hospital treatment. Transfer across care levels for this patient group increases the risk of adverse events. The aim of this paper is to establish knowledge of quality in transitional care of the elderly in two Norwegian hospital regions by identifying issues affecting the quality of transitional care and based on these issues suggest improvement measures. Methodology Included in the study were elderly patients (75+) receiving health care in the municipality admitted to hospital emergency department or discharged to community health care with hip fracture or with a general medical diagnosis. Participant observations of admission and discharge transitions (n = 41) were carried out by two researchers. Results Six main challenges with belonging descriptions have been identified: (1) next of kin (bridging providers, advocacy, support, information brokering), (2) patient characteristics (level of satisfaction, level of insecurity, complex clinical conditions), (3) health care personnel's competence (professional, system, awareness of others’ roles), (4) information exchange (oral, written, electronic), (5) context (stability, variability, change incentives, number of patient handovers) and (6) patient assessment (complex clinical picture, patient description, clinical assessment). Conclusion Related to the six main challenges, several measures have been suggested to improve quality in transitional care, e.g. information to and involvement of patients and next of kin, staff training, standardisation of routines and inter-organisational staff meetings. PMID:24868196

Built environment interventions aimed at improving physical activity levels in rural Ontario health units: a descriptive qualitative study.

PubMed

Coghill, Cara-Lee; Valaitis, Ruta K; Eyles, John D

2015-05-03

Few studies to date have explored the relationship between the built environment and physical activity specifically in rural settings. The Ontario Public Health Standards policies mandate that health units in Ontario address the built environment; however, it is unclear how public health practitioners are integrating the built environment into public health interventions aimed at improving physical activity in chronic disease prevention programs. This descriptive qualitative study explored interventions that have or are being implemented which address the built environment specifically related to physical activity in rural Ontario health units, and the impact of these interventions. Data were collected through twelve in-depth semi-structured interviews with rural public health practitioners and managers representing 12 of 13 health units serving rural communities. Key themes were identified using qualitative content analysis. Themes that emerged regarding the types of interventions that health units are employing included: Engagement with policy work at a municipal level; building and working with community partners, committees and coalitions; gathering and providing evidence; developing and implementing programs; and social marketing and awareness raising. Evaluation of interventions to date has been limited. Public health interventions, and their evaluations, are complex. Health units who serve large rural populations in Ontario are engaging in numerous activities to address physical activity levels. There is a need to further evaluate the impact of these interventions on population health.

Arsenic in public water supplies and cardiovascular mortality in Spain.

PubMed

Medrano, M A José; Boix, Raquel; Pastor-Barriuso, Roberto; Palau, Margarita; Damián, Javier; Ramis, Rebeca; Del Barrio, José Luis; Navas-Acien, Ana

2010-07-01

High-chronic arsenic exposure in drinking water is associated with increased cardiovascular disease risk. At low-chronic levels, as those present in Spain, evidence is scarce. In this ecological study, we evaluated the association of municipal drinking water arsenic concentrations during the period 1998-2002 with cardiovascular mortality in the population of Spain. Arsenic concentrations in drinking water were available for 1721 municipalities, covering 24.8 million people. Standardized mortality ratios (SMRs) for cardiovascular (361,750 deaths), coronary (113,000 deaths), and cerebrovascular (103,590 deaths) disease were analyzed for the period 1999-2003. Two-level hierarchical Poisson models were used to evaluate the association of municipal drinking water arsenic concentrations with mortality adjusting for social determinants, cardiovascular risk factors, diet, and water characteristics at municipal or provincial level in 651 municipalities (200,376 cardiovascular deaths) with complete covariate information. Mean municipal drinking water arsenic concentrations ranged from <1 to 118 microg/L. Compared to the overall Spanish population, sex- and age-adjusted mortality rates for cardiovascular (SMR 1.10), coronary (SMR 1.18), and cerebrovascular (SMR 1.04) disease were increased in municipalities with arsenic concentrations in drinking water > 10 microg/L. Compared to municipalities with arsenic concentrations < 1 microg/L, fully adjusted cardiovascular mortality rates were increased by 2.2% (-0.9% to 5.5%) and 2.6% (-2.0% to 7.5%) in municipalities with arsenic concentrations between 1-10 and >10 microg/L, respectively (P-value for trend 0.032). The corresponding figures were 5.2% (0.8% to 9.8%) and 1.5% (-4.5% to 7.9%) for coronary heart disease mortality, and 0.3% (-4.1% to 4.9%) and 1.7% (-4.9% to 8.8%) for cerebrovascular disease mortality. In this ecological study, elevated low-to-moderate arsenic concentrations in drinking water were associated with increased cardiovascular mortality at the municipal level. Prospective cohort studies with individual measures of arsenic exposure, standardized cardiovascular outcomes, and adequate adjustment for confounders are needed to confirm these ecological findings. Our study, however, reinforces the need to implement arsenic remediation treatments in water supply systems above the World Health Organization safety standard of 10 microg/L. 2009 Elsevier Inc. All rights reserved.

The role of municipal public policies in oral health socioeconomic inequalities in Brazil: A multilevel study.

PubMed

Aguiar, Violeta Rodrigues; Pattussi, Marcos Pascoal; Celeste, Roger Keller

2018-06-01

It is known that fluoridation has a contextual effect on oral health socioeconomic inequalities, but broad public policies have not been investigated. Thus, the aim of this study was to determine the effects of municipal public policies on oral health across different social strata. This was a cross-sectional study with 7328 12-year-old children and 5445 15-19-year-old adolescents from 177 Brazilian municipalities. Information at municipal level was collated for dental services, educational services, sanitation and water fluoridation. The main individual-level exposure was the disposable equivalent household income. The dichotomous outcomes were as follows: untreated dental caries (≥1 tooth), missing teeth (≥1 tooth) and filled teeth (≥1 tooth). Analyses were carried out using multilevel logistic regression. Interaction terms were tested between individual-level income and policy variables. The prevalence of untreated dental caries, missing and filled teeth was 47.0%, 15.1% and 47.5%, respectively. There was no significant interaction between income and policy indicators. Individuals living in municipalities with no water fluoridation had 1.42 (95% CI: 1.08-1.86) higher odds of having untreated dental caries; the odds ratio (OR) for those in municipalities with less education policies was 1.36 (95% CI: 1.07-1.73); those in municipalities with less sanitation had OR = 1.05 (95% CI: 0.78-1.40); and those in municipalities with less dental care had OR = 1.36 (95% CI: 1.02-1.80). Fluoridation and policies about sanitation, education and dental care were similarly associated with oral health in different social strata. Other policies on social and economic fields may be further explored. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

78 FR 75398 - Self-Regulatory Organizations; Municipal Securities Rulemaking Board; Order Granting Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-70990; File No. SR-MSRB-2013-08] Self...\\ Securities Exchange Act Release No. 70607 (October 3, 2013), 78 FR 62736 (``Notice''). II. Description of the... dealer, acting as an underwriter or remarketing agent with no prior or future long-term economic interest...

78 FR 68052 - Town of Telluride, Colorado; Notice of Preliminary Determination of a Qualifying Conduit...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

...--Criteria for Qualifying Conduit Hydropower Facility Satisfies (Y/ Statutory provision Description N) FPA 30(a)(3)(A), as amended by The conduit the Y HREA. facility uses is a tunnel, canal, pipeline, aqueduct... agricultural, municipal, or industrial consumption and not primarily for the generation of electricity. FPA 30...

World Perspective Case Descriptions on Educational Programs for Adults: China.

ERIC Educational Resources Information Center

Mingchuan, Dong; And Others

This document contains six case studies of Chinese adult education: (1) China's Adult Education at Present and in Prospect (Mingchuan and Zhongdan); (2) Aging Issue and Education for the Aged in China (Mingchuan and Zhongdan); (3) Adult Education in Beijing Municipality (Youren); (4) A University without Campus: Introduction to China's Higher…

Social capital and neo-materialist contextual determinants of sense of insecurity in the neighbourhood: a multilevel analysis in Southern Sweden.

PubMed

Lindström, Martin; Lindström, Christine; Moghaddassi, Mahnaz; Merlo, Juan

2006-12-01

The aim of this study was to investigate the influence of contextual (social capital and neo-materialist) and individual factors on sense of insecurity in the neighbourhood. The 2000 public health survey in Scania is a cross-sectional study. A total of 13,715 persons answered a postal questionnaire, which is 59% of the random sample. A multilevel logistic regression model, with individuals at the first level and municipalities at the second, was performed. The effect (median odds ratios, intra-class correlation, cross-level modification and odds ratios) of individual and municipality/city quarter (social capital and police district) factors on sense of insecurity was analysed. The crude variance between municipalities/city quarters was not affected by individual factors. The introduction of administrative police district in the model reduced the municipality variance, although some of the significant variance between municipalities remained. The introduction of social capital did not affect the municipality variance. This study suggests that the neo-materialist factor administrative police district may partly explain the individual's sense of insecurity in the neighbourhood.

The effects of the Norwegian Coordination Reform on the use of rehabilitation services: panel data analyses of service use, 2010 to 2013.

PubMed

Monkerud, Lars C; Tjerbo, Trond

2016-08-05

In 2012 the Norwegian Coordination Reform was implemented. The main motivation was to encourage municipalities to expand local, primary health care services. From 2012 to 2014, under the Municipal Co-Financing regime, municipalities were obliged to cover 20 % of the costs of health services provided at the specialist (hospital) level. Importantly, use of rehabilitation services in private institutions was not part of the cost-sharing mechanism of Municipal Co-Financing. Rehabilitation services may be seen as quite similar in nature whether they be provided by municipalities, hospitals or private institutions. Thus, with rehabilitation patients readily "transferrable" between levels, the question is whether the reform brought with it a sought after shift towards more municipal rehabilitation and less specialist rehabilitation. Data from the Norwegian Patient Register and from Statistics Norway/KOSTRA were utilized to gauge annual expenditures and inputs in specialist, municipal and private institution rehabilitation services respectively. Fixed effects and first difference regression analyses for the period 2010-2013 were carried out to account for certain time-invariant traits of municipalities and/or hospital regions, and results were adjusted for contemporaneous trends in local needs. Expenditures in specialist rehabilitation services declined sharply (typically by 8-10 %) from 2011 (pre-reform) to 2012 (post-reform), while expenditures in private rehabilitation services rose markedly in the same period (typically by 42-44 %). The results do not suggest any general expansion of municipal rehabilitation services. The results of the analyses suggest that municipalities shift away from the use of specialist rehabilitation services and towards the use of rehabilitation services in private institutions since the latter becomes relatively cheaper (free-of charge) than both municipal and specialist services in post-reform periods (as specialist services come at a cost to municipalities post-reform). While the main goal of the reform has not materialized the results nevertheless suggest that incentives (of cost-shifting) do play a significant role in rehabilitation service use.

[Women's health in violent situations: municipal administrative roles and decision-making in the Brazilian public health system].

PubMed

Porto, Madge; McCallum, Cecilia; Scott, Russell Parry; de Morais, Heloísa M Mendonça

2003-01-01

The aim of this study was to investigate the role of health management staff concerning the health of women facing violent situations and the impact these roles have on decisions concerning health measures targeting these women. The study employed a qualitative, descriptive methodology including 18 health management staff members from three municipalities classified as having fully autonomous municipal management systems under the Unified National Health System (SUS) in Greater Metropolitan Recife, Pernambuco State, Brazil. Staff members were divided into three distinct groups according to their opinions on women in violent situations and women's health interventions. However, the three groups were convergent with respect to their roles in determining decisions on health actions for these women. The health management staff's commitment to the feminist movement proved to be the most relevant factor. Common issues among staff members, such as the problem of public health and quality of living, or more technically, the cost-benefit issue, did appear as key arguments.

On the (In)Consistency of Citizen and Municipal Level Indicators of Social Capital and Local Government Performance

ERIC Educational Resources Information Center

Kampen, Jarl K.

2010-01-01

We study the empirical consistency of survey based (micro level) indicators of social capital and local government performance on the one, and municipality based (aggregate level) measures of these two concepts on the other hand. Knowledge about the behavior of these indicators is helpful for evaluating the value of studies carried out in isolated…

[Personal dose monitoring of radiation workers in medical institutions at the municipal level and below in a city from 2011 to 2014].

PubMed

Wang, C; Mo, S F; Zhang, J B; Li, J R; Huang, R L; Tan, H Y

2017-08-20

Objective: To determine the personal dose level of radiation workers in medical institutions at the municipal level and below in a city, and to provide a scientific support for strengthening the radiation protection in the city's medical institutions. Methods: Information of the successful applicants for the "Radiation Worker Permit" from 174 medical institutions at the municipal level and below was collected from October 1, 2011 to December 31, 2014. The annual effective dose was calculated based on the personal dose monitoring report, and indicators including sex, permit application time, hospital level, type of occupational radiation, length of radiation work, blood test, and micronucleated lymphocyte rate were analyzed. Results: Of the 1 143 radiation worker permit applications submitted by medical institutions the municipal level and below in this city from 2011 to 2014, 1 123 provided at least one personal dose monitoring report. The annual effective dose of the radiation workers was 0-4.76 mSv (mean 0.31±0.40 mSv) , and the collective annual effective dose was 351.96 mSv. The annual effective dose was significantly different between radiation workers with different times of permit application, hospital levels, and types of occupational radiation ( P <0.05) . Interventional radiology workers had the highest annual effective dose (0.63 mSv) , and annual effective dose was significantly different between interventional radiology workers with different lengths of radiation work ( H =10.812, P <0.05) . Conclusion: The personal radiation dose of radiation workers in medical institutions at the municipal level and below in this city is maintained at a relatively low level, suggesting that the occupational environment is relatively safe for these workers. However, more focus should be placed on clinical interventional radiology workers.

Study on Construction Technology of Municipal Road and Bridge Concrete

NASA Astrophysics Data System (ADS)

Tang, Fuyong

2018-03-01

With the continuous development of social economy and the accelerating process of urbanization, municipal road and bridge projects have also shown a trend of rapid development. Municipal road and bridge work can fully reflect the economic and cultural development level of cities and is also an important symbol of urban development. As a basic material of construction, concrete is widely used in engineering construction. This article will analyze the municipal road and bridge concrete construction technology, put forward corresponding measures.

Smoking during pregnancy was up to 70% more common in the most deprived municipalities - a multilevel analysis of all singleton births during 2005-2010 in Finland.

PubMed

Räisänen, Sari; Kramer, Michael R; Gissler, Mika; Saari, Juho; Hakulinen-Viitanen, Tuovi; Heinonen, Seppo

2014-10-01

We investigated whether there was an association between maternal smoking habits during pregnancy and municipality level deprivation defined based on education, income and unemployment after adjustment for individual level covariates, including socioeconomic status (SES), in Finland, a Nordic welfare state. Data were gathered from the Medical Birth Register and comprised all singleton births (n=337,876) during 2005-2010. To account for any correlation of women clustered within a municipality, we fitted generalized estimating equation (GEE) models. In total, 15.3% of the women with singleton pregnancies smoked during pregnancy. After adjustment for individual level confounders, smoking during pregnancy was 5.4-fold higher among women with the lowest as compared with highest individual SES. Controlling for individual SES, age and year of birth, women living in municipalities defined as intermediately and highly deprived based on education were 53.7% (adjusted odds ratio [aOR] 1.537, 95% confidence interval [CI] 1.493-1.583) and 71.5% (aOR 1.715, 95% CI 1.647-1.785), respectively, more likely to smoke during pregnancy than women in the least deprived municipalities. Individual SES is the strongest correlate of smoking during pregnancy but conditional on individual variables; lower municipality aggregate education is associated with up to 70% higher smoking prevalence. Copyright © 2014 Elsevier Inc. All rights reserved.

Residential Knowledge of Native Tree Species: A Case Study of Residents in Four Southern Ontario Municipalities

NASA Astrophysics Data System (ADS)

Almas, Andrew D.; Conway, Tenley M.

2017-01-01

In the past decade, municipalities across North America have increased investment in their urban forests in an effort to maintain and enhance the numerous benefits provided by them. Some municipalities have now drafted long-term urban forest management plans that emphasize the planting of native trees, to improve ecological integrity, and participation of residents, since the majority of urban trees are typically located on residential property. Yet it is unclear if residents are familiar with native trees or municipalities' urban forest management goals. Through a case study of southern Ontario municipalities, we administered a survey exploring residents' ability to correctly label common tree species as native or non-native, as well as their knowledge of urban forest management plans to test four hypotheses: 1) residents in municipalities with an urban forest management plans will be more knowledgeable about the native status of common street trees; 2) residents who have lived in the area longer will have greater knowledge; 3) knowledge level will be correlated with education level, ethnicity, and income; and 4) residents' knowledge will be related to having planted trees on their property. Our results indicate that residents are better able to identify common native trees than correctly determine which trees are non-native, although knowledge levels are generally low. Knowledge was significantly related to length of residency and tree planting experience, supporting hypotheses 2 and 4. These results highlight the importance of experience and local knowledge acquisition in relation to basic knowledge about urban trees, and also point to the failures of resident outreach within the case study municipalities.

[Travel time and participation in breast cancer screening in a region with high population dispersion].

PubMed

Borda, Alfredo; Sanz, Belén; Otero, Laura; Blasco, Teresa; García-Gómez, Francisco J; de Andrés, Fuencisla

2011-01-01

To analyze the association between travel time and participation in a breast cancer screening program adjusted for contextual variables in the province of Segovia (Spain). We performed an ecological study using the following data sources: the Breast Cancer Early Detection Program of the Primary Care Management of Segovia, the Population and Housing Census for 2001 and the municipal register for 2006-2007. The study period comprised January 2006 to December 2007. Dependent variables consisted of the municipal participation rate and the desired level of municipal participation (greater than or equal to 70%). The key independent variable was travel time from the municipality to the mammography unit. Covariables consisted of the municipalities' demographic and socioeconomic factors. We performed univariate and multivariate Poisson regression analyses of the participation rate, and logistic regression of the desired participation level. The sample was composed of 178 municipalities. The mean participation rate was 75.2%. The desired level of participation (≥ 70%) was achieved in 119 municipalities (67%). In the multivariate Poisson and logistic regression analyses, longer travel time was associated with a lower participation rate and with lower participation after adjustment was made for geographic density, age, socioeconomic status and dependency ratio, with a relative risk index of 0.88 (95% CI: 0.81-0.96) and an odds ratio of 0.22 (95% CI: 0.1-0.47), respectively. Travel time to the mammography unit may help to explain participation in breast cancer screening programs. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Residential Knowledge of Native Tree Species: A Case Study of Residents in Four Southern Ontario Municipalities.

PubMed

Almas, Andrew D; Conway, Tenley M

2017-01-01

In the past decade, municipalities across North America have increased investment in their urban forests in an effort to maintain and enhance the numerous benefits provided by them. Some municipalities have now drafted long-term urban forest management plans that emphasize the planting of native trees, to improve ecological integrity, and participation of residents, since the majority of urban trees are typically located on residential property. Yet it is unclear if residents are familiar with native trees or municipalities' urban forest management goals. Through a case study of southern Ontario municipalities, we administered a survey exploring residents' ability to correctly label common tree species as native or non-native, as well as their knowledge of urban forest management plans to test four hypotheses: 1) residents in municipalities with an urban forest management plans will be more knowledgeable about the native status of common street trees; 2) residents who have lived in the area longer will have greater knowledge; 3) knowledge level will be correlated with education level, ethnicity, and income; and 4) residents' knowledge will be related to having planted trees on their property. Our results indicate that residents are better able to identify common native trees than correctly determine which trees are non-native, although knowledge levels are generally low. Knowledge was significantly related to length of residency and tree planting experience, supporting hypotheses 2 and 4. These results highlight the importance of experience and local knowledge acquisition in relation to basic knowledge about urban trees, and also point to the failures of resident outreach within the case study municipalities.

Adoption and diffusion of zoning bylaws banning fast food drive-through services across Canadian municipalities.

PubMed

Nykiforuk, Candace I J; Campbell, Elizabeth J; Macridis, Soultana; McKennitt, Daniel; Atkey, Kayla; Raine, Kim D

2018-01-15

Healthy public policy is an important tool for creating environments that support human health and wellbeing. At the local level, municipal policies, such as zoning bylaws, provide an opportunity for governments to regulate building location and the type of services offered. Across North America, there has been a recent proliferation of municipal bylaws banning fast food drive-through services. Research on the utilization of this policy strategy, including bylaw adopters and adopter characteristics, is limited within the Canadian context. The aim of this study was to identify and characterize Canadian municipalities based on level of policy innovation and nature of their adopted bylaw banning fast food drive-through services. A multiple case history methodology was utilized to identify and analyse eligible municipal bylaws, and included development of a chronological timeline and map of adopter municipalities within Canada. Grey literature and policy databases were searched for potential adopters of municipal fast food drive-through service bylaws. Adopters were confirmed through evidence of current municipal bylaws. Geographic diffusion and diffusion of innovations theories provided a contextual framework for analysis of bylaw documents. Analysis included assignment of adopter-types, extent and purpose of bans, and policy learning activities of each adopter municipality. From 2002 to 2016, 27 municipalities were identified as adopters: six innovators and twenty-one early adopters. Mapping revealed parallel geographic diffusion patterns in western and eastern Canada. Twenty-two municipalities adopted a partial ban and five adopted a full ban. Rationales for the drive-through bans included health promotion, environmental concerns from idling, community character and aesthetics, traffic concerns, and walkability. Policy learning, including research and consultation with other municipalities, was performed by nine early adopters. This study detailed the adoption of fast food drive-through bylaws across Canada. Understanding the adopter-type characteristics of municipalities and the nature of their bylaws can assist other jurisdictions in similar policy efforts. While the implications for research and practice are evolving and dynamic, fast food drive-through service bans may play a role in promoting healthier food environments. Further research is required to determine the viability of this strategy for health promotion and chronic disease prevention.

Desigualdad social y tendencias de mortalidad por diabetes.

PubMed

Medina-Gómez, Oswaldo; Medina-Reyes, E Ismael Seth

2017-01-01

To identify the trend of national diabetes mortality by level of marginality at the state and municipal levels. A descriptive study was conducted with records of deaths from diabetes in over 20 years from 1990 to 2013. The national mortality rate was calculated standardized by age according to the 2000 world population and the state level 2013 saw the projected naational population by join point analysis for trend analysis was performed. For the general population, the annual percentage change between 1990 and 1996 was 2.2, from 1996 to 2005 was 4.3, and from 2005 to 2013 was 0.1. The largest increase among women occurred between 1998 and 2005 while among men occurred between 1995 and 2006. At the state level was found higher annual percentage change between the towns with the highest degree of marginalization. The mortality of diabetes in women shows a significant decrease since 2004, among men, the mortality with a continuous upward trend, consistent with the trend that the disease has had in recent years. Copyright: © 2017 SecretarÍa de Salud

Factors associated with inter-municipality differences in dental caries experience among Danish adolescents. An ecological study.

PubMed

Ekstrand, K R; Christiansen, M E C; Qvist, V; Ismail, A

2010-02-01

Caries on children and adolescents in Denmark has declined significantly over the last 30 years. Our first analysis in 1999, however, disclosed huge inter-municipality disparities in mean DMFS values as well as in prevalence of caries on Danish children; that fluoride in the water supply and the length of the education of the mothers could explain up to 45% of the above-mentioned disparity and that very few municipalities were positive outliers, i.e. were providing significant better caries results than expected from the background variables. Three of the aims of this second analysis were to repeat the analyses done on the 1999 sample, but now on a 2004 sample and then compare it with the results from 1999. A fourth aim was by means of an interview of CDOs to determine their interpretation of relevant conditions in the public dental health service in relation dental health outcome. A total of 204 (99%) and 191 (93%) municipalities were involved in 1999 and 2004, respectively. Unit of analysis were the municipalities. Mean DMFS of 15-year-olds was used as outcome variable. Eight background variables were accounted for during the analysis: For the fourth aim, a sample of CDOs representing municipalities with positive (n = 10), with no change (n = 10), or with negative change (n = 10) in mean DMFS, relative to all municipalities, between 1999 and 2004 was selected. The inter-municipality variation in mean DMFS 1999 was 0.88 to 8.73 and in 2004 was 0.56 to 6.19. The analyses found that fluoride level of the drinking water and mothers' length of education were significant variables explaining about 44% of the variations in mean DMFS in both years. Only one municipality was characterized as a positive outlier in 1999 as well as in 2004. The dose-response relations between increasing fluoride concentrations in the water supply and DMF-S values diminished in both years at a level above 0.35 ppm. The structured interview disclosed that municipalities with significant improvement in mean DMFS from 1999 to 2004 had established goals and were committed to the prevention of dental caries at the individual level. Instability in manpower; number of children in the service and economy was associated to municipalities with negative changes in caries experience.

[Tooth decay: epidemiological and therapeutic aspects in dental service of University Teaching Hospital Yalgado Ouedraogo and Municipal Centre of Oral Health].

PubMed

Ouedraogo, Y; Kabore, W A D; Konsem, T; Fall, M; Millogo, M; Ouattara, S; Ouedraogo, D

2015-12-01

In order to improve the prevention and treatment of dental caries in Burkina Faso, we conducted a study on the epidemiological and therapeutic aspects of dental caries in the dental services of University Teaching Hospital Yalgado Ouedraogo and in the Municipal Centre of Oral Health of Ouagadougou. A prospective and descriptive study from October, 15th 2012 to January, 15th 2013 was conducted on a sample of 191 patients. The variables recorded were: patient's identity, age, sex, area of residence, food mode, socioeconomic level, reason for consultation, oral hygiene, DMFT index, degree of tissue damage, the topography of the carious lesions and the applied therapy. Caries prevalence was 93.19% more female consultations, with sex ratio at 0.77. The average age was 31 years for a sample often engaged in trade and the informal sector. Carious lesions were usually limited to less than 4 teeth. The main motivation for the consultation was pain at 82.20%. The use of preventive care is quite low in our population. Extractions still occupy an important part of treatment. We need to improve oral hygiene and show to patients the necessity of routine visits to the dentist every year for early treatment.

Gastrointestinal nematodes in ostriches, Struthio camelus, in different regions of the state of Rio de Janeiro, Brazil.

PubMed

Ederli, Nicole Brand; de Oliveira, Francisco Carlos Rodrigues

2015-01-01

The ratite group is composed of ostriches, rheas, emus, cassowaries and kiwis. Little research has been done on parasitism in these birds. The aim of this study was to determine the distribution of infections by gastrointestinal nematodes in ostriches in the state of Rio de Janeiro. For this, fecal samples were collected from 192 on 13 farms. From each sample, four grams of feces were used to determine the eggs per gram of feces (EPG) count, by means of the McMaster technique. Part of the feces sample was used for fecal cultures, to identify 100 larvae per sample. The results were subjected to descriptive central trend and dispersion analysis, using confidence intervals at the 5% error probability level in accordance with the Student t distribution, and Tukey's test with a 95% confidence interval. The mean EPG in the state was 1,557, and the municipality of Três Rios had the lowest average (62). The city of Campos dos Goytacazes presented the highest mean EPG of all the municipalities analyzed. The northern region presented the highest mean EPG, followed by the southern, metropolitan, coastal lowland and central regions. Libyostrongylus species were observed on all the farms: L. douglassii predominated, followed by L. dentatus and Codiostomum struthionis.

Perceptions of health and risk management among home care workers in Sweden.

PubMed

Larsson, A; Karlqvist, L; Westerberg, M; Gard, G

2013-10-01

Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way. This study aims to examine home care workers' perceptions of health, risks, working conditions, and risk management within their organization. The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides ( n  = 133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified. There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations.

75 FR 46918 - Gresham Municipal Utilities; Notice of Application for Amendment of License and Soliciting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... Utilities. e. Name of Project: Upper Red Lake Dam Hydroelectric Project. f. Location: On the Red River, in.... Description of Request: The licensee proposes to amend the license for the Upper Red Lake Dam Hydroelectric... Project No. 2464), which is located immediately downstream from the Upper Red Lake Dam Project; (2) the...

78 FR 69847 - North Side Canal Company; Notice of Preliminary Determination of a Qualifying Conduit Hydropower...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

...--Criteria for Qualifying Conduit Hydropower Facility Satisfies (Y/ Statutory provision Description N) FPA 30(a)(3)(A), as amended by The conduit the Y HREA. facility uses is a tunnel, canal, pipeline, aqueduct... agricultural, municipal, or industrial consumption and not primarily for the generation of electricity. FPA 30...

"BELTEK" Project for the Training and Employability of Women in Turkey

ERIC Educational Resources Information Center

Yavuz, Erisen; Nadir, Celikoz; Mehmet, Sahin; Kurtkan, Kapicioglu M. Osman; Sait, Atas; Cemal, Akyol; Cagla, Girgin

2010-01-01

This is a case study based on BELTEK, which is a training organisation under Ankara metropolitan Municipality in Turkey. BELTEK is one of the initiatives aiming to train women and help to boost their employability. In this descriptive study, the goals, structure, training activities for the training and employability of women are put under…

Motivational Practices and Teachers' Performance in Jinja Municipality Secondary Schools, Jinja District, Uganda

ERIC Educational Resources Information Center

Justine, Nairuba

2011-01-01

The purpose of the study was to establish the effect of provision of fringe benefits and the nature of working conditions under motivational practices on teachers' performance in secondary schools. The study was qualitative and quantitative; and descriptive-correlation research design was used in the study. The researcher used purposive and simple…

Physical fitness of an industrial fire department vs. a municipal fire department.

PubMed

Garver, Julie N; Jankovitz, Kristine Z; Danks, Jane M; Fittz, Ashley A; Smith, Heather S; Davis, Steven C

2005-05-01

Both industrial and municipal firefighters need to maintain high levels of physical fitness and minimize cardiovascular risk factors. The nature of firefighter responsibilities in industrial and municipal settings may vary, affecting the ability to sustain high levels of physical fitness. We compared the working conditions, physical fitness, and exercise training practices of an industrial fire department (n = 17) to those of a nearby municipal fire department (n = 55). After informed consent, aerobic capacity, muscular strength, muscular endurance, body composition, flexibility, blood lipid concentrations, and blood pressure levels were measured. Exercise training practices and related factors were assessed using a questionnaire. Despite programmatic differences, these departments demonstrated similar, relatively high degrees of physical fitness and similar blood lipid concentrations, blood pressure levels, and cardiac risk factors. It is recommended that fire departments involve appropriately trained staff, schedule on-duty times for exercise, offer well-equipped exercise facilities, and follow National Strength and Conditioning Association (NSCA) and American College of Sports Medicine (ACSM) guidelines for exercise conditioning in order to maintain a high degree of physical fitness.

Description of water-systems operations in the Arkansas River basin, Colorado

USGS Publications Warehouse

Abbott, P.O.

1985-01-01

To facilitate a current project modeling the hydrology of the Arkansas River basin in Colorado, a description of the regulation of water in the basin is necessary. The geographic and climatic setting of the Arkansas River basin that necessitates the use, reuse, importation, and storage of water are discussed. The history of water-resource development in the basin, leading to the present complex of water systems, also is discussed. Municipal, irrigation, industrial, and multipurpose water systems are described. System descriptions are illustrated with schematic line drawings, and supplemented with physical data tables for the lakes, tunnels, conduits, and canals in the various systems. Copies of criteria under which certain of the water systems operate, are included. (USGS)

Municipal-level responses to household food insecurity in Canada: a call for critical, evaluative research.

PubMed

Collins, Patricia A; Power, Elaine M; Little, Margaret H

2014-04-09

Household food insecurity (HFI) is a persistent public health problem affecting 3.8 million Canadians. While the causes of HFI are rooted in income insecurity, solutions to HFI have been primarily food-based, with the bulk of activity occurring at the municipal level across Canada. We conceptualize these municipal-level actions as falling within three models: "charitable", "household improvements and supports" and "community food systems". Many initiatives, especially non-charitable ones, generate widespread support, as they aim to increase participants' food security using an empowering and dignified approach. While these initiatives may offer some benefits to their participants, preliminary research suggests that any food-based solution to an income-based problem will have limited reach to food-insecure households and limited impact on participants' experience of HFI. We suspect that widespread support for the local-level food-based approach to HFI has impeded critical judgement of the true potential of these activities to reduce HFI. As these initiatives grow in number across Canada, we are in urgent need of comprehensive and comparative research to evaluate their impact on HFI and to ensure that municipal-level action on HFI is evidence-based.

Gender inequalities in the association between area deprivation and perceived social support: a cross-sectional multilevel analysis at the municipality level in Germany

PubMed Central

Kroll, Lars Eric; Maier, Werner; Bolte, Gabriele

2018-01-01

Objectives To investigate the association between area deprivation at municipality level with low perceived social support, independent of individual socioeconomic position and demographic characteristics. To assess whether there are gender inequalities in this association. Design Cross-sectional multilevel analysis of survey data. Setting Germany. Participants 3350 men and 3665 women living in 167 municipalities throughout Germany participating in the ‘German Health Interview and Examination Survey for Adults’ (DEGS1 2008–2011) as part of the national health monitoring. Outcome Perceived social support as measured by Oslo-3 Social Support Scale. Results Prevalence of low perceived social support was 11.4% in men and 11.1% in women. Low social support was associated in men and women with sociodemographic characteristics that indicate more disadvantaged living situations. Taking these individual-level characteristics into account, municipal-level deprivation was independently associated with low perceived social support in men (OR for the most deprived quintile: 1.80 (95% CI 1.14 to 2.84)), but not in women (OR 1.22 (95% CI 0.78 to 1.90)). Conclusion The results of our multilevel analysis suggest that there are gender inequalities in the association of municipal-level deprivation with the prevalence of low perceived social support in Germany independent of individual socioeconomic position. Community health interventions aiming at promotion of social support among residents might profit from a further understanding of the observed gender differences. PMID:29654020

Activities for Teaching State, County, and Municipal Government: A Curriculum Guide for Understanding State, County, and Municipal Government in Oklahoma.

ERIC Educational Resources Information Center

Hopkins, Michael J., Ed.; Wright, Clifford, Ed.

The intent of this curriculum guide is to suggest objectives, teaching methods, and learning activities to aid social studies classroom teachers at the elementary and secondary levels as they incorporate material on state, county, and municipal governments into the curriculum. Although developed for use in Oklahoma public schools, the guide can…

Description of the female of Navicordulia aemulatrix Pinto & Lamas and additional notes on the male (Odonata: Corduliidae).

PubMed

Pinto, A P; Lamas, C J E

2011-01-01

The female of Navicordulia aemulatrix Pinto & Lamas is described and illustrated for the first time based on a single specimen from the same locality of the type series (state of Santa Catarina, [municipality of São Bento do Sul, 26°14'58"S, 49°22'59"W, railroad station] Rio Vermelho, 29.I.1952, in MZSP). In addition, further morphological notes for the male are provided based on three specimens collected at the type locality and at a new locality in the state of Santa Catarina (Timbó municipality). The pronotal process present in N. aemulatrix is re-evaluated and considered non-homologous to that found in Neocordulia setifera (Hagen in Selys) as previously suggested.

The effects of performance appraisal in the Norwegian municipal health services: a case study

PubMed Central

2011-01-01

Introduction Previous research in performance appraisal (PA) indicates that variation exists in learning and job motivation from performance appraisal between occupational groups. This research evaluates the potential effect of job motivation, learning and self-assessment through performance appraisals for health personnel. Case description This article focuses on goal-setting, feedback, participation and training in performance appraisals in municipal health services in Norway; and job motivation, learning and self-assessment of performance are the dependent factors. Questionnaires were distributed to a representative sample of 600 health personnel from the Norwegian municipal health service, with a response rate of 62%. Factor analysis and regression analysis were run in SPSS 12. Discussion and evaluation The study suggests that respondents learn from performance appraisal. Nurses experienced some higher job motivation from performance appraisal than auxiliary nurses. All subordinates perceived higher job motivation after performance appraisal than managers. Conclusion Useful feedback, active participation and higher education are fundamental elements of discussion in performance appraisal, as well as the role of increasing employees' job motivation. In this study, nurses' job motivation seems to be more effected by PA, than for auxiliary nurses. Both nurses and auxiliary nurses indicate that there is a learning effect from PA. This study may be of interest to health researchers and managers in municipal health services. PMID:21974831

[Population dynamics and armed violence in Colombia, 1985-2010].

PubMed

Salaya, Hernán Eduardo; Rodríguez, Jesús

2014-09-01

Describe changes in the population structure of Colombia's municipalities in relation to internal displacement in response to armed violence. A descriptive ecological study was carried out. Secondary sources were consulted, taken from the Consolidated Registry of Displaced Population and from the National Administrative Department of Statistics, to calculate expulsion and reception rates for population displaced by violence from 2002 to 2010. Based on these rates, four groups were created of municipalities in the extreme quartile for each rate during the entire period, which were classified as high expulsion, low expulsion, high reception, and low reception. Subsequently, population pyramids and structure indicators were constructed for each group of municipalities for two comparative reference years (1985 and 2010). Municipalities with high expulsion or reception rates experienced a slower epidemiological transition, with lower mean ages and aging indices. The high expulsion group had the least regression, based on the Sundbärg index. In the high reception group, the masculinity ratio decreased the most, especially among the economically active population, and it had the highest population growth. Population dynamics in Colombia have been affected by armed violence and changes in these dynamics are not uniform across the country, leading to important social, economic, and cultural consequences. This study is useful for decision-making and public policy making.

Breast Developmental Anomalies in Dormaa Municipality of Ghana: Prevalence and Impact on the Life of the Individual

PubMed Central

Agbenorku, P.; Otupiri, E.; Fugar, S.

2013-01-01

Background. Breast developmental anomalies (BDAs) are abnormalities of breast tissue that arise during breast development. Some of the anomalies can have negative impact on the person's life. This study seeks to assess the prevalence of BDA in the Dormaa Municipality in Ghana and its impact on the life of the individual. Materials and Methods. A descriptive study involving 500 female respondents aged between 11 and 25 years from selected schools in the Dormaa Municipality using self-administered questionnaires and interviews. Results. From the study, it was found that the prevalence of BDA in the municipality was 12.8%. The commonest BDA was bilateral hypoplasia which accounted for 31.3% of the BDAs found in the study. Nine (14.1%) complained of the BDA affecting their lives with most being teased in school. Twenty-two (34.4%) girls out of the 64 with BDAs had a family member with a BDA. Conclusion. BDA is a worry; therefore, comprehensive educational programs for health workers and the general public are needed to increase awareness. Also, work should be done to include education on BDA when awareness is being raised about breast cancer and on the importance of breast self-Examination (BSE). PMID:23577249

Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

PubMed Central

Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

2016-01-01

Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil. PMID:26959332

Strengths and weaknesses in the supply of school food resulting from the procurement of family farm produce in a municipality in Brazil.

PubMed

Soares, Panmela; Martinelli, Suellen Secchi; Melgarejo, Leonardo; Davó-Blanes, Mari Carmen; Cavalli, Suzi Barletto

2015-06-01

The objective of this study was to assess compliance with school food programme recommendations for the procurement of family farm produce. This study consists of an exploratory descriptive study utilising a qualitative approach based on semistructured interviews with key informants in a municipality in the State of Santa Catarina in Brazil. Study participants were managers and staff of the school food programme and department of agriculture, and representatives of a farmers' organisation. The produce delivery and demand fulfilment stages of the procurement process were carried out in accordance with the recommendations. However, nonconformities occurred in the elaboration of the public call for proposals, elaboration of the sales proposal, and fulfilment of produce quality standards. It was observed that having a diverse range of suppliers and the exchange of produce by the cooperative with neighbouring municipalities helped to maintain a regular supply of produce. The elaboration of menus contributed to planning agricultural production. However, agricultural production was not mapped before elaborating the menus in this case study and an agricultural reform settlement was left out of the programme. A number of weaknesses in the programme were identified which need to be overcome in order to promote local family farming and improve the quality of school food in the municipality.

[Financial and economic sustainability of public spending on health care by local governments: an analysis of data from municipalities in Mato Grosso State, Brazil].

PubMed

Scatena, João Henrique Gurtler; Viana, Ana Luiza d'Avila; Tanaka, Oswaldo Yoshimi

2009-11-01

Brazil's Unified National Health System is financed according to a model known as fiscal federalism, the fund-sharing rules of the Social Security Budget, Ministry of Health norms, and Constitutional Amendment 29 (EC-29), which links Federal, State, and municipal resources to health. This article discusses the sustainability of public spending on health at the municipal level. Twenty-one municipalities were studied, using municipal budget data. From 1996 to 2006, total current per capita revenues increased by 280% above the accumulated inflation and Gross Domestic Product, varying by size of municipality, which also defined the composition of the municipal budgets. Meanwhile, the budget comprising the basis for EC-29 increased less (178%), thus placing limits on the municipal share of health spending. The results observed in these municipalities are believed to reflect the reality in thousands of other Brazilian municipalities, thus jeopardizing the capacity for municipal investment in health, especially beginning in 2008. The situation may become even worse, considering the repeal of the so-called Bank Transaction Tax (CPMF), Bills of Law 306/08 and 233/08 (currently under review in the National Congress), and the world recession stemming from the U.S. financial crisis.

Registered nurses' use of research findings in the care of older people.

PubMed

Boström, Anne-Marie; Kajermo, Kerstin Nilsson; Nordström, Gun; Wallin, Lars

2009-05-01

To describe registered nurses' reported use of research in the care of older people and to examine associations between research use and factors related to the elements: the communication channels, the adopter and the social system. Research use among registered nurses working in hospital settings has been reported in many studies. Few studies, however, have explored the use of research among registered nurses working in the care of older people. A cross-sectional survey. In eight municipalities, all registered nurses (n = 210) working in older people care were invited to participate (response rate 67%). The Research Utilisation Questionnaire was adopted. Questions concerning the work organisation and research-related resources were sent to the Community Chief Nurse at each municipality. Descriptive statistics and logistic regression were applied. The registered nurses reported a relatively low use of research findings in daily practice, despite reporting a positive attitude to research. The registered nurses reported lack of access to research reports at the work place and that they had little support from unit managers and colleagues. Registered nurses working in municipalities with access to research-related resources reported more use of research than registered nurses without resources. The factors 'Access to research findings at work place', 'Positive attitudes to research' and 'Nursing programme at university level' were significantly associated with research use. There is a great potential to increase registered nurses' use of research findings in the care of older people. Factors which were linked to the communication channels and the adopter were associated with research use. Strategies to enhance research use should focus on access to and adequate training in using information sources, increased knowledge on research methodology and nursing science and a supportive organisation.

Integration of the Atlas of Natural Hazards and the Ecological Territorial Order Program for Puerto Vallarta using GIS.

NASA Astrophysics Data System (ADS)

Trejo-Gómez, E.; Nuñez-Cornu, F.; Suarez-Plascencia, C.; Chavez-Dagostino, R.

2006-12-01

The Atlas of Natural Hazards in Puerto Vallarta (ARN) and the Ecological Territorial Order Program (POET), are documents needed to carry out recommendations to the municipal adminitrations for tasks such as the preservation and recoverment of important zones conserning the natural environment in Puerto Vallarta. These tasks can improve the quality level of life and offer security to the financial investors of this tourist destiny. Both documents are generated with the support of HABITAT Program by the Secretary's of Social Development (SEDESOL) and City Council of Puerto Vallarta. The purpose of this work is to recommend the implementation of a Geographical Information System with the ARN and POET, that responds to the necessities of the municipal goverment in areas like State and Municipal Civil Defense, Urban Planning, Tourism and Ecology. The study has a surface of 340.75 square kilometers and the initial information corresponds to a restitution of year 2000; on graphic scale 1:20,000. At the moment, we have alredy included the descriptions of geology, morphology, seismology, hydrology, type of vegetation, flora and fauna with protected and endemic species. By means of field work, we have related 266 sites with geophysical and hydrometereological hazards. The practices performed by the population in these sites increase their own risk. We have also delimited hazard zones by rock fall, flows and floods along the routes. The valuation is obtained like Affectation-Surface including consolidated houses of different surplus values. In the future, it will be necessary to keep updated the ARN and quantify the information of risks caussed by natural hazards in Puerto Vallarta.

[Estimates of the prevalence of child malnutrition in Brazilian municipalities in 2006].

PubMed

Benício, Maria Helena D'Aquino; Martins, Ana Paula Bortoletto; Venancio, Sonia Isoyama; Barros, Aluísio Jardim Dornellas de

2013-06-01

To estimate the prevalence of malnutrition in children for all Brazilian municipalities. A multilevel logistic regression model was used to estimate the individual probability of malnutrition in 5,507 Brazilian municipalities in 2006, in terms of predictive factors grouped according to hierarchical levels. The response variable was child malnutrition (children aged from six to 59 months with height for age and sex below -2 z-scores, according to the World Health Organization standard). The predictive variables were determinants of malnutrition measured similarly by the National Demographics and Health Survey-2006 and the Sample from the 2000 Demographic Census. At level 1 (individual): sex and age, level 2 (household): socioeconomic variables, water and indoor plumbing, urban or rural area and level 3 (municipal): location of the municipality and coverage of the Family Health Strategy (FHS) in 2006. The study detected a statistically significant chance of malnutrition in male children, those living in households with two or more individuals per room, those belonging to the lowest quintiles of the socioeconomic score, those with three or more children under five in the household, those with no access to running water or located in the North. There was a negative dose-response association between FHS coverage and the chance of malnutrition (p = 0.007). FHS coverage in the municipality equal to or greater than 70% showed a 45% reduction in the chance of infant malnutrition. Estimates of the prevalence of child malnutrition show that most of the cities have the risk of malnutrition under control, very low or low. Risks of greater magnitude exist only in 158 municipalities in the North Region. Childhood malnutrition as a public health problem is concentrated in the cities of the North region, where FHS coverage is lower. A protective effect of FHS in relation to child malnutrition was found in the country as a whole, irrespective of other determinants of the problem.

Breast cancer mortality and associated factors in São Paulo State, Brazil: an ecological analysis.

PubMed

Diniz, Carmen Simone Grilo; Pellini, Alessandra Cristina Guedes; Ribeiro, Adeylson Guimarães; Tedardi, Marcello Vannucci; Miranda, Marina Jorge de; Touso, Michelle Mosna; Baquero, Oswaldo Santos; Santos, Patrícia Carlos Dos; Chiaravalloti-Neto, Francisco

2017-08-23

Identify the factors associated with the age-standardised breast cancer mortality rate in the municipalities of State of São Paulo (SSP), Brazil, in the period from 2006 to 2012. Ecological study of the breast cancer mortality rate standardised by age, as the dependent variable, having each of the 645 municipalities in the SSP as the unit of analysis. The female resident population aged 15 years or older, by age group and municipality, in 2009 (mid-term), obtained from public dataset (Informatics Department of the Unified Health System). Women 15 years or older who died of breast cancer in the SSP were selected for the calculation of the breast cancer mortality rate, according to the municipality and age group, from 2006 to 2012. Mortality rates for each municipality calculated by the direct standardisation method, using the age structure of the population of SSP in 2009 as the standard. In the final linear regression model, breast cancer mortality, in the municipal level, was directly associated with rates of nulliparity (p<0.0001), mammography (p<0.0001) and private healthcare (p=0.006). The findings that mammography ratio was associated, in the municipal level, with increased mortality add to the evidence of a probable overestimation of benefits and underestimation of risks associated with this form of screening. The same paradoxical trend of increased mortality with screening was found in recent individual-level studies, indicating the need to expand informed choice for patients, primary prevention actions and individualised screening. Additional studies should be conducted to explore if there is a causality link in this association. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Breast cancer mortality and associated factors in São Paulo State, Brazil: an ecological analysis

PubMed Central

Diniz, Carmen Simone Grilo; Pellini, Alessandra Cristina Guedes; Ribeiro, Adeylson Guimarães; Tedardi, Marcello Vannucci; de Miranda, Marina Jorge; Touso, Michelle Mosna; Baquero, Oswaldo Santos; dos Santos, Patrícia Carlos

2017-01-01

Objective Identify the factors associated with the age-standardised breast cancer mortality rate in the municipalities of State of São Paulo (SSP), Brazil, in the period from 2006 to 2012. Design Ecological study of the breast cancer mortality rate standardised by age, as the dependent variable, having each of the 645 municipalities in the SSP as the unit of analysis. Settings The female resident population aged 15 years or older, by age group and municipality, in 2009 (mid-term), obtained from public dataset (Informatics Department of the Unified Health System). Participants Women 15 years or older who died of breast cancer in the SSP were selected for the calculation of the breast cancer mortality rate, according to the municipality and age group, from 2006 to 2012. Main outcome measures Mortality rates for each municipality calculated by the direct standardisation method, using the age structure of the population of SSP in 2009 as the standard. Results In the final linear regression model, breast cancer mortality, in the municipal level, was directly associated with rates of nulliparity (p<0.0001), mammography (p<0.0001) and private healthcare (p=0.006). Conclusions The findings that mammography ratio was associated, in the municipal level, with increased mortality add to the evidence of a probable overestimation of benefits and underestimation of risks associated with this form of screening. The same paradoxical trend of increased mortality with screening was found in recent individual-level studies, indicating the need to expand informed choice for patients, primary prevention actions and individualised screening. Additional studies should be conducted to explore if there is a causality link in this association. PMID:28838894

The municipalities of the Northwest region of the Czech Republic adapt to climate change: overview of barriers and challenges

NASA Astrophysics Data System (ADS)

Emmer, Adam; Krkoška Lorencová, Eliška; Vačkář, David

2017-04-01

The municipalities of the Czech Republic have been facing negative impacts of changing climate in the past decades - especially floods (1997, 2002, 2010, 2013), droughts and heat waves (2013, 2015), claiming lives, material damages and economic losses up to several % of GDP. Reflecting these events, climate change adaptation should represent major issue in strategical planning on all administrative levels, which is actually not fully met nowadays. Sectoral National Adaptation Strategy (NAS) was approved by the Government of the Czech Republic in autumn 2015 and the implementation action plan is currently being approved. Adaptation strategies on lower administrative level (adaptation strategies of individual municipalities) are, however, still quite rare. In this contribution, we analyse barriers and challenges for: (i) the development of climate change adaptation strategies on administrative level of individual municipalities in the Northwest region, Czech Republic; and (ii) implementation of adaptation measures into the decision-making processes. Based on participatory seminars with key stakeholders organised in pilot municipalities, it was shown that municipalities are (at least partly) able to cope with existing risks such as floods, but are not well-prepared for expected regionally "new" risks such as long lasting heat waves, insufficient water retention and flash floods. Linking the goals of adaptation strategy with urban planning seems to be challenging task but also potentially powerfull tool to implement specific adaptation measures. It emerged, that complicated ownership relations often cause obstacles for implementation of adaptation measures, highlighting the potential of stimulation and motivation tools from the side of the municipality. On the other hand, it was also shown that despite experiencing its negative impacts, climate change is often neglected or percepted as a marginal issue by some municipalities and developing adaptation strategy is considered needless, referring to another burning issues such as socioeconomic situation. The role of information campaigns and education of stakeholders as well as public regarding climate change and possible future climate change impacts is, therefore, considered highly important task.

Municipal Overburden: Its Influence on Education Expenditures in Cities.

ERIC Educational Resources Information Center

Brazer, Harvey E.; McCarty, Therese A.

The study reported in this document found no evidence for the minicipal overburden (m/o) hypothesis of urban school finance. The theory asserts that there is a causal relationship between high levels of non-school municipal expenditure or tax rates and low levels of school spending. Demand for expenditure on education in a sample of school…

[Gap between the use of and need for youth care: research in Rotterdam neighbourhoods].

PubMed

Jansen, Wilma; Mieloo, Cathelijne L; Anschutz, Justine; de Zwart, Onno

2015-01-01

To determine the relationship between the need for care and the use of care in the youth care system at neighbourhood level and the relationship with population characteristics, with consideration of the decentralisation of youth care. Descriptive, retrospective study. Data on youth care use, indicators of need for care and population characteristics were gathered from monitors and the records of the municipality, institutions and health insurance companies. Data were grouped on a neighbourhood level (n = 49). For the analyses we used univariate and multivariate regression. We used these to distinguish between neighbourhoods with large and small gaps between youth care use and need for youth care. Differences between these neighbourhoods were analysed with t-tests. A multivariate model showed that the percentage of youths with emotional problems and behavioural problems and the percentage of parents with self-reported need for care were not predictors of youth care use at a neighbourhood level. About two thirds of the variance in youth care use between neighbourhoods could be explained by the population characteristics of a neighbourhood, particularly the percentage of youths originally from non-western countries, the percentage of youths with a low level of education or special training and the percentage of people who received income support. The number of 12-18-year-olds in a neighbourhood was a predictor of youth mental health care, and the percentage of youths in a single-parent family was a predictor of out-patient youth and parenting support. Neighbourhoods with a large gap between the need for and use of youth care were socially more disadvantaged than neighbourhoods with a smaller gap. Population characteristics explain the rate of use of youth care better than the need for youth care in a neighbourhood as measured by municipal monitors. The possible gap between the use of and need for youth care on an individual level in neighbourhoods with many characteristics of disadvantage is an important focus point for future neighbourhood teams.

Ombudsmen in health care: case study of a municipal health ombudsman

PubMed Central

da Silva, Rita de Cássia Costa; Pedroso, Marcelo Caldeira; Zucchi, Paola

2014-01-01

OBJECTIVE To analyze the role of a Municipal Health Ombudsman and its contribution to the public health management from the perspective of the public health system users and the municipal health counselors. METHODS Qualitative research approach using the case study, descriptive and transversal methods. The unit of analysis was a Municipal Health Ombudsman, in the state of Minas Gerais, Southeastern Brazil, between May and August 2010. The study was observational in nature and data were collected through interviews with two groups of stakeholders: users and municipal health counselors. We interviewed 44 Brazilian Unified Health System users who had made direct use of the Municipal Health Ombudsman and all 20 municipal health counselors. The data obtained were analyzed based on three issues: (1) nature of the data obtained; (2) discussion of subsidies to qualify the ombudsman’s functioning as a management tool; (3) proposals for actions to improve democratic management in the area of public health. RESULTS The complaints to the ombudsman denoted difficulties in access to health care services running the risk of their being perceived as shortcuts to gaining accessibility, disregarding the principle of social justice. The role of the ombudsman has the citizens’ approval. Users reported the following main functions of the ombudsman: to support the resolution of health problems, to listen and to clarify issues regarding Brazilian Unified Health System operations and procedures. Information was emphasized by health counselors as an instrument of power and access to the rights of Brazilian Unified Health System users. They highlighted that the ombudsman has the role of ensuring justice to foster an effective health policy, besides playing an important mediating role between the board of the municipal health system, its managers and citizens. Furthermore, the ombudsman was shown to have an execution role that transcends its regular functions. CONCLUSIONS The study found that the ombudsman is a key management tool in monitoring the health care system. Therefore, the establishment of the ombudsman is an advance in the field of democratic management. Nevertheless, there are challenges to be overcome in order to improve ombudsman contribution to the execution of health policies and representing citizens in ensuring their rights to health care. PMID:24789646

The importance of social characteristics of communities for the medically based disability pension.

PubMed

Krokstad, Steinar; Magnus, Per; Skrondal, Anders; Westin, Steinar

2004-12-01

The aim of this study was to look for any possible contextual effect of deprivation at municipality level on the risk of being granted the medically based disability pension, controlled for compositional effects due to spatial concentration of people with a high risk of disability. The material consists of the residentiary part of a total Norwegian county population aged 20-54 years without disability pension at baseline, n=40,083. This study was performed as a 10-year follow-up study. The relative risk of being granted a disability pension was estimated by logistic regression analyses as odds ratios (OR) between people living in different municipalities according to a municipality deprivation index at three levels, adjusted for individual factors. The OR of disability pension was 1.36 (1.22, 1.51) for people residing in intermediate deprived municipalities and 1.48 (1.31, 1.67) for people residing in the most deprived municipalities compared to the most affluent municipalities, adjusted for gender and age. After adjustment for individual risk factors the OR was 1.26 (1.12, 1.41) and 1.18 (1.04, 1.35) respectively. Analyses stratified by gender showed that the increased risk of receiving a disability pension for men in the most deprived municipalities was explained by individual factors alone. Relative municipality deprivation seems to account for an increase in the incidence of disability pension. This effect contributes to marginalization of people living in less affluent areas out of employment and thus to widening socioeconomic inequalities in the population.

[Food and nutritional security: situation analysis of decentralization in the national public policy].

PubMed

Vasconcellos, Ana Beatriz Pinto de Almeida; Moura, Leides Barroso Azevedo de

2018-03-01

The aim of this study was to analyze the situation with the decentralization of the Brazilian National System of Food and Nutritional Security (SISAN), created in 2006 under the Brazilian National Food and Nutritional Security Act (LOSAN). Based on the criteria for joining SISAN, as set out in Decree 7,272 of August 25, 2010, the authors analyzed data from the basic information surveys of the Brazilian Institute of Geography and Statistics, 2014 (Estadic e Munic/2014). The results show that decentralization of SISAN is still incipient at the municipal level, although all the states of Brazil have already joined the system. The social assistance sector has played an outstanding role in coordinating SISAN at the state and municipal levels, while in the latter the health sector has also played a relevant role. The analysis of food and nutritional security activities conducted to date, based on the sources of federal, state, and municipal funds, further shows that the federal sphere has still not played a strong inductive role capable of leading the expansion of SISAN. More effective funding mechanisms and the assignment of responsibilities to the states and municipalities are relevant factors for consolidating the system's state-level base and expanding the municipal base in the search for an identity and capillarity for SISAN.

Influence of Head Teachers' General and Instructional Supervisory Practices on Teachers' Work Performance in Secondary Schools in Entebbe Municipality, Wakiso District, Uganda

ERIC Educational Resources Information Center

Jared, Nzabonimpa Buregeya

2011-01-01

The study examined the Influence of Secondary School Head Teachers' General and Instructional Supervisory Practices on Teachers' Work Performance. Qualitative and qualitative methods with a descriptive-correlational research approach were used in the study. Purposive sampling technique alongside random sampling technique was used to select the…

Income inequality, socioeconomic deprivation and depressive symptoms among older adults in Mexico.

PubMed

Fernández-Niño, Julián Alfredo; Manrique-Espinoza, Betty Soledad; Bojorquez-Chapela, Ietza; Salinas-Rodríguez, Aarón

2014-01-01

Depression is the second most common mental disorder in older adults (OA) worldwide. The ways in which depression is influenced by the social determinants of health - specifically, by socioeconomic deprivation, income inequality and social capital - have been analyzed with only partially conclusive results thus far. The objective of our study was to estimate the association of income inequality and socioeconomic deprivation at the locality, municipal and state levels with the prevalence of depressive symptoms among OA in Mexico. Cross-sectional study based on a nationally representative sample of 8,874 OA aged 60 and over. We applied the brief seven-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to determine the presence of depressive symptoms. Additionally, to select the principal context variables, we used the Deprivation Index of the National Population Council of Mexico at the locality, municipal and state levels, and the Gini Index at the municipal and state levels. Finally, we estimated the association of income inequality and socioeconomic deprivation with the presence of depressive symptoms using a multilevel logistic regression model. Socioeconomic deprivation at the locality (OR = 1.28; p<0.10) and municipal levels (OR = 1.16; p<0.01) correlated significantly with the presence of depressive symptoms, while income inequality did not. The results of our study confirm that the social determinants of health are relevant to the mental health of OA. Further research is required, however, to identify which are the specific socioeconomic deprivation components at the locality and municipal levels that correlate with depression in this population group.

Resources and quality of care in services for the elderly.

PubMed

Winsløw, Jacob Hilden; Borg, Vilhelm

2008-05-01

To investigate the association between resources of the workplace and the quality of care in municipal long-term care. At the municipal level, the resources comprised the proportion of care workers with a long period of professional training and the relative availability of care-giving manpower. At the level of the organizational unit, the resources comprised aspects of the psychosocial working environment. A survey of 7,500 care workers in 36 municipalities in Denmark was performed. Quality of care was measured by seven standardized questions in a questionnaire. Data on the psychosocial resources of the workplace were aggregated responses from the care workers to questions from the Copenhagen Psychosocial Questionnaire. Data on the training and relative availability of care workers were derived by combining information from payroll lists and data available from government databases. There was a positive association between psychosocial resources at the level of the organizational unit and the quality of care provided by the individual care worker. There was no association between the level of professional training of the municipal workforce of care-givers and the quality of care provided by the individual care worker. There was a complex relationship between the relative availability of care-giving manpower at the municipal level and the quality of care provided by the individual care worker. Improving the psychosocial working environment of care workers is one key to securing sufficient caring staff for the long-term care sector; increasing manpower or increasing the proportion of highly trained staff are not in themselves such keys.

Gender inequalities in the association between area deprivation and perceived social support: a cross-sectional multilevel analysis at the municipality level in Germany.

PubMed

Mena, Emily; Kroll, Lars Eric; Maier, Werner; Bolte, Gabriele

2018-04-12

To investigate the association between area deprivation at municipality level with low perceived social support, independent of individual socioeconomic position and demographic characteristics. To assess whether there are gender inequalities in this association. Cross-sectional multilevel analysis of survey data. Germany. 3350 men and 3665 women living in 167 municipalities throughout Germany participating in the 'German Health Interview and Examination Survey for Adults' (DEGS1 2008-2011) as part of the national health monitoring. Perceived social support as measured by Oslo-3 Social Support Scale. Prevalence of low perceived social support was 11.4% in men and 11.1% in women. Low social support was associated in men and women with sociodemographic characteristics that indicate more disadvantaged living situations. Taking these individual-level characteristics into account, municipal-level deprivation was independently associated with low perceived social support in men (OR for the most deprived quintile: 1.80 (95% CI 1.14 to 2.84)), but not in women (OR 1.22 (95% CI 0.78 to 1.90)). The results of our multilevel analysis suggest that there are gender inequalities in the association of municipal-level deprivation with the prevalence of low perceived social support in Germany independent of individual socioeconomic position. Community health interventions aiming at promotion of social support among residents might profit from a further understanding of the observed gender differences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Skills for the literacy process.

PubMed

Côrrea, Kelli Cristina do Prado; Machado, Maria Aparecida Miranda de Paula; Hage, Simone Rocha de Vasconcellos

2018-03-01

Examine a set of competencies in children beginning the process of literacy and find whether there is positive correlation with their level of writing. Study conducted with 70 six-year-old students enrolled in the first year of Elementary School in municipal schools. The children were submitted to the Initial Reading and Writing Competence Assessment Battery (BACLE) and the Diagnostic Probing Protocol for classification of their level of writing. Descriptive statistical analysis and the Spearman coefficient were used for correlation between instruments. The students presented satisfactory performance in the tasks of the BACLE. Regarding the writing hypothesis, most children presented syllabic level with sound value. Significant positive correlation was observed between body scheme/time-space orientation and language skills. The group of schoolchildren performed satisfactorily on tests that measure pre-reading and writing skills. The areas of body scheme/time-space orientation and language presented significant correlation with the level of writing hypothesis, indicating that children with higher scores in these areas present better levels of writing. Identification of the necessary competencies for learning of reading and writing can provide teachers and educational audiology professionals with conditions for evaluation and early intervention in certain abilities for the development of reading and writing.

[Social environment and risky eating behaviors: an exploratory study in adolescent females in Mexico].

PubMed

Bojorquez, Ietza; Saucedo-Molina, Teresita de Jesús; Juárez-García, Francisco; Unikel-Santoncini, Claudia

2013-01-01

The objectives of the current study were to explore: (1) the association between the social environment at the city and family levels and risky eating behaviors in adolescent females and (2) the interaction between the social and cultural environment and body mass index (BMI). The data were obtained from a representative survey of female high school students in Mexico State, Mexico (15-19 years). A questionnaire was applied on risky eating behaviors and socio-demographic data. The municipal social and cultural environment was evaluated using the municipal marginalization index. Data analysis used multivariate regression. Prevalence of risky eating behaviors was 4.23%. BMI and family socioeconomic status were directly associated with risky eating behaviors. The municipal marginalization index was not associated with risky eating behaviors. Possible explanations for the latter are that the relevant components of the social and cultural environment were not measured, or that the municipal level does not exert a contextual effect on risky eating behaviors. The effect of BMI on risky eating behaviors was greater in more marginalized municipalities.

Nonstate Actors in Colombia: Threat and Response

DTIC Science & Technology

2002-05-01

municipalities in 1985 to 622 in 1995, out of a total of approximately 1,050.18 Thus, Colombian insurgents have taken control of large portions of the...AUC, interestingly, mirror those of the insurgents. They seek to expand their control of grass-roots levels of government— municipalities or townships...percent of the municipalities in the country.21 6 Despite paramilitary success against insurgents where the state has been absent or ineffective and

Local negotiation on compensation siting of the spent nuclear fuel repository in Finland

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kojo, Matti

The aim of the paper is to analyse the local negotiation process between the Municipality of Eurajoki and the nuclear power company Teollisuuden Voima (TVO) and the nuclear waste management company Posiva Oy. The aim of the negotiations was to find an acceptable form of compensation for siting a spent nuclear fuel repository in Olkiluoto, Finland. The paper includes background information on the siting process in Finland, the local political setting in the Municipality of Eurajoki and a description of the negotiation process. The analysis of the negotiations on compensation is important for better understanding the progress of the Finnishmore » siting process. The paper describes the picture of the contest to host the spent nuclear fuel repository. It also provides more information on the relationship between the Municipality of Eurajoki and the power company TVO. The negotiations on compensation and the roles of various players in the negotiations have not been studied in detail because the minutes of the Vuojoki liaison group were not available before the decision of the Supreme Administrative Court in May 2006. (author)« less

Public water supplies in eastern Texas

USGS Publications Warehouse

Sundstrom, Raymond W.; Hastings, W.W.; Broadhurst, W.L.

1948-01-01

This report gives a summarized description of the public water supplies in 77 counties of eastern Texas, extending from the Louisiana boundary to a northsouth line approximately along the ninety-seventh meridian. It gives the available data as follows for each of 323 communities: The population of the community; the name of the official from whom the information was obtained; the ownership of the waterworks, whether private or municipal; the source of supply, whether ground or surface water; the amount of water consumed; the facilities for storage; the number of customers served; the character of the chemical and sanitary treatment of the water, if any; and the chemical analyses of the water. Where ground water is used the following is also given: Records of wells, including drillers' logs; character of the pumping equipment; yield of the wells and water level records where they are available.

Local energy governance in vermont: an analysis of energy system transition strategies and actor capacity

NASA Astrophysics Data System (ADS)

Rowse, Tarah

While global, national, and regional efforts to address climate and energy challenges remain essential, local governments and community groups are playing an increasingly stronger and vital role. As an active state in energy system policy, planning and innovation, Vermont offers a testing ground for research into energy governance at the local level. A baseline understanding of the energy planning and energy organizing activities initiated at the local level can support efforts to foster a transition to a sustainable energy system in Vermont. Following an inductive, applied and participatory approach, and grounded in the fields of sustainability transitions, energy planning, and community energy, this research project identifies conditions for change, including opportunities and challenges, within Vermont energy system decision-making and governance at the local level. The following questions are posed: What are the main opportunities and challenges for sustainable energy development at the town level? How are towns approaching energy planning? What are the triggers that will facilitate a faster transition to alternative energy systems, energy efficiency initiatives, and localized approaches? In an effort to answer these questions two studies were conducted: 1) an analysis of municipal energy plans, and 2) a survey of local energy actors. Study 1 examined Vermont energy planning at the state and local level through a review and comparison of 40 municipal plan energy chapters with the state 2011 Comprehensive Energy Plan. On average, municipal plans mentioned just over half of the 24 high-level strategies identified in the Comprehensive Energy Plan. Areas of strong and weak agreement were examined. Increased state and regional interaction with municipal energy planners would support more holistic and coordinated energy planning. The study concludes that while municipalities are keenly aware of the importance of education and partnerships, stronger policy mechanisms and financial stimulus are essential if Vermont hopes to increase strategic energy planning alignment and spur whole-scale energy system change. Study 2 examined local energy actors to assess their ability to develop and sustain energy action on the local level. A survey of 120 municipalities collected statewide baseline data covering the structures, processes, and activities of local energy actors. The analysis examined the role that various forms of capacity play in local energy activity. The results show that towns with higher incomes are more likely to have local energy actors and towns with higher populations have higher aggregate energy activity levels. Structurally, energy actors that had both an energy coordinator and an energy committee were more active, and municipal committees were more active than independent committees. Access to a budget and volunteer engagement were both associated with higher activity levels. The network of local energy actors in Vermont consists of committed and knowledgeable volunteers. Yet, the capacity of these local energy actors to implement sustainable energy change is limited due to resource constraints of time and money. In most cases, the scope of municipal energy planning strategy is modest. Prioritization of strategy and action at the central and local levels, along with increased interaction and coordination, is necessary to increase the regional compatibility and pace of energy system transformation.

Regionalized LCA-based optimization of building energy supply: method and case study for a Swiss municipality.

PubMed

Saner, Dominik; Vadenbo, Carl; Steubing, Bernhard; Hellweg, Stefanie

2014-07-01

This paper presents a regionalized LCA-based multiobjective optimization model of building energy demand and supply for the case of a Swiss municipality for the minimization of greenhouse gas emissions and particulate matter formation. The results show that the environmental improvement potential is very large: in the optimal case, greenhouse gas emissions from energy supply could be reduced by more than 75% and particulate emissions by over 50% in the municipality. This scenario supposes a drastic shift of heat supply systems from a fossil fuel dominated portfolio to a portfolio consisting of mainly heat pump and woodchip incineration systems. In addition to a change in heat supply technologies, roofs, windows and walls would need to be refurbished in more than 65% of the municipality's buildings. The full potential of the environmental impact reductions will hardly be achieved in reality, particularly in the short term, for example, because of financial constraints and social acceptance, which were not taken into account in this study. Nevertheless, the results of the optimization model can help policy makers to identify the most effective measures for improvement at the decision making level, for example, at the building level for refurbishment and selection of heating systems or at the municipal level for designing district heating networks. Therefore, this work represents a starting point for designing effective incentives to reduce the environmental impact of buildings. While the results of the optimization model are specific to the municipality studied, the model could readily be adapted to other regions.

ETHNOBIOLOGICAL SURVEY OF PLANTS AND ANIMALS USED FOR THE TREATMENT OF ACUTE RESPIRATORY INFECTIONS IN CHILDREN OF A TRADITIONAL COMMUNITY IN THE MUNICIPALITY OF BARBALHA, CEARÁ, BRAZIL

PubMed Central

Lemos, Izabel Cristina Santiago; Delmondes, Gyllyandeson de Araújo; dos Santos, Ana Deyva Ferreira; Santos, Enaide Soares; de Oliveira, Dayanne Rakelly; de Figueiredo, Patrícia Rosane Leite; Alves, Dailon de Araújo; Barbosa, Roseli; de Menezes, Irwin Rose Alencar; Coutinho, Henrique Douglas Melo; Kerntopf, Marta Regina; Fernandes, George Pimentel

2016-01-01

Background: The use of natural resources for the treatment of acute respiratory infections in children is a widespread practice within traditional communities, especially by women by being the primary caregivers. This study aimed to perform ethnobiological survey of plants and animals used for the treatment of acute respiratory infections in children of a traditional community in the municipality of Barbalha, Ceará, Brazil. Methods: It is a descriptive exploratory study with a quantitative approach, developed in Sitio Santo Antonio, in the municipality of Barbalha, Ceará, Brazil. As a tool for data collection, was applied a questionnaire and a semi-structured interview. Data analysis used descriptive statistics (simple and percentage rate) and the Relative Frequency of Citation. Results: The research included a total of 54 informants. In total, there were 38 species cited. According to the Relative Frequency of Citation the following species were the most cited: Ocimum basilicum L. (0.59), Eucalyptus globulus Labili (0.59), Plectranthus amboinicus (L.) Spreng (0.42), Hyptis suaveolens (L.) Poit. (0.24), Allium aescalonicum L. (0.22) and Mentha arvensis L. (0.18). Among the symptoms mentioned by the research subjects to treat the acute respiratory infections in childhood, there were: fever; cough; coughing with secretions; sore throat; hoarseness; tiredness; nasal congestion. Conclusions: It is important the knowledge about the usefulness of natural resources as alternative practices in diseases treatment, seeking to rescue popular knowledge used in the traditional community and fomenting the need to consider cultural aspects in the full practice to children’s health care. PMID:28852733

Formative Peacetime Engagement Workshop Report

DTIC Science & Technology

1999-09-01

the 1998 Government Budget resulted in a greater proportion of the business tax going to municipalities (10% vs . the traditional 6.5%). Five regional...economic and political tire of Ukraine through entrepreneurship and leadership training, support to women’s credit unions and strengthening NGOs that...program and has negotiated a program agreement with a new bank to continue the loan program. Description: USAID is promoting entrepreneurship by

Geo-epidemiologic mapping in the new public health surveillance. The malaria case in Chiapas, Mexico, 2002.

PubMed

Castillo-Salgado, Carlos

2017-01-01

The new public health surveillance requires at the global, national and local levels the use of new authoritative analytical approaches and tools for better recognition of the epidemiologic characteristics of the priority health events and risk factors affecting the population health. The identification of the events in time and space is of fundamental importance so that the geo-spatial description of the situation of diseases and health events facilitates the identification of social, environmental and health care related risks. This assessment examines the application and use of geo-spatial tools for identifying relevant spatial and epidemiological conglomerates of malaria in Chiapas, Mexico. The study design was ecological and the level of aggregation of the collected information of the epidemiological and spatial variables was municipalities. The data were collected in all municipalities of the state of Chiapas, Mexico during the years 2000-2002. The main outcome variable was cases and types of malaria diagnosed by blood smears in weekly reports. Independent variables were age, sex, ethnicity, literacy of the cases of malaria and environmental factors such as altitude, road type and network in the municipalities and cities of Chiapas. The production of thematic maps and the application of geo-spatial analytical tools such Moran and local indicator of spatial autocorrelation metrics for malaria clustering allowed the visualization and recognition that the important population risk factors associated with high malaria incidence in Chiapas were low literacy rate, areas with high percentage of indigenous population that reflects the social inequalities gaps in health and the great burden of disease that is affecting this important vulnerable group in Chiapas. The presence of road networks allowed greater spatial diffusion of Malaria. An important epidemiological and spatial cluster of malaria was identified in the areas and populations in the proximity of the southern border. The use of geospatial metrics in local areas will assist in the epidemiological stratification of malaria for better targeting more effective and equitable prevention and control interventions. Copyright: © 2017 SecretarÍa de Salud.

Income Inequality, Socioeconomic Deprivation and Depressive Symptoms among Older Adults in Mexico

PubMed Central

Fernández-Niño, Julián Alfredo; Manrique-Espinoza, Betty Soledad; Bojorquez-Chapela, Ietza; Salinas-Rodríguez, Aarón

2014-01-01

Objective Depression is the second most common mental disorder in older adults (OA) worldwide. The ways in which depression is influenced by the social determinants of health – specifically, by socioeconomic deprivation, income inequality and social capital - have been analyzed with only partially conclusive results thus far. The objective of our study was to estimate the association of income inequality and socioeconomic deprivation at the locality, municipal and state levels with the prevalence of depressive symptoms among OA in Mexico. Methods Cross-sectional study based on a nationally representative sample of 8,874 OA aged 60 and over. We applied the brief seven-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to determine the presence of depressive symptoms. Additionally, to select the principal context variables, we used the Deprivation Index of the National Population Council of Mexico at the locality, municipal and state levels, and the Gini Index at the municipal and state levels. Finally, we estimated the association of income inequality and socioeconomic deprivation with the presence of depressive symptoms using a multilevel logistic regression model. Results Socioeconomic deprivation at the locality (OR = 1.28; p<0.10) and municipal levels (OR = 1.16; p<0.01) correlated significantly with the presence of depressive symptoms, while income inequality did not. Conclusions The results of our study confirm that the social determinants of health are relevant to the mental health of OA. Further research is required, however, to identify which are the specific socioeconomic deprivation components at the locality and municipal levels that correlate with depression in this population group. PMID:25250620

A new species of Brachycephalus (Anura, Brachycephalidae) from the coast of Santa Catarina State, southern Atlantic Forest, Brazil.

PubMed

De Carli Monteiro, Juliane Petry; Condez, Thais Helena; De Anchietta Garcia, Paulo Christiano; Comitti, EstevÃo Jasper; Amaral, Ivan Borel; Haddad, CÉlio Fernando Baptista

2018-04-12

We describe a new species of Brachycephalus from municipality of São Francisco do Sul and municipality of Itapoá, in the state of Santa Catarina, Brazil, southern Atlantic Forest. The new species is known from six localities from near sea level up to 250 meters and represents the first record of a "pumpkin-toadlet" occurring in the lowlands. Morphological traits and phylogenetic analysis of a fragment the 16S mtDNA gene place the new species in the Brachycephalus pernix group. The new species is supported by external morphology, osteology, advertisement call, and mtDNA divergence. It is characterized, among other traits by a dorsal body color dark green with a dark brown vertebral stripe, and an orange background; snout-vent length of 9.2-10.8 mm in males and 11.1-12.4 mm in females; and advertisement call short (0.02-0.03 seconds), composed of one high-frequency note (dominant frequency 6.6-7.3 kHz). We observed synchronized alternation in the emission of vocalizations among neighbor males, indicating that males of the new species are able to hear and use vocalizations to interact with each other. We provide descriptions of clutch, eggs, and juvenile and observations on parental care. The new species has not been recorded within any protected area and can be threatened by human-induced habitat loss and modification.

[Mortality by homicides in Colombia, 1998-2012].

PubMed

Chaparro-Narváez, Pablo; Cotes-Cantillo, Karol; León-Quevedo, Willian; Castañeda-Orjuela, Carlos

2016-12-01

Homicide is a universal indicator of social violence with large public health consequences. To describe mortality by homicides and to analyze its trends and geographic distribution in Colombia between 1998 and 2012. We conducted a descriptive study of deaths by homicide in Colombia between 1998 and 2012 using official mortality databases and the population projections of the Departamento Administrativo Nacional de Estadística, DANE. We calculated age- and sex-specific mortality rates, and we analyzed the geographical distribution of mean-adjusted homicide mortality rates at municipal level. Between 1998 and 2012, 331,470 homicides were reported in Colombia. The mean crude rate was 51.5 per 100,000 inhabitants: 95.9 in men and 8.2 in women. Since 2003, a decrease in the number of deaths and rates was observed; 91.9% of the victims were men and the highest mortality rates were reported in the 20-29 years old group. The most frequently involved mechanism was the firearm: Eight of 10 homicides in men, and seven of 10 homicides in women. Out of 1,122 municipalities, 186 were in the highest quintile, accumulating 50.1% of all deaths. In Colombia, homicides have been one of the leading causes of death with a trend towards reduction since 2002. Its geographical distribution has been heterogeneous. To continue addressing this public health issue we must recur to multidisciplinary analytical methodologies for a better understanding of the phenomenon.

What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway.

PubMed

Gjestsen, Martha Therese; Wiig, Siri; Testad, Ingelin

2017-09-07

To identify contextual factors at different organisational levels to guide the implementation of an assistive living technology intervention in Norwegian primary home care. A single embedded case study design was carried out in an urban municipality in Western Norway to get an overview of key contextual factors from the municipality's perspective. The data collection was based on a triangulation of methods involving document analysis, semi-structured individual interviews and focus group interviews to get a broad insight when preparing for an intervention. Data were collected on three levels of the healthcare system: (1) national policy documents and regulations (macro), (2) five individual interviews with senior managers and municipal strategy documents (meso) and (3) two focus group interviews with nurses and nurse managers in direct patient care (micro). The Model for Understanding Success in Quality framework was used as a guide in the data analysis. The main contextual factors identified were external motivators and project sponsorship (macro level); leadership, workforce focus and maturity (meso level);and motivation to change and maturity (micro level). Strategies developed in policy documents affected upper management in the municipality, but healthcare personnel at the micro level were not so familiar with strategies and emphasis on assistive living technologies. Healthcare personnel in our study were motivated to use technological solutions, but lack of data infrastructure and resource availability hindered this. Aligning interests across multiple stakeholders remain a challenge when planning for an assistive living technology intervention in primary care. In the studied municipality, integration of technological solutions into healthcare services was more a vision than a reality because of a low level of organisational readiness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Assessment and comparison of hospital operating efficiency under different management systems].

PubMed

2017-06-18

To assess and analyze the operation efficiency of 8 commission general public hospitals managed directly by National Health and Family Planning Commission and 8 municipal general hospitals managed directly by Beijing Municipal Administration of Hospitals in Beijing and to provide suggestions on improving service capacity and designing relevant health policy. Input and output data of 8 commission hospitals and 8 municipal hospitals were obtained from Beijing Direct-Reported Health Statistics data from 2011 to 2014. Data envelopment analysis was used as the hospital operation efficiency measurement tool. The CCR and BCC models were built to calculate technical efficiency (TE), pure technical efficiency (PTE), scale efficiency (SE) and the status of scale efficiency of 16 hospitals in 2011 and 2014; the Malmquist index model was built to analyze the total factor productivity change (TFPC), technological change (TC), technical efficiency change, pure technical efficiency change and scale efficiency change of the 16 hospitals from 2011 to 2014. In 2011, the TE, PTE and SE of the commission hospitals were higher than those of the municipal hospitals, and the TEs of the commission hospitals and the municipal hospitals were 0.918 and 0.873 respectively. In 2014, the TE, PTE and SE of commission hospitals were lower than those of the municipal hospitals, and the TE of the commission hospitals and the municipal hospitals were 0.906 and 0.951, respectively, which was contrary to the results in 2011. According to the Malmquist index model, the average of TFPC of the municipal hospitals was larger than that of the commission hospitals, the former increased 5.9% and the latter increased 2.8% per year; the average of TC was greater than the one in both the municipal hospitals and the commission hospitals, with a growth of 3.2% and 2.9% per year, respectively; the average growth of PTE in the commission hospitals was lower than that of the municipal hospitals, and the average descent of SE in the commission hospitals was larger than that in the municipal hospitals. There are significant differences in the operation efficiency between different management systems and the main factors associated with operation efficiency are the technological and management level. Given scale efficiency status and macroeconomic medical policies, the commission hospitals and the municipal hospitals require further adjusting the distribution of medical resources, and it is of great significance for all the commission hospitals and the municipal hospitals to improve the management level and resource integration capability.

Better parks through law and policy: a legal analysis of authorities governing public parks and open spaces.

PubMed

Henderson, Ana; Fry, Christine R

2011-01-01

Improving parks in low income and minority neighborhoods may be a key way to increase physical activity and decrease overweight and obesity prevalence among children at the greatest risk. To advocate effectively for improved recreation infrastructure, public health advocates must understand the legal and policy landscape in which public recreation decisions are made. In this descriptive legal analysis, we reviewed federal, state, and local laws to determine the authority of each level of government over parks. We then examined current practices and state laws regarding park administration in urban California and rural Texas. We identified several themes through the analysis: (1) multiple levels of governments are often involved in parks offerings in a municipality, (2) state laws governing parks vary, (3) local authority may vary substantially within a state, and (4) state law may offer greater authority than local jurisdictions use. Public health advocates who want to improve parks need to (1) think strategically about which levels of government to engage; (2) identify parks law and funding from all levels of government, including those not typically associated with local parks; and (3) partner with advocates with similar interests, including those from active living and school communities.

Implementation of public policy on alcohol and other drugs in Brazilian municipalities: comparative studies.

PubMed

Mota, Daniela Belchior; Ronzani, Telmo Mota

2016-07-01

One of the challenges with respect to public health and the abuse of alcohol and other drugs is to implement policies in support of greater co-ordination among various levels of government. In Brazil, policies are formulated by the Secretaria Nacional de Políticas sobre Drogas (SENAD - State Department for Policies on Drugs) and the Ministério da Saúde (MS - Ministry of Health). This study aims to compare implementation of policies adopted by SENAD and MS at the municipal level. Three municipalities were intentionally selected: Juiz de Fora having a larger network of treatment services for alcohol and drug users; Lima Duarte, a small municipality, which promotes the political participation of local actors (COMAD - Municipal Council on Alcohol and Drugs); and São João Nepomuceno, also a small municipality, chosen because it has neither public services specialised to assist alcohol and other drugs users, nor COMAD. Data collection was conducted through interviews with key informants (n = 19) and a review of key documents concerned with municipal policies. Data analysis was performed using content analysis. In Juiz de Fora, there are obstacles regarding the integration of the service network for alcohol and other drug users and also the articulation of local actors, who are predominant in the mental health sector. In Lima Duarte, while there is a link between local actors through COMAD, their actions within the local service network have not been effective. In São João Nepomuceno, there were no public actions in the area of alcohol and drugs, and consequently insufficient local debate. However, some voluntary, non-governmental work has been undertaken. There were weaknesses in the implementation of national-level policies by SENAD and the MS, due to the limited supply of available treatment, assistance and the lack of integration among local actors. © 2015 John Wiley & Sons Ltd.

Health and equity in all policies in local government: processes and outcomes in two Norwegian municipalities.

PubMed

Von Heimburg, Dina; Hakkebo, Berit

2017-08-01

To identify key factors in implementing Health and Equity in All Policies (HEiAP) at the local level in two Norwegian municipalities in order to accelerate the progress of promoting health, well-being and equity in other local governments. This case study is presented as a narrative from policy-making processes in two Norwegian municipalities. The story is told from an insider perspective, with a focus on HEiAP policy makers in these two municipalities. The narrative identified key learning from implementing HEiAP at the local level, i.e. the importance of strengthening system and human capacities. System capacity is strengthened by governing HEiAP according to national legislation and a holistic governance system at the local level. Municipal plans are based on theory, evidence and local data. A 'main story' is developed to support the vision, defining joint societal goals and co-creation strategies. Policies are anchored by measuring and monitoring outcomes, sharing accountability and continuous dialogue to ensure political commitment. Human capacity is strengthened through participatory leadership, soft skills and health promotion competences across sectors. Health promotion competence at a strategic level in the organization, participation in professional networks, crowd sourcing toward common goals, and commitment through winning hearts and minds of politicians and other stakeholders are vital aspects. Our experience pinpoints the importance of strengthening system and human capacity in local governments. Further, we found it important to focus on the two strategic objectives in the European strategy 'Health 2020': (1) Improving health for all and reducing health inequalities; (2) improving leadership and participatory governance for health.

Use of surface water in drinking water production associated with municipal Legionnaires' disease incidence.

PubMed

Den Boer, J W; Coutinho, R A; Yzerman, E P F; van der Sande, M A B

2008-04-01

Given an observed geographical variation in Legionnaires' disease incidence in The Netherlands, the aim of the study was to test the hypothesis that the type of drinking water production was an independent determinant of the incidence of Legionnaires' disease. For the 1987-2005 period, the incidence of Legionnaires' disease in The Netherlands and the price of water as a proxy for production type was studied at the municipal level. The data on the price of water were available at the municipal level. For each of the 466 municipalities in The Netherlands a mean standardised incidence rate per 100,000 inhabitants over the 1987-2005 period was calculated, excluding patients with the most probable source of infection abroad or in hospital. Logistic regression was used to assess the relation of the price of water to the incidence rates. In order to control for diagnostic and inclusion bias, they were estimated using questionnaire data collected from all 62 medical microbiology laboratories in the country. The incidence of Legionnaires' disease varied between municipalities from 0.0 to 5.6 per 100,000 person-years. In univariate analysis high versus low water price was positively associated with a high municipal incidence rate (odds ratio (OR) 1.9; 95% CI 1.5-2.6). The association persisted (OR 5.1; 95% CI 3.2-8.0) after correction for diagnostic and inclusion bias. The price of water as a proxy for the type of water production was an independent risk factor for high municipal Legionnaires' disease incidence in The Netherlands. This can guide future prevention policies.

Level of quality management in the Municipal Sports Services, contrast trough EFQM Excellence Model.

PubMed

Martínez-Moreno, Alfonso; Díaz Suárez, Arturo

2016-01-01

The quality management in the Municipal Sports Services is embedded in the servuction provided to the citizens, which are their internal customers who determine the quality improvement ensuring competitiveness with excellence criteria. The Model of the European Foundation for Quality Management enables the evaluation of organization progress towards achieving quality goals, from a structured, measurable and comparable methodology. The aim is to carry out a diagnosis of the level of implementation of quality in the Municipal Sports Services of the Region of Murcia, Spain. The sample of 287 workers of 30 sports services gets a high level of reliability at all scales, with a coefficient of variation of .985 (range .810-.943). The score in the criteria of Policy and Strategy, People Management, Alliances and Resources, Processes and People Results were significantly higher (p < .05) in the Municipalities with more than 25,000 inhabitants when compared with those less than 10,000 and with those from 10,000 to 25,000 inhabitants obtaining global ratings of 571 points, those less than 10,000, 590 points those from 10,000 to 25,000 and those higher than 25,000 reach 636, having a good level of quality in relation to the scale that determines the model.

Do elections matter for private-sector healthcare management in Brazil? An analysis of municipal health policy.

PubMed

McGregor, Alecia J; Siqueira, Carlos Eduardo; Zaslavsky, Alan M; Blendon, Robert J

2017-07-12

This study analyzed several political determinants of increased private-sector management in Brazilian health care. In Brazil, the poor depend almost exclusively on the public Unified Health System (the SUS), which remains severely underfunded. Given the overhead costs associated with privately contracted health services, increased private management is one driver of higher expenditures in the system. Although left parties campaign most vocally in support of greater public control of the SUS, the extent to which their stated positions translate into health care policy remains untested. Drawing on multiple publicly available data sources, we used linear regression to analyze how political party-in-power and existing private sector health care contracting affect the share of privately managed health care services and outsourcing in municipalities. Data from two election periods-2004 to 2008 and 2008 to 2012-were analyzed. Our findings showed that although private sector contracting varies greatly across municipalities, this variation is not systematically associated with political party in power. This suggests that electoral politics plays a relatively minor role in municipal-level health care administration. Existing levels of private sector management appear to have a greater effect on the public-private makeup of the Brazilian healthcare system, suggesting a strong role of path dependence in the evolution of Brazilian health care delivery. Despite campaign rhetoric asserting distinct positions on privatization in the SUS, factors other than political party in power have a greater effect on private-sector health system management at the municipal-level in Brazil. Given the limited effect of elections on this issue, strengthening participatory bodies such as municipal health councils may better enfranchise citizens in the fundamental debate over public and private roles in the health care sector.

The role of spatial mobility in malaria transmission in the Brazilian Amazon: The case of Porto Velho municipality, Rondônia, Brazil (2010-2012)

PubMed Central

Sabroza, Paulo Chagastelles; de Carvalho, Lino Augusto Sander; Nobre, Carlos Afonso

2017-01-01

Background This study aims to describe the role of mobility in malaria transmission by discussing recent changes in population movements in the Brazilian Amazon and developing a flow map of disease transmission in this region. Methodology/Principal findings This study presents a descriptive analysis using an ecological approach on regional and local scales. The study location was the municipality of Porto Velho, which is the capital of Rondônia state, Brazil. Our dataset was obtained from the official health database, the population census and an environmental database. During 2000–2007 and 2007–2010, the Porto Velho municipality had an annual population growth of 1.42% and 5.07%, respectively. This population growth can be attributed to migration, which was driven by the construction of the Madeira River hydroelectric complex. From 2010 to 2012, 63,899 malaria-positive slides were reported for residents of Porto Velho municipality; 92% of the identified samples were autochthonous, and 8% were allochthonous. The flow map of patients' movements between residential areas and areas of suspected infection showed two patterns of malaria transmission: 1) commuting between residential areas and the Jirau hydropower dam reservoir, and 2) movements between urban areas and farms and resorts in rural areas. It was also observed that areas with greater occurrences of malaria were characterized by a low rate of deforestation. Conclusions The Porto Velho municipality exhibits high malaria endemicity and plays an important role in disseminating the parasite to other municipalities in the Amazon and even to non-endemic areas of the country. Migration remains an important factor for the occurrence of malaria. However, due to recent changes in human occupation of the Brazilian Amazon, characterized by intense expansion of transportation networks, commuting has also become an important factor in malaria transmission. The magnitude of this change necessitates a new model to explain malaria transmission in the Brazilian Amazon. PMID:28222159

The role of spatial mobility in malaria transmission in the Brazilian Amazon: The case of Porto Velho municipality, Rondônia, Brazil (2010-2012).

PubMed

Angelo, Jussara Rafael; Katsuragawa, Tony Hiroshi; Sabroza, Paulo Chagastelles; de Carvalho, Lino Augusto Sander; Silva, Luiz Hildebrando Pereira da; Nobre, Carlos Afonso

2017-01-01

This study aims to describe the role of mobility in malaria transmission by discussing recent changes in population movements in the Brazilian Amazon and developing a flow map of disease transmission in this region. This study presents a descriptive analysis using an ecological approach on regional and local scales. The study location was the municipality of Porto Velho, which is the capital of Rondônia state, Brazil. Our dataset was obtained from the official health database, the population census and an environmental database. During 2000-2007 and 2007-2010, the Porto Velho municipality had an annual population growth of 1.42% and 5.07%, respectively. This population growth can be attributed to migration, which was driven by the construction of the Madeira River hydroelectric complex. From 2010 to 2012, 63,899 malaria-positive slides were reported for residents of Porto Velho municipality; 92% of the identified samples were autochthonous, and 8% were allochthonous. The flow map of patients' movements between residential areas and areas of suspected infection showed two patterns of malaria transmission: 1) commuting between residential areas and the Jirau hydropower dam reservoir, and 2) movements between urban areas and farms and resorts in rural areas. It was also observed that areas with greater occurrences of malaria were characterized by a low rate of deforestation. The Porto Velho municipality exhibits high malaria endemicity and plays an important role in disseminating the parasite to other municipalities in the Amazon and even to non-endemic areas of the country. Migration remains an important factor for the occurrence of malaria. However, due to recent changes in human occupation of the Brazilian Amazon, characterized by intense expansion of transportation networks, commuting has also become an important factor in malaria transmission. The magnitude of this change necessitates a new model to explain malaria transmission in the Brazilian Amazon.

The influence of an intermediate care hospital on health care utilization among elderly patients--a retrospective comparative cohort study.

PubMed

Dahl, Unni; Johnsen, Roar; Sætre, Rune; Steinsbekk, Aslak

2015-02-01

An intermediate care hospital (ICH) was established in a municipality in Central Norway in 2007 to improve the coordination of services and follow-up among elderly and chronically ill patients after hospital discharge. The aim of this study was to compare health care utilization by elderly patients in a municipality with an ICH to that of elderly patients in a municipality without an ICH. This study was a retrospective comparative cohort study of all hospitalized patients aged 60 years or older in two municipalities. The data were collected from the national register of hospital use from 2005 to 2012, and from the local general hospital and two primary health care service providers from 2008 to 2012 (approx. 1,250 patients per follow-up year). The data were analyzed using descriptive statistics and analysis of covariance (ANCOVA). The length of hospital stay decreased from the time the ICH was introduced and remained between 10% and 22% lower than the length of hospital stay in the comparative municipality for the next five years. No differences in the number of readmissions or admissions during one year follow-up after the index stay at the local general hospital or changes in primary health care utilization were observed. In the year after hospital discharge, the municipality with an ICH offered more hour-based care to elderly patients living at home (estimated mean = 234 [95% CI 215-252] versus 175 [95% CI 154-196] hours per person and year), while the comparative municipality had a higher utilization of long-term stays in nursing homes (estimated mean = 33.3 [95% CI 29.0-37.7] versus 21.9 [95% CI 18.0-25.7] days per person and year). This study indicates that the introduction of an ICH rapidly reduces the length of hospital stay without exposing patients to an increased health risk. The ICH appears to operate as an extension of the general hospital, with only a minor impact on the pattern of primary health care utilization.

Community-Based Policies and Support for Free Drinking Water Access in Outdoor Areas and Building Standards in U.S. Municipalities

PubMed Central

Onufrak, Stephen; Wilking, Cara; Cradock, Angie

2018-01-01

We examined community-level characteristics associated with free drinking water access policies in U.S. municipalities using data from a nationally representative survey of city managers/officials from 2,029 local governments in 2014. Outcomes were 4 free drinking water access policies. Explanatory measures were population size, rural/urban status, census region, poverty prevalence, education, and racial/ethnic composition. We used multivariable logistic regression to test differences and presented only significant findings. Many (56.3%) local governments had at least one community plan with a written objective to provide free drinking water in outdoor areas; municipalities in the Northeast and South regions and municipalities with ≤ 50% of non-Hispanic whites were less likely and municipalities with larger population size were more likely to have a plan. About 59% had polices/budget provisions for free drinking water in parks/outdoor recreation areas; municipalities in the Northeast and South regions were less likely and municipalities with larger population size were more likely to have it. Only 9.3% provided development incentives for placing drinking fountains in outdoor, publicly accessible areas; municipalities with larger population size were more likely to have it. Only 7.7% had a municipal plumbing code with a drinking fountain standard that differed from the statewide plumbing code; municipalities with a lower proportion of non-Hispanic whites were more likely to have it. In conclusion, over half of municipalities had written plans or a provision for providing free drinking water in parks, but providing development incentives or having a local plumbing code provision were rare. PMID:29713617

Community-Based Policies and Support for Free Drinking Water Access in Outdoor Areas and Building Standards in U.S. Municipalities.

PubMed

Park, Sohyun; Onufrak, Stephen; Wilking, Cara; Cradock, Angie

2018-04-01

We examined community-level characteristics associated with free drinking water access policies in U.S. municipalities using data from a nationally representative survey of city managers/officials from 2,029 local governments in 2014. Outcomes were 4 free drinking water access policies. Explanatory measures were population size, rural/urban status, census region, poverty prevalence, education, and racial/ethnic composition. We used multivariable logistic regression to test differences and presented only significant findings. Many (56.3%) local governments had at least one community plan with a written objective to provide free drinking water in outdoor areas; municipalities in the Northeast and South regions and municipalities with ≤ 50% of non-Hispanic whites were less likely and municipalities with larger population size were more likely to have a plan. About 59% had polices/budget provisions for free drinking water in parks/outdoor recreation areas; municipalities in the Northeast and South regions were less likely and municipalities with larger population size were more likely to have it. Only 9.3% provided development incentives for placing drinking fountains in outdoor, publicly accessible areas; municipalities with larger population size were more likely to have it. Only 7.7% had a municipal plumbing code with a drinking fountain standard that differed from the statewide plumbing code; municipalities with a lower proportion of non-Hispanic whites were more likely to have it. In conclusion, over half of municipalities had written plans or a provision for providing free drinking water in parks, but providing development incentives or having a local plumbing code provision were rare.

Performance of centralized versus decentralized tuberculosis treatment services in Southern Brazil, 2006-2015.

PubMed

Scheffer, Mara Cristina; Prim, Rodrigo Ivan; Wildner, Leticia Muraro; Medeiros, Taiane Freitas; Maurici, Rosemeri; Kupek, Emil; Bazzo, Maria Luiza

2018-04-25

Tuberculosis (TB) control programs face the challenges of decreasing incidence, mortality rates, and drug resistance while increasing treatment adherence. The Brazilian TB control program recommended the decentralization of patient care as a strategy for combating the disease. This study evaluated the performance of this policy in an area with high default rates, comparing epidemiological and operational indicators between two similar municipalities. This study analyzed epidemiological and operational indicators on new cases of pulmonary tuberculosis reported in the Brazilian Notifiable Diseases Information System between 2006 and 2015. In addition, to characterize differences between the populations of the two studied municipalities, a prospective cohort study was conducted between 2014 and 2015, in which patients with new cases of culture-confirmed pulmonary tuberculosis were interviewed and monitored until the disease outcome. A descriptive analysis, the chi-square test, and a Poisson regression model were employed to compare TB treatment outcomes and health care indicators between the municipalities. Two thousand three hundred nine cases were evaluated, of which 207 patients were interviewed. Over the 2006-2015 period, TB incidence per 100,000 population in the municipality with decentralized care was significantly higher (39%, 95% CI 27-49%) in comparison to that of the municipality with centralized care. TB treatment default rate (45%, 95% CI 12-90%) was also higher in the municipality with decentralized care. During the two-year follow-up, significant differences were found between patients in centralized care and those in decentralized care regarding treatment success (84.5 vs. 66.1%), treatment default (10.7 vs. 25.8%), illicit drug use (27.7 vs. 45.9%), and homelessness (3.6 vs. 12.9%). The operational indicators revealed that the proportion of control smear tests, medical imaging, and HIV tests were all significantly higher in the centralized care. However, a significantly higher proportion of patients started treatment in the early stages of the disease in the municipality with decentralized care. These data showed a low success rate in TB treatment in both municipalities. Decentralization of TB care, alone, did not improve the main epidemiological and operational indicators related to disease control when compared to centralized care. Full implementation of strategies already recommended is needed to improve TB treatment success rates.

CONSIDERATION IN THE DESIGN OF TREATMENT BEST MANAGEMENT PRACTICES (BMPS) TO IMPROVE WATER QUALITY

EPA Science Inventory

For the past three decades, municipalities in the United States have successfully addressed pollution in the watershed by collecting and treating their wastewater. Currently, all municipalities provide secondary level treatment, and in some cases tertiary treatment, and industri...

Disparities in systems development for elder abuse prevention among municipalities in Japan: implications for strategies to help municipalities develop community systems.

PubMed

Nakanishi, Miharu; Nakashima, Taeko; Honda, Tatsuo

2010-07-01

In April 2006, a national elder abuse prevention and caregiver support law was enacted in Japan, where elder abuse prevention is carried out by municipalities, and caregiver support and intervention are provided by a public long-term care insurance program. The aims of this study were (1) to examine factors at baseline affecting disparities in the progress of systems development for elder abuse prevention among municipalities, and (2) to determine what kind of support municipalities request from prefectural or national governments to help municipalities develop systems for elder abuse prevention. Written questionnaires were administered to the most knowledgeable person in the department responsible for reporting elder abuse in each municipal government between December 2006 and October 2008. The final sample for analysis consisted of 489 (26.6% of 1840) municipalities that provided complete information. Municipalities that achieved a high level of implementation originally had a higher rate of reports of abuse per 1000 elderly persons and greater involvement by police and advocacy groups at baseline. Since cities were the largest type of municipality, they had the greatest number of activities as of 2 years after implementation of the law. The results highlight that the prefectural or national government should offer different types of support according to the kind of municipality: sharing and using experts in an extended association for municipalities with limited resources and smaller size (towns and villages) and aggregating information on difficult cases for larger municipalities (cities). Further research should investigate specific strategies that the prefectural or national government can implement to help promote systems development for municipalities with low rates of reported cases of elder abuse, such as training programs to ensure that all care providers can recognize the signs and symptoms of elder abuse. Copyright 2010 Elsevier Ltd. All rights reserved.

Geographic distribution of risk of death due to homicide in Puerto Rico, 2001-2010.

PubMed

Zavala-Zegarra, Diego E; López-Charneco, Magdalena; Garcia-Rivera, Enid J; Concha-Eastman, Alberto; Rodriguez, José F; Conte-Miller, María

2012-11-01

To raise awareness of the impact of homicides in Puerto Rico based on the findings of the spatial and temporal distribution of homicides and the use of firearms, by age and gender, using reports of interpersonal violent deaths from the Institute of Forensic Science (IFS) headquartered in San Juan, Puerto Rico. This was a descriptive study of all homicide incidents in Puerto Rico reported by the IFS for the period 2001-2010. For each of the 8 542 cases, data analyzed included age, sex, municipality of incident, date of death, and mechanism. Crude sex- and age-specific mortality rates for Puerto Rico and for each municipality per year and for the 10-year period were calculated. Cumulative rate and cumulative risks were estimated and defined as lifetime risk. The relative distribution of cumulative rates for each municipality was categorized into quartiles of highest to lowest risk and displayed as a map. The risk of homicide death among males is 13 times greater than among females. The highest rates were observed among males 20-24 years of age (198.4 homicides per 100 000). In any given year, firearms were used in at least 80% of homicides. The average lifetime risk of homicide death for males is 1 in 34. Young adult males with access to firearms are at greatest risk of homicide in Puerto Rico. Also, highly urbanized municipalities are at highest risk; however, certain non-urban municipalities along the coast also have a very high homicide risk. Top priorities should be applying the WHO "ecological model" for violent injury prevention and establishing a surveillance system that will assist in identifying the role that socioeconomics, illegal firearms trade, and drug trafficking are playing.

[Required manpower for health care and nursing services for the aged at home public health nurses, visiting nurses, dental hygienists, dietitians, physical therapists, and occupational therapists].

PubMed

Ojima, T; Saito, E; Kanagawa, K; Sakata, K; Yanagawa, H

1997-04-01

The purpose of this study was to estimate the manpower required for the health care and nursing services for the aged at home. For prefectural health care and welfare planning for the aged, data such as the proportion of the aged who need help, service demand, and required frequency of services were obtained. The means and "mean +/- 2 x standard deviations" were calculated to obtain various parameters. Calculated figures were those which can be obtained with some effort. The results are as follows (middle level estimation (low level estimation-high level estimation)): requirements are 1.9 (0.61-5.7) public health nurses, 2.6 (0.63-14) visiting nurses, 0.20 (0.084-0.42) dental hygienists, 0.35 (0.17-0.66) dietitians, and 0.25 (0.014-1.27) physical and occupational therapists per population 10,000. For the national total, requirements are 23 (7.3-67) thousand public health nurses, 31 (7.5-160) thousand visiting nurses, 2.4 (1.0-5.0) thousand dental hygienists, 3.9 (2.0-7.8) thousand dietitians, and 3.0 (0.17-15) thousand physical and occupational therapists. By population sizes, for example in the municipalities which has 10-30 thousand people, required are 4.2 (1.7-11) public health nurses, 5.3 (1.3-27) visiting nurses, 0.4 (0.2-0.8) dental hygienists, 0.5 (0.3-0.9) dietitians, and 0.5 (0.0-2.5) physical and occupational therapists. Comparison of the present numbers with estimated manpower needs show that, the present number of public health personnel is almost the same as the low level estimation. But the present numbers of other manpower is lower than the low level estimation. Considering other services such as maternal and child health, it seems that the municipalities which has 10+ thousand population should employ full-time dietitians and dental hygienists. For policy making in a municipality, the policies of other municipalities should be considered. Because it is based on means for municipalities, the results of this study should be useful for application by other municipalities.

[Rediscovery of Melipona subnitida Ducke (Hymenoptera: Apidae) in the "Restinga" in the Nacional Park Lençóis Maranhenses, Barreirinhas, MA, Brazil].

PubMed

Rêgo, Márcia; Albuquerque, Patrícia

2006-01-01

Approximately 95 years after the original description, a nest of Melipona subnitida Ducke was rediscovered in the state of Maranhão, in a restinga ecosystem of the Barreirinhas municipality, Northeastern Brazil. The voucher specimens are deposited in the collection of the "Laboratório de Estudos sobre Abelhas" of the "Departamento de Biologia UFMA".

Aspects of the Health Inspection Authority in the People's Republic of China.

PubMed

Ma, Sha; Chen, Gang; Tan, B-K

2015-05-20

In China, there was a pressing need to establish a governmental agency to oversee the organizations that provide public health and medical services. The Chinese Health Inspection Authority (HIA), a relatively independent organization functioning at each administrative level (provincial, municipal, and county), was mandated to conduct 11 health inspection functions to maintain efficient public health and medical services. These functions include issuing health permit, conducting health supervision and inspection, health testing and evaluation, case investigation, complaint handling, managing public health crisis, monitoring and safeguarding public health at major public events, enforcing supervision and inspection compliance, public health education, information management, and team training and management. Since the reform of the health inspection system by the Ministry of Health in 2000, the HIA underwent a series of changes and transitions. This study aimed to describe and assess the five factors that were considered to be important for meeting service delivery objectives of the HIA in the People's Republic of China. A total of 604 HIAs, sampled across three geographical regions of China at three administrative levels, participated in a cross-sectional survey conducted in 2013. Descriptive statistics were used to analyze the status of mandated operations, manpower, revenue and expenditures, and institutional infrastructure. Differences in these characteristics across the geographical regions and administrative levels were compared. On average, the HIAs had not fully implemented the 11 mandated functions at any administrative levels. Governmental financial allocations were the main sources of revenue. Three primary personnel employment models coexisted and most employed the quasi-civil service employment model. The institutional infrastructure did not meet governmental mandated standards with respect to building area or the number and types of equipment available to conduct key functions. In 2012, the majority of the HIAs in China at the provincial, municipal, and county levels did not meet the mandated requirements, although positive indications toward meeting these requirements were observed. It is necessary for the government to pay more attention to institutional resources (buildings, equipment, and the level of the staff's educational attainment) and ensure that the HIAs can meet their service delivery objectives.

Discrepancies in assessing home care workers' working conditions in a Norwegian home care service: differing views of stakeholders at three organizational levels.

PubMed

Andersen, Gunn Robstad; Westgaard, Rolf H

2015-07-25

The present study is a follow-up study of factors contributing to an undesirable quality of work environment and sick leave rate in the home care services in a Norwegian municipality. The underlying assumption is that organizational discrepancies in the perceptions and appraisals of significant factors and processes in an organization have detrimental effects on the management of the organization and on work environment conditions. Thus, the study aim is to explore potential organizational discrepancies in the appraisals of factors relating to home care workers' working conditions. The study, using a mixed-methods design, comprised six home care units. It included survey responses of home care workers (80 respondents, response rate 54 %) and qualitative descriptions of stakeholders' appraisals of organizational issues gathered through semi-structured interviews (33 interviews with stakeholders at three organizational levels). Employees at different organizational levels in the home care services expressed divergent appraisals of factors related to the working conditions of home care workers, including impact of organizational measures (i.e. time pressure, work tasks, a new work program, organizational changes, budget model, budget allocation and coping strategies). Survey responses supported interview descriptions by home care workers. Results suggest that organizational discrepancy serve as an important barrier to a sustainable, well-functioning organization in general and to quality-enhancing changes to work procedures in particular. It is recommended to improve communication channels and facilitate the exchange of information across levels to ensure a common understanding of matters significant to the organization of the home care services and to the work environment of home care workers. The prevalence and impact of organizational discrepancy should be included in organization research, particularly when exploring explanatory factors of an unhealthy organization.

Developing a holistic strategy for integrated waste management within municipal planning: challenges, policies, solutions and perspectives for Hellenic municipalities in the zero-waste, low-cost direction.

PubMed

Zotos, G; Karagiannidis, A; Zampetoglou, S; Malamakis, A; Antonopoulos, I-S; Kontogianni, S; Tchobanoglous, G

2009-05-01

The present position paper addresses contemporary waste management options, weaknesses and opportunities faced by Hellenic local authorities. It focuses on state-of-the-art, tested as well as innovative, environmental management tools on a municipal scale and identifies a range of different collaboration schemes between local authorities and related service providers. Currently, a policy implementation gap is still experienced among Hellenic local authorities; it appears that administration at the local level is inadequate to manage and implement many of the general policies proposed; identify, collect, monitor and assess relevant data; and safeguard efficient and effective implementation of MSWM practices in the framework of integrated environmental management as well. This shortfall is partly due to the decentralisation of waste management issues to local authorities without a parallel substantial budgetary and capacity support, thus resulting in local activity remaining often disoriented and isolated from national strategies, therefore yielding significant planning and implementation problems and delays against pressing issues at hand as well as loss or poor use of available funds. This paper develops a systemic approach for MSWM at both the household and the non-household level, summarizes state-of-the-art available tools and compiles a set of guidelines for developing waste management master plans at the municipal level. It aims to provide a framework in the MSWM field for municipalities in Greece as well as other countries facing similar problems under often comparable socioeconomic settings.

OCCURRENCE OF PATHOGENS IN MUNICIPAL WASTEWATER AND THEIR SURVIVAL DURING WASTEWATER TREATMENT

EPA Science Inventory

Pathogens can enter municipal wastewaters from several sources including homes, hospitals and slaughter houses. They are identified, typical levels found in sludges are given along with infectious doses, and their survival on crops and in the soil presented. As wastewater is clea...

TOXICITY REDUCTION EVALUATION (TRE) AT A MUNICIPAL WASTEWATER TREATMENT PLANT USING MUTAGENICITY AS AN END- POINT

EPA Science Inventory

Previous work revealed substantial levels of mutagenicity in effluents from certain municipal wastewater treatment plants. One of these treatment plants was selected for further study to track the effluent mutagenicity to its sources, to chemically characterize the mutagenicity, ...

Recruitment and Retention of Information Technology Professionals in Southern California Municipal Government

ERIC Educational Resources Information Center

Roberts, Douglas P.

2009-01-01

This study investigates the recruitment and retention challenges, facing municipal government IT organizations in Southern California, by examining the relationships between worker demographics, competencies, experience levels, tenure, and training within the organizations. Utilizing a mixed method, non-experimental design, the study examines…

Public water supplies in southern Texas

USGS Publications Warehouse

Broadhurst, W.L.; Sundstrom, R.W.; Rowley, J.H.

1950-01-01

This report gives a summarized description of the public water supplies in 42 counties of southern Texas, extending from the Rio Grande northward to the northern boundaries of Kinney, Uvalde, Bandera, Kendall, and Hays Counties and eastward to the eastern boundaries of Caldwell, Gonzales, DeWitt, Victoria, and Calhoun Counties. It gives the available data as follows for each of the 114 communities: Population of the community; name of the official from whom the information was obtained; ownership of water works, whether private or municipal; source of supply, whether ground or surface water; the amount of water consumed; the facilities for storage; the number of customers served; the character of the chemical and sanitary treatment, if any; and chemical analyses of the water. Where ground water is used, the following information also is given: Records of wells, including drillers' logs; character of the pumping equipment; yield of the wells and records of water levels, where they are available.

Public water supplies in central and north-central Texas

USGS Publications Warehouse

Sundstrom, Raymond W.; Broadhurst, W.L.; Dwyer, B.C.

1949-01-01

This report gives a summarized description of the public water supplies in 35 counties of central and north-central Texas, extending from the southern boundaries of Travis, Blanco, Gillespie, and Kerr Counties northward to the TexasOklahoma State line. It gives the available data as follows for each of the 145 communities: Population of the community; name of the official from whom the information was obtained; ownership of water works, whether private or municipal source of supply, whether ground water or surface water; the amount of water consumed; the facilities for storage; the number of customers served; the character of the chemical and sanitary treatment, if any; and chemical analyses of the water. Where ground water is used, the following is also given: Records of wells, including drillers' logs; character of the pumping equipment; yields of the wells, and records of water levels, if available.

[Transmission risk of Trypanosoma cruzi in Metztitlán municipality from Hidalgo state, México, by characterization of domiciliary units and their entomologic indexes].

PubMed

Becerril, Marco A; Angeles-Pérez, Vidal; Noguez-García, Julio Cr; Imbert-Palafox, José L

2010-01-01

In order to determine the risk of transmission of Trypanosoma cruzi by triatomines in Metztitlan municipality, Hidalgo State, Mexico, entomological indexes were calculated and the characteristics of dwellings were described. A transversal, retrospective, descriptive, and observational study was performed by means of an intentional not probabilistic and expertise sampling from January to December of 2005 in 10 localities in which presence of triatomines were investigated either intra or peridomestic environmental in 699 houses. Building material and presence of infected triatomines with T. cruzi were registered to determine entomologic indexes. The triatomine species collected were: Triatoma barberi (Usinger) and T. mexicana (Herrich-Schaeffer) (Hemiptera: Reduviidae). The results indicated that natural infection index varied from 7.7% to 50%; colonization index reached 80%; infestation index varied from 7.7% to 25%; dispersion index was 70%. Stone-walled houses were more infested. We can conclude that it is necessary to establish T. cruzi transmission control measures against triatomines in localities from Metztitlan, primarily in stone-walled houses where T. barberi occurs, as it was the most important vector species in the transmission of T. cruzi in this municipality.

Characteristics of the distribution of doctors in the Mais Médicos (More Doctors) Program in the states of Brazil's Northeast.

PubMed

Nogueira, Priscila Tamar Alves; Bezerra, Adriana Falangola Benjamin; Leite, Antonio Flaudiano Bem; Carvalho, Islândia Maria de Sousa; Gonçalves, Rogério Fabiano; Brito-Silva, Keila Silene de

2016-09-01

Inequalities in access to health, reflecting shortages and inadequate geographical distribution of health professionals, have been indicated as a challenge for Brazil. This paper analyzes the geographical distribution of professionals of the Mais Médicos Program allocated in the Northeastern Region of Brazil, through a descriptive cross-sectional study. Secondary data provided by the Health Ministry were used, and thematic maps of distribution of doctors in the Region were prepared. Data on 4,716 doctors who became members of health teams in 1,294 municipalities in six Indigenous Health Districts in the years 2013 and 2014 were analyzed. The greater part of the municipalities of the Region received between one and five doctors. The municipalities most benefited had, at least, 20% of their population in extreme poverty. 99.9% of the doctors were allocated in a Health Center or Primary Healthcare Unit. The majority were women (57%), predominantly of the 45-49 age group (24%). In spite of the advances achieved by the Program - such as distribution of the doctors in locations with greater vulnerability - some States continue to have significant shortages of healthcare.

Amelioration of municipal sludge by Pistia stratiotes L.: role of antioxidant enzymes in detoxification of metals.

PubMed

Tewari, Anamika; Singh, Ragini; Singh, Naveen Kumar; Rai, U N

2008-12-01

Pistia stratiotes when exposed to mixture of municipal sludge and effluent accumulated substantial amount of metals in the fronds and roots. With the increase in the metal accumulation by the plants, a reduction in the concentration of metals was found in leachates. The treated plants showed reduced level in chlorophylls but enhanced level of carotenoids and protein. The plant showed a concomitant increase in the activities of antioxidant enzymes; superoxide dismutase, guiacol peroxidase and also an enhanced level of lipid peroxidation. The activities were more in the root tissues as compared to frond. Initially a reduced level of cysteine content in roots of sludge treated plant as compared to control was found, but with time duration it increased progressively. The level of non-protein thiols also increased gradually at all the durations in both fronds and roots. Thus, beside the reduction of metals from municipal sludge, the ability of P. stratiotes to combat metal generated damages by induced synthesis of antioxidant enzymes and other metal binding ligands shows its suitability for the phytoremediation of the waste.

Tailoring community-based wellness initiatives with latent class analysis--Massachusetts Community Transformation Grant projects.

PubMed

Arcaya, Mariana; Reardon, Timothy; Vogel, Joshua; Andrews, Bonnie K; Li, Wenjun; Land, Thomas

2014-02-13

Community-based approaches to preventing chronic diseases are attractive because of their broad reach and low costs, and as such, are integral components of health care reform efforts. Implementing community-based initiatives across Massachusetts' municipalities presents both programmatic and evaluation challenges. For effective delivery and evaluation of the interventions, establishing a community typology that groups similar municipalities provides a balanced and cost-effective approach. Through a series of key informant interviews and exploratory data analysis, we identified 55 municipal-level indicators of 6 domains for the typology analysis. The domains were health behaviors and health outcomes, housing and land use, transportation, retail environment, socioeconomics, and demographic composition. A latent class analysis was used to identify 10 groups of municipalities based on similar patterns of municipal-level indicators across the domains. Our model with 10 latent classes yielded excellent classification certainty (relative entropy = .995, minimum class probability for any class = .871), and differentiated distinct groups of municipalities based on health-relevant needs and resources. The classes differentiated healthy and racially and ethnically diverse urban areas from cities with similar population densities and diversity but worse health outcomes, affluent communities from lower-income rural communities, and mature suburban areas from rapidly suburbanizing communities with different healthy-living challenges. Latent class analysis is a tool that may aid in the planning, communication, and evaluation of community-based wellness initiatives such as Community Transformation Grants projects administrated by the Centers for Disease Control and Prevention.

Organizing principles and management climate in high-performing municipal elderly care.

PubMed

Kajonius, Petri; Kazemi, Ali; Tengblad, Stefan

2016-01-01

Purpose - Previous research has shown that user-oriented care predicts older persons' satisfaction with care. What is yet to be researched is how senior management facilitates the implementation of user-oriented care. The purpose of this study is to investigate the organizing principles and management climate characterizing successful elderly care. Design/methodology/approach - The department in one highly ranked municipality was selected and compared with a more average municipality. On-site in-depth semi-structured interviews with department managers and participatory observations at managers' meetings were conducted in both municipalities. Findings - Results revealed three key principles for successful elderly care: organizing care from the viewpoint of the older person; recruiting and training competent and autonomous employees; instilling a vision for the mission that guides operations at all levels in the organization. Furthermore, using climate theory to interpret the empirical material, in the highly successful municipality the management climate was characterized by affective support and cognitive autonomy, in contrast to a more instrumental work climate primarily focusing on organizational structure and doing the right things characterizing the more average municipality. Originality/value - The authors suggest that guiding organizing principles are intertwined with management climate and that there are multiple perspectives that must be considered by the management, that is, the views of the older persons, the co-workers and the mission. These results can guide future care quality developments, and increase the understanding of the importance of organizational climate at the senior management level.

Co-digestion of municipal sludge and external organic wastes for enhanced biogas production under realistic plant constraints.

PubMed

Tandukar, Madan; Pavlostathis, Spyros G

2015-12-15

A bench-scale investigation was conducted to select external organic wastes and mixing ratios for co-digestion with municipal sludge at the F. Wayne Hill Water Resources Center (FWHWRC), Gwinnett County, GA, USA to support a combined heat and power (CHP) project. External wastes were chosen and used subject to two constraints: a) digester retention time no lower than 15 d; and b) total biogas (methane) production not to exceed a specific target level based on air permit constraints on CO2 emissions. Primary sludge (PS), thickened waste activated sludge (TWAS) and digested sludge collected at the FWHWRC, industrial liquid waste obtained from a chewing gum manufacturing plant (GW) and dewatered fat-oil-grease (FOG) were used. All sludge and waste samples were characterized and their ultimate digestibility was assessed at 35 °C. The ultimate COD to methane conversion of PS, TWAS, municipal sludge (PS + TWAS; 40:60 w/w TS basis), GW and FOG was 49.2, 35.2, 40.3, 72.7, and 81.1%, respectively. Co-digestion of municipal sludge with GW, FOG or both, was evaluated using four bench-scale, mesophilic (35 °C) digesters. Biogas production increased significantly and additional degradation of the municipal sludge between 1.1 and 30.7% was observed. Biogas and methane production was very close to the target levels necessary to close the energy deficit at the FWHWRC. Co-digestion resulted in an effluent quality similar to that of the control digester fed only with the municipal sludge, indicating that co-digestion had no adverse effects. Study results prove that high methane production is achievable with the addition of concentrated external organic wastes to municipal digesters, at acceptable higher digester organic loadings and lower retention times, allowing the effective implementation of CHP programs at municipal wastewater treatment plants, with significant cost savings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Competencies Demonstrated by Municipal Employees during Adaptation to Climate Change: A Pilot Study

ERIC Educational Resources Information Center

Pruneau, Diane; Kerry, Jackie; Blain, Sylvie; Evichnevetski, Evgueni; Deguire, Paul; Barbier, Pierre-Yves; Freiman, Viktor; Therrien, Jimmy; Langis, Joanne; Lang, Mathieu

2013-01-01

Since coastal communities are already subjected to the impacts of climate change, adaptation has become a necessity. This article presents competencies demonstrated by Canadian municipal employees during an adaptation process to sea level rise. To adapt, the participants demonstrated the following competencies: problem solving (highlighting…

Source Separation and Composting of Organic Municipal Solid Waste.

ERIC Educational Resources Information Center

Gould, Mark; And Others

1992-01-01

Describes a variety of composting techniques that may be utilized in a municipal level solid waste management program. Suggests how composting system designers should determine the amount and type of organics in the waste stream, evaluate separation approaches and assess collection techniques. Outlines the advantages of mixed waste composting and…

40 CFR 60.1410 - What must I include in my annual report?

Code of Federal Regulations, 2011 CFR

2011-07-01

...) For municipal waste combustion units that use activated carbon for controlling dioxins/furans or mercury emissions, include four records: (1) The average carbon feed rates recorded during the most recent..., nitrogen oxides emissions. (3) Carbon monoxide emissions. (4) Load level of the municipal waste combustion...

LEVELS OF SYNTHETIC MUSKS COMPOUNDS IN MUNICIPAL WASTEWATER FOR ESTIMATING BIOTA EXPOSURE IN RECEIVING WATERS

EPA Science Inventory

Synthetic musk compounds are consumer chemicals manufactured as fragrance materials and consumed in very large quantities worldwide. Due to their high use and release, they have become ubiquitous in the environment. We analyzed water samples from the confluence of three municipal...

MULTI-MEDIA MICROBIOLOGICAL RISK ASSESSMENT METHODOLOGY FOR MUNICIPAL WASTEWATER SLUDGES

EPA Science Inventory

In order to reduce the risk of municipal sludge to acceptable levels, the U.S. EPA has undertaken a regulatory program based on risk assessment and risk management. The key to such a program is the development of a methodology which allows the regulatory agency to quantify the re...

Paracoccidioidomycosis in Colombia: an ecological study.

PubMed Central

Calle, D.; Rosero, D. S.; Orozco, L. C.; Camargo, D.; Castañeda, E.; Restrepo, A.

2001-01-01

The natural habitat of Paracoccidioides brasiliensis, agent of paracoccidioidomycosis (PCM), remains unknown. This study is aimed at establishing associations between the ecological variables present in all Colombian municipalities and the incidence of PCM. Records of 940 patients were studied and several ecological variables analysed, as well as their association to amount of patients per total rural population in each municipality, determined through a multivariate analysis. All 940 patients came from 216 municipalities (20-3%), out of which, 93 were birthplace and place of long-term residence for 121 patients. The Incidence Rate Ratio (IRR) was determined for these 93 municipalities. The following variables fitted the model: altitude from 1,000 to 1,499 metres above sea level (IRR = 6.37), rainfall from 2000 to 2999 mm (IRR = 2.15), presence of humid forests (Holdridge) (IRR = 1.79) and coffee (IRR = 1.95), tobacco (IRR = 3.59) crops. These results indicate that these municipalities constitute reservareas for P. brasiliensis (Borelli). PMID:11349982

[Fluoride intake through consumption of water from municipal network in the INMA-Gipuzkoa cohort].

PubMed

Jiménez-Zabala, Ana; Santa-Marina, Loreto; Otazua, Mónica; Ayerdi, Mikel; Galarza, Ane; Gallastegi, Mara; Ulibarrena, Enrique; Molinuevo, Amaia; Anabitarte, Asier; Ibarluzea, Jesús

2017-05-22

To estimate fluoride intake through consumption of water from the municipal network in pregnant women and their children from the INMA-Gipuzkoa cohort and to compare these intakes with recommended levels. In Euskadi (Spain), fluoridation of drinking water is compulsory in water supplies for more than 30,000 inhabitants. 575 pregnant women (recruitment, 2006-2008) and 424 4-year-old children (follow-up, 2010-2012) have been included. Fluoride levels in drinking water were obtained from the water consumption information system of the Basque Country (EKUIS). Water consumption habits and socioeconomic variables were obtained by questionnaire. 74.9% and 87.7% of women and children consumed water from the municipal network. Average fluoride levels in fluoridated water were 0.805 (SD: 0.194) mg/L during baseline recruitment and 0.843 (SD: 0.080) mg/L during follow up, at 4 years old of the children. Average and 95th percentile of fluoride intake were 0.015 and 0.026mg/kg per day in women and 0.033 and 0.059mg/kg per day in children. Considering only fluoride provided by drinking water, 8.71% of children living in fluoridated areas exceeded intake level recommended by the European Food Safety Authority, consisting in 0.05mg/kg per day. The results show that ingested levels of fluoride through consumption of municipal water can exceed the recommended levels in children and encourages further studies that will help in fluoridation policies of drinking water in the future. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

HIV/AIDS among women in Havana, Cuba: 1986-2011.

PubMed

Oliva, Dinorah C; Viñas, Arturo L; Saavedra, Clarivel; Oliva, Maritza; González, Ciro; de la Torre, Caridad

2013-10-01

Women are being diagnosed with HIV infection in increasing numbers, and now account for 50% of cases worldwide. In Cuba, HIV is more frequent in men, but in recent years, a growing number of women have been diagnosed. Describe patterns of HIV among women in Havana, Cuba, 1986-2011. Descriptive study of women with HIV aged >14 years, residents of Havana, Cuba, who were diagnosed with HIV from 1 January 1986 through 31 December 2011. Information was obtained from the limited-access HIV/AIDS database of Cuba's Ministry of Public Health. Data were studied from all reported cases, a total of 1274 women. Variables selected were age at diagnosis, education, municipality of residence, screening group, year of HIV diagnosis, late presentation, AIDS-defining condition, year of diagnosis as AIDS case, vital status at the end of 2011, and year of death (if applicable). Incidence of HIV and AIDS, cumulative incidence by municipality of residence, and case fatality rates were calculated. Those aged 20-29 years were most affected by HIV. Almost half (46.7%) the women had completed middle school, and a further 35.4% had completed high school or middle-level technical studies. HIV incidence began to increase more steeply starting in 1998, as did AIDS incidence by year of diagnosis, though to a lesser extent. Central Havana and Old Havana municipalities had the highest cumulative incidence. Late presentation was seen in 7.4% of cases; mean age of those diagnosed late was 38.9 years. Wasting syndrome and Pneumocystis jirovecii pneumonia were the most frequent AIDS-defining conditions. Case fatality rates started to decline in 1998. HIV infection in women is occurring in a predominantly young, relatively well-educated population. Increasing rates of HIV and AIDS in the past decade are a warning sign of the possible expansion of HIV infection in women, even though mortality is declining.

Multi-source analysis reveals latitudinal and altitudinal shifts in range of Ixodes ricinus at its northern distribution limit.

PubMed

Jore, Solveig; Viljugrein, Hildegunn; Hofshagen, Merete; Brun-Hansen, Hege; Kristoffersen, Anja B; Nygård, Karin; Brun, Edgar; Ottesen, Preben; Sævik, Bente K; Ytrehus, Bjørnar

2011-05-19

There is increasing evidence for a latitudinal and altitudinal shift in the distribution range of Ixodes ricinus. The reported incidence of tick-borne disease in humans is on the rise in many European countries and has raised political concern and attracted media attention. It is disputed which factors are responsible for these trends, though many ascribe shifts in distribution range to climate changes. Any possible climate effect would be most easily noticeable close to the tick's geographical distribution limits. In Norway- being the northern limit of this species in Europe- no documentation of changes in range has been published. The objectives of this study were to describe the distribution of I. ricinus in Norway and to evaluate if any range shifts have occurred relative to historical descriptions. Multiple data sources - such as tick-sighting reports from veterinarians, hunters, and the general public - and surveillance of human and animal tick-borne diseases were compared to describe the present distribution of I. ricinus in Norway. Correlation between data sources and visual comparison of maps revealed spatial consistency. In order to identify the main spatial pattern of tick abundance, a principal component analysis (PCA) was used to obtain a weighted mean of four data sources. The weighted mean explained 67% of the variation of the data sources covering Norway's 430 municipalities and was used to depict the present distribution of I. ricinus. To evaluate if any geographical range shift has occurred in recent decades, the present distribution was compared to historical data from 1943 and 1983. Tick-borne disease and/or observations of I. ricinus was reported in municipalities up to an altitude of 583 metres above sea level (MASL) and is now present in coastal municipalities north to approximately 69°N. I. ricinus is currently found further north and at higher altitudes than described in historical records. The approach used in this study, a multi-source analysis, proved useful to assess alterations in tick distribution.

Los Angeles - Long Beach Harbors, California. Los Angeles Harbor Deepening Project. Final Phase 2. General Design Memorandum.

DTIC Science & Technology

1980-01-01

land- marks are the San Pedro Breakwater and Angels Gate Lighthouse, the Termial Island Schoolhouse, and the Municipal Fish Market. Descriptions of...MILES, Chairman Navigation and Ocean Development Commission I, Marty Mercado , Secretary of the Navigation and Ocean Development Commission, do hereby...officials who have authority or responsibility in this area. STAN1&’.~LIMCara NAVIGATION AND OCEAN DEVELOPMENT COIISSION I, Marty Mercado , Secretary

Implementation of national guidelines for the prevention and treatment of overweight and obesity in children and adolescents: a phenomenographic analysis of public health nurses' perceptions.

PubMed

Nordstrand, Aina; Fridlund, Bengt; Sollesnes, Ragnhild

2016-01-01

To explore and describe how public health nurses (PHNs) perceive the implementation of national guidelines for the prevention and treatment of overweight and obesity among children and adolescents in well-baby clinics and school health services. An explorative descriptive design was carried out through individual interviews with 18 PHNs and analysed according to the phenomenographic tradition. Four implementation strategies were described and assigned a metaphor: the structured PHN, pragmatic PHN, critical PHN, and the resigned PHN. Competence, patient receptiveness, internal consensus, interdisciplinary collaboration, resources, and organizational embedding were the determinants identified that most frequently affect implementation, and these determinants were distributed at different levels of the organization. The extent of facilitation seemed to determine which implementation strategy would be used. How PHNs implemented the guidelines for overweight and obesity were affected by determinants at different organizational levels. Contextual facilitation of implementation seemed better in larger organizations, but factors such as leadership, drive, and experience compensated in smaller municipalities. The implementation of guidelines was hindered when the barriers exceeded the benefits.

Settlement behavior of municipal solid waste due to internal and external environmental factors in a lysimeter.

PubMed

Melo, Márcio C; Caribé, Rômulo M; Ribeiro, Libânia S; Sousa, Raul B A; Monteiro, Veruschka E D; de Paiva, William

2016-12-05

Long-term settlement magnitude is influenced by changes in external and internal factors that control the microbiological activity in the landfill waste body. To improve the understanding of settlement phenomena, it is instructive to study lysimeters filled with MSW. This paper aims to understand the settlement behavior of MSW by correlating internal and external factors that influence waste biodegradation in a lysimeter. Thus, a lysimeter was built, instrumented and filled with MSW from the city of Campina Grande, the state of Paraíba, Brazil. Physicochemical analysis of the waste (from three levels of depth of the lysimeter) was carried out along with MSW settlement measurements. Statistical tools such as descriptive analysis and principal component analysis (PCA) were also performed. The settlement/compression, coefficient of variation and PCA results indicated the most intense rate of biodegradation in the top layer. The PCA results of intermediate and bottom levels presented fewer physicochemical and meteorological variables correlated with compression data in contrast with the top layer. It is possible to conclude that environmental conditions may influence internal indicators of MSW biodegradation, such as the settlement.

Localizing Climate Information for Municipal Planning in the Central U.S.

NASA Astrophysics Data System (ADS)

Shulski, M.; Umphlett, N.; Abdel-Monem, T.; Tang, Z.; Uhlarik, F.

2017-12-01

The impacts of projected climate change are an ongoing concern for municipalities. Planning at the local level often involves investigations of multiple hazards on decadal timescales. Of particular interest to cities are implications of too much or too little water, snow storms, heat waves, and freeze/thaw cycles on infrastructure, health, energy demands and water quality and availability. A two-year project led by the University of Nebraska - Lincoln has brought together scientist and stakeholder for the purpose of informing municipal planning and climate adaptation for 12 cities in the lower Missouri River Basin states (IA, NE, KS, MO). City-specific climate reports have been developed with municipal input to aid local planning efforts. Surveys to assess municipal climate data usage were distributed to all cities with a population greater than 5,000 in the four-state region. In addition, planning efforts for 18 municipalities have been evaluated for nearly 20 cities in the region to investigate local hazard mitigation, emergency, and comprehensive plans. This presentation will outline key outcomes of the project and discuss decision support tools developed in co-production with city planners.

Interaction among actors in retail market competition in malang city

NASA Astrophysics Data System (ADS)

Kurniawan, B.; Ma'ruf, M. F.

2018-01-01

In several countries, traditional market lose in competition with supermarket. Supermarket has several advantages compared with traditional market. It can provides consumers with lower prices, offer more varieties of products and higher quality products than traditional retailers, has more comfortable place for shopping. In Malang City, the existence of traditional traders was threatened. In a competitive retail market, traditional traders get less protection from the Government of Malang Municipality. Massive demonstrations conducted by traditional traders along with other society elements unable to stem the rapid growth of modern retail. This paper focus on the interaction of Malang Municipality actors in the local retail market competition. How those interaction can make imbalance retail market competition. The author uses descriptive-analytic method with a qualitative approach in this work. As a result, the interaction tend to produce imbalance retail market competition. Interaction between legislative, executive, bureaucracy and mass media tend to support modern retail growth than traditional one.

Solar heating and hot water system installed at Municipal Building complex, Abbeville, South Carolina

NASA Technical Reports Server (NTRS)

1979-01-01

Information on the solar energy system installed at the new municipal building for the City of Abbeville, SC is presented, including a description of solar energy system and buildings, lessons learned, and recommendations. The solar space heating system is a direct air heating system. The flat roof collector panel was sized to provide 75% of the heating requirement based on an average day in January. The collectors used are job-built with two layers of filon corrugated fiberglass FRP panels cross lapped make up the cover. The storage consists of a pit filled with washed 3/4 in - 1 1/2 in diameter crushed granite stone. The air handler includes the air handling mechanism, motorized dampers, air circulating blower, sensors, control relays and mode control unit. Solar heating of water is provided only those times when the hot air in the collector is exhausted to the outside.

Waterborne norovirus outbreak in a municipal drinking-water supply in Sweden.

PubMed

Riera-Montes, M; Brus Sjölander, K; Allestam, G; Hallin, E; Hedlund, K-O; Löfdahl, M

2011-12-01

During Easter 2009, almost 200 people resident in a small Swedish village fell ill with gastrointestinal symptoms. We conducted a retrospective cohort study and a molecular investigation in order to identify the source of the outbreak. Residents living in households connected to the public water network were at an increased risk of developing disease (relative risk 4·80, 95% confidence interval 1·68-13·73) compared to those with no connection to the public network. Norovirus genotype GI.3 was identified in stool samples from six patients and in a sample from the public water network. Contamination of one of the wells supplying the public water network was thought to be the source of the outbreak. This is a description of a norovirus outbreak linked to a municipal drinking-water supply in Sweden. Information from epidemiological and molecular investigations is of utmost importance to guide outbreak control measures and to prevent future outbreaks.

Implicating municipalities in addressing household food insecurity in Canada: A pan-Canadian analysis of news print media coverage.

PubMed

Collins, Patricia A; Gaucher, Megan; Power, Elaine M; Little, Margaret H

2016-06-27

Household food insecurity (HFI) affects approximately 13% of Canadian households and is especially prevalent among low-income households. Actions to address HFI have been occurring primarily at the local level, despite calls for greater income supports from senior governments to reduce poverty. News media may be reinforcing this trend, by emphasizing food-based solutions to HFI and the municipal level as the site where action needs to take place. The objective of this study was to examine the level and framing of print news media coverage of HFI action in Canada. Using a quantitative newspaper content analysis approach, we analyzed 547 articles gathered from 2 national and 16 local/regional English-language newspapers published between January 2007 and December 2012. News coverage increased over time, and over half was produced from Ontario (33%) and British Columbia (22%) combined. Of the 374 articles that profiled a specific action, community gardens/urban agriculture was most commonly profiled (17%), followed by food banks/meal programs (13%); 70% of articles implicated governments to take action on HFI, and of these, 43% implicated municipal governments. Article tone was notably more negative when senior governments were profiled and more neutral and positive when municipal governments were profiled. News media reporting of this issue in Canada may be placing pressure on municipalities to engage in food-based actions to address HFI. A more systematic approach to HFI action in Canada will require more balanced media reporting that acknowledges the limitations of food-based solutions to the income-based problem of HFI.

USING A LIFE-CYCLE APPROACH TO ACHIEVE SUSTAINABLE MUNICIPAL SOLID WASTE MANAGEMENT STRATEGIES IN THE UNITED STATES

EPA Science Inventory

The paper discusses a computer-based decision support tool that has been developed to assist local governments in evaluating the cost and environmental performance of integrated municipal solid waste (MSW) managment systems. ongoing case studies of the tool at the local level are...

Their Personal Side of Street-Level Bureaucracy: Discrimination or Neutral Competence?

ERIC Educational Resources Information Center

Thomas, John Clayton

1986-01-01

Analysis of data on citizen contacts with the Cincinnati municipal bureaucracy reveals some possible racial and social discrimination in treatment of citizens, but no discrimination by income. However, municipal administrators appear mostly to be exercising neutral competence in their dealings with citizens, and not always to the disadvantage of…

The Roots of Urban Discontent: Public Policy, Municipal Institutions, and the Ghetto.

ERIC Educational Resources Information Center

Rossi, Peter H.; And Others

The central concern of this volume is to examine the interrelationships between three levels of urban social structure: (1) local public policy-makers, comprised of elected public officials, the heads of major municipal departments, and "civic notables," or persons who play important roles in urban civic life; (2) "institutional agents," or…

Development of maintenance composite priority index for buildings in Palestine: A pilot case study

NASA Astrophysics Data System (ADS)

Issa, Amjad; Awad, Riyad

2017-11-01

The current building maintenance practices in Palestine are not based on scientific systematic methods. Most of the municipalities use one criterion to define the maintenance priorities, which is the "worst-first" criterion. Therefore, the current practices in defining buildings maintenance plans are not dealing with the known phases that are generally followed, including those in establishing building inventories, building condition survey, detailed visual inspection, identification of the proper maintenance and rehabilitation measures, and setting priorities. Accordingly, the recent preparation of the Operation and Maintenance (O&M) Manual for Palestinian municipalities is an important step to guide them towards preparing and implementing their O&M priority-based plans, considering scare resources. During the course of preparation of the Manual, the proposed procedures were applied at ten pilot municipalities. This study aims to explore the outcome of the implementation of the 2014/2015 O&M buildings maintenance priorities at these municipalities through the development of maintenance composite priority index (PI). The new proposed priority index is a scientific tool that will identify the priority of maintenance buildings through using a systematic procedure instead of first worst one. To achieve this, analyses of the outcome of a questionnaire designed to collect relevant information from these municipalities was conducted. The maintenance priority index for buildings is calculated considering different indicators among them building status (condition), classification and importance of the building, number of beneficiaries (users), safety aspects (severity level in the building), and people complaints. The main component of the PI is the building condition index (BCI) which forms about 40% of the total weight. The physical inspection, which is the main input for calculating the BCI, is conducted on two levels; the primary level, and the secondary level. The buildings are ranked in descending order based on the PI values for each public building. The buildings that have the highest values of PI take the most priority till the specified asset maintenance budget for the targeted year is achieved. Finally, the results indicate that most of the maintenance works are funded by municipalities own budgets and not by the government.

[Aedes aegypti larval infestation index and identification of awareness, attitudes and practices related to Dengue in tire shops in Atlántico, Colombia].

PubMed

Maestre-Serrano, Ronald; Pacheco-Lugo, Lisandro; Salcedo-Mendoza, Soraya

2015-10-01

Objective To identify the awareness, attitudes and practices related to dengue in owners and workers of tire ships, as well as the levels of mosquito infestation in tire shops in Atlántico department - Colombia. Methods We conducted a descriptive study. The variables were described as percentages and measures of central tendency and dispersion. Index of larval infestation and containers were calculated in each of the municipalities studied. We visited and inspected 111 tire shops. 26.1 % (29/111) of these were found positive for Ae. aegypti larvae. The municipalities of Piojó, Santo Tomás, Santa Lucia, Sabanagrande and Luruaco were characterized by a higher larval infestation index. Results Regarding dengue, 90.9 % of respondents considered it a problem for them and their families. 94.6 % know that is transmitted by mosquitoes. 91.1 % know the vector larvae under the name "sarapico", 3.6 % as "gusarapo". 98.2 % felt that there is a relationship between the larva and Ae. aegypti mosquito. 100 % of participantes recognized tires to be a breeding for mosquitoes. 85.7% believed fever to be the most common symptom. 83 % reported accessing the health post to cure the disease. 90.8 % throw out unusable tires as if they were garbage. Conclusion In the population studied, there is good awareness of dengue and its vector. Nevertheless, there are problems related to attitudes and prevention practices.

[Social and family support to the elderly in urban areas].

PubMed

Zapata-López, Bertha I; Delgado-Villamizar, Norma L; Cardona-Arango, Doris

2015-12-01

Objective To describe the social and family support networks available to the elderly living in urban areas of the municipality of Angelópolis-Antioquia during the year 2011. Materials A descriptive transversal study was conductedusing the population experience to determine the social support received by the 239 seniors in the urban area of Angelópolis-Antioquia. The data was obtained from primary sources and univariate and bivariate analysis was conducted. Results Mostly women were interviewed (59.8 %) aged between 60 and 74 (66.9 %). The social status that appeared with the highest percentage was "married" (47.3 %) though with the interviewed women the social status with the highest occurrence was "widow" (40.6 %). 69,5 % had an elementary school educational level and 16,7 % had no formal education at all. 60.3 % were registered in the subsidized program. The support from families and friends was qualified as satisfactory. A statistically significant connection was found between gender and undertaking different activities in free time (value of p=0,004). Conclusions the study indicates that loneliness is an aspect that makes the elderly feel unprotected and vulnerable. Despite the general feeling of satisfaction regarding family support, some of them, especially women, expressed feeling mistreated. The data along with the lack of activities for spare time must be taken into account to formulate intervention strategies for effective support networks to improve the situation of this vulnerable population of the municipality.

Nutrition Standards for Food Service Guidelines for Foods Served or Sold in Municipal Government Buildings or Worksites, United States, 2014

PubMed Central

Zaganjor, Hatidza; Moore, Latetia V; Carlson, Susan; Kimmons, Joel; Galuska, Deborah

2016-01-01

Introduction The Institute of Medicine and Centers for Disease Control and Prevention have recommended that government agencies use nutrition standards for foods and beverages sold and provided at their facilities. In this study, we examine written nutrition standards for foods sold or served in local government buildings or worksites among US municipalities. Methods We used data from a 2014 national survey of 1,945 municipal governments serving populations of 1,000 or more to assess the presence of written nutrition standards, the food groups or nutrients addressed by standards, and the populations served by facilities where standards are applied. The prevalence of standards was estimated by municipality population size, rural–urban status, census region, poverty prevalence, education level, and racial/ethnic composition. Results Overall, 3.2% of US municipalities reported nutrition standards with greater prevalence observed among large municipalities (12.8% of municipalities with ≥50,000 people vs 2.2% of municipalities with <2,500 people, P < .001). Prevalence differed by region, and standards were most common in the West (6.6%) and least common in the Midwest (2.0%, P = .003).The most common nutrition topics addressed in standards were offering low-calorie beverages, fruits and vegetables, and free drinking water. Most standards applied to facilities serving government employees (67%) or the general public (66%), with fewer serving institutionalized populations (23%). Conclusion Few municipal governments reported having written nutrition standards for foods and beverages sold in their facilities in 2014. Implementing nutrition standards for foods sold or served by local governments is a strategy for increasing access to healthier foods and beverages among municipal employees and local residents. PMID:28005531

Spatial and temporal patterns of North Carolina pedestrian and bicycle plans.

PubMed

Aytur, Semra A; Rodriguez, Daniel A; Kerr, Zachary Y; Ji, Kai; Evenson, Kelly R

2013-01-01

Pedestrian and bicycle plans support community-level physical activity. In North Carolina, pedestrian/bicycle plans are becoming more prevalent. However, no studies have examined the spatial and temporal diffusion of pedestrian/bicycle plans. This study assessed (a) temporal trends associated with municipal pedestrian/bicycle planning from 1974 to 2011 and (b) spatial patterns associated with municipal plans, specifically, whether the publication of a pedestrian/bicycle plan in a given year was associated with the number of neighboring municipalities with plans. North Carolina from 1974 to 2011. The main outcome was date of publication of all North Carolina municipal pedestrian and bicycle plans (1974-2011). We calculated Euclidean distances from each municipality center to all other municipality centers to derive whether municipalities were within 20 and 50 miles of each other. Sociodemographic covariates (eg, education, grant funding status, poverty, urbanicity, racial composition, population size, population growth) were collected from the US Census of Population (1980-2010) and the American Community Survey (2006-2010). Time series models fitted by generalized estimating equations were used to assess relationships between plan presence and the temporal and spatial predictor variables. The number of pedestrian and bicycle plans significantly increased over time, especially after 2006 when a state grant funding program was initiated. Unadjusted models indicated that municipalities were significantly more likely to have a pedestrian plan if higher numbers of neighboring municipalities had pedestrian plans. After adjustment for sociodemographic covariates and funding source, this relationship was attenuated but remained statistically significant. For bicycle plans, no significant associations were observed between plan presence and the number of neighboring municipalities with bicycle plans in adjusted models. Findings from this study can be used to generate hypotheses to test theories about diffusion of innovation and social contagion processes in pedestrian/bicycle planning.

Nutrition Standards for Food Service Guidelines for Foods Served or Sold in Municipal Government Buildings or Worksites, United States, 2014.

PubMed

Onufrak, Stephen J; Zaganjor, Hatidza; Moore, Latetia V; Carlson, Susan; Kimmons, Joel; Galuska, Deborah

2016-12-22

The Institute of Medicine and Centers for Disease Control and Prevention have recommended that government agencies use nutrition standards for foods and beverages sold and provided at their facilities. In this study, we examine written nutrition standards for foods sold or served in local government buildings or worksites among US municipalities. We used data from a 2014 national survey of 1,945 municipal governments serving populations of 1,000 or more to assess the presence of written nutrition standards, the food groups or nutrients addressed by standards, and the populations served by facilities where standards are applied. The prevalence of standards was estimated by municipality population size, rural-urban status, census region, poverty prevalence, education level, and racial/ethnic composition. Overall, 3.2% of US municipalities reported nutrition standards with greater prevalence observed among large municipalities (12.8% of municipalities with ≥50,000 people vs 2.2% of municipalities with <2,500 people, P < .001). Prevalence differed by region, and standards were most common in the West (6.6%) and least common in the Midwest (2.0%, P = .003).The most common nutrition topics addressed in standards were offering low-calorie beverages, fruits and vegetables, and free drinking water. Most standards applied to facilities serving government employees (67%) or the general public (66%), with fewer serving institutionalized populations (23%). Few municipal governments reported having written nutrition standards for foods and beverages sold in their facilities in 2014. Implementing nutrition standards for foods sold or served by local governments is a strategy for increasing access to healthier foods and beverages among municipal employees and local residents.

Governance in managing public health resources in Brazilian municipalities.

PubMed

Avelino, George; Barberia, Lorena G; Biderman, Ciro

2014-09-01

This study contributes to the health governance discussion by presenting a new data set that allows for comparisons of the management of health resources among Brazilian municipalities. Research on Brazil is particularly important as the provision of health services was decentralized in 1988 and since then municipalities have been given greater responsibilities for the management of fiscal resources for public health service provision. Based on detailed information on corruption practices (such as over-invoicing, illegal procurement and fake receipts) from audit reports of health programmes in 980 randomly selected Brazilian municipalities, this study deepens understanding of the relationship between health governance institutions and the incidence of corruption at the local level by exploring the extent to which horizontal and vertical accountabilities contribute to reducing the propensity of municipal government officials to divert public health resources for private gain. The results of our multiple regression analysis suggest that the experience of health municipal councils is correlated with reductions in the incidence of corruption in public health programmes. This impact is significant over time, with each additional year of health council experience reducing corruption incidence levels by 2.1% from baseline values. The findings reported in this study do not rely on the subjectivity of corruption measures which usually conflate the actual incidence of corruption with its perception by informants. Based on our results, we provide recommendations that can assist policy makers to reduce corruption. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

A new species of tree crickets Oecanthus (Orthoptera, Gryllidae, Oecanthinae) in tobacco plantation from Southern Brazil, with body color variation.

PubMed

Milach, Elisa Machado; Martins, Luciano De P; Da Costa, Maria Kátia Matiotti; Gottschalk, Marco Silva; De Oliveira, Gabriel Lobregat; Redü, Darlan Rutz; Neutzling, Alexandre Schneid; Dornelles, José Eduardo Figueiredo; Vasconcellos, Lucas Azevedo; Zefa, Edison

2015-09-15

We provide herein a description of a new species of Oecanthus collected from the tobacco plantation in southern Brazil, municipality of São Lourenço do Sul, State of Rio Grande do Sul. Description focused metanotal gland features, phallic sclerites, and calling song. A large sampling of individuals was distributed into four groups according to body and appendages color and dotted. We also rank all kind of marks present in the scape and pedicel. We compare linear morphometric variables of the metanotal glands and tegmina, as well as calling song parameters between groups in order do define all of them as the same species. Photographs and measurements are provided.

Spatial patterns of dengue cases in Brazil

PubMed Central

Antonio, Fernando Jose; de Picoli, Sergio; Teixeira, Jorge Juarez Vieira; Mendes, Renio dos Santos

2017-01-01

Dengue infection plays a central role in our society, since it is the most prevalent vector-borne viral disease affecting humans. We statistically investigated patterns concerning the spatial spreading of dengue epidemics in Brazil, as well as their temporal evolution in all Brazilian municipalities for a period of 12 years. We showed that the distributions of cases in municipalities follow power laws persistent in time and that the infection scales linearly with the population of the municipalities. We also found that the average number of dengue cases does not have a clear dependence on the longitudinal position of municipalities. On the other hand, we found that the average distribution of cases varies with the latitudinal position of municipalities, displaying an almost constant growth from high latitudes until reaching the Tropic of Capricorn leveling to a plateau closer to the Equator. We also characterized the spatial correlation of the number of dengue cases between pairs of municipalities, where our results showed that the spatial correlation function decays with the increase of distance between municipalities, following a power-law with an exponential cut-off. This regime leads to a typical dengue traveling distance. Finally, we considered modeling this last behaviour within the framework of a Edwards-Wilkinson equation with a fractional derivative on space. PMID:28715435

Time to change focus? Transitioning from higher neonatal to higher stillbirth mortality in São Paulo State, Brazil.

PubMed

Andrews, Kathryn; Bourroul, Maria Lúcia Moraes; Fink, Günther; Grisi, Sandra; Scoleze Ferrer, Ana Paula; Diniz, Edna Maria de Albuquerque; Brentani, Alexandra

2017-01-01

Differential trends in mortality suggest that stillbirths may dominate neonatal mortality in the medium to long run. Brazil has made major efforts to improve data collection on health indicators at granular geographic levels, and provides an ideal environment to test this hypothesis. Our goals were to examine levels and trends in stillbirths and neonatal deaths and the extent to which the mortality burden caused by stillbirths dominates neonatal mortality at the municipality- and state-level. We used data from the Brazilian Ministry of Health's repository on births, fetal, and neonatal deaths (2010-2014) to calculate stillbirth and neonatal mortality rates for São Paulo state's 645 municipalities. At the state level, 7.9 per 1000 pregnancies ended in stillbirth (fetal death >22 weeks gestation or fetal weight >500g), but this varied from 0.0 to 28.4 per 1000 across municipalities. 7.9 per 1000 live births also died within the first 28 days. 42% of municipalities had a higher stillbirth rate than neonatal mortality rate, and in 61% of areas with low neonatal mortality (<8.0 per 1000), stillbirth rates exceeded neonatal mortality rates. This analysis suggests large variability and inequality in mortality outcomes at the sub-national level. The results also imply that stillbirth mortality may exceed neonatal mortality in Brazil and similar settings in the next few decades, which suggests a need for a shift in policy. This work further underscores the importance of continued research into causes and prevention of stillbirth.

Time to change focus? Transitioning from higher neonatal to higher stillbirth mortality in São Paulo State, Brazil

PubMed Central

Bourroul, Maria Lúcia Moraes; Fink, Günther; Grisi, Sandra; Scoleze Ferrer, Ana Paula; Diniz, Edna Maria de Albuquerque; Brentani, Alexandra

2017-01-01

Background Differential trends in mortality suggest that stillbirths may dominate neonatal mortality in the medium to long run. Brazil has made major efforts to improve data collection on health indicators at granular geographic levels, and provides an ideal environment to test this hypothesis. Our goals were to examine levels and trends in stillbirths and neonatal deaths and the extent to which the mortality burden caused by stillbirths dominates neonatal mortality at the municipality- and state-level. Methods We used data from the Brazilian Ministry of Health’s repository on births, fetal, and neonatal deaths (2010–2014) to calculate stillbirth and neonatal mortality rates for São Paulo state’s 645 municipalities. Results At the state level, 7.9 per 1000 pregnancies ended in stillbirth (fetal death >22 weeks gestation or fetal weight >500g), but this varied from 0.0 to 28.4 per 1000 across municipalities. 7.9 per 1000 live births also died within the first 28 days. 42% of municipalities had a higher stillbirth rate than neonatal mortality rate, and in 61% of areas with low neonatal mortality (<8.0 per 1000), stillbirth rates exceeded neonatal mortality rates. Conclusions This analysis suggests large variability and inequality in mortality outcomes at the sub-national level. The results also imply that stillbirth mortality may exceed neonatal mortality in Brazil and similar settings in the next few decades, which suggests a need for a shift in policy. This work further underscores the importance of continued research into causes and prevention of stillbirth. PMID:29272295

[A nationwide survey for implementation of Health Japan 21 anti-smoking countermeasures in municipalities throughout Japan].

PubMed

Shinmura, Hiromi; Wakabayashi, Chihiro; Kunisawa, Naoko; Kayaba, Kazunori; Miura, Yoshihiko; Ojima, Toshiyuki; Yanagawa, Hiroshi

2008-03-01

Smoking cessation is one of the most important items for improvement of health in Japan. The Japanese government started a new campaign called the "Health Japan 21" to promote better health of Japanese citizens in the 21st century. The purpose of the present study was to observe the situation of the municipalities throughout Japan regarding implementation of anti-smoking countermeasures and setting of the level of target values to be achieved over the next ten years. Mail questionnaire forms were sent to 953 municipalities which had formulated specific local plans for the promotion of health. Of this total, 793 (83.2%) responded to the inquiry. The most commonly implemented countermeasure against smoking was restricting smoking only to limited areas in municipality offices (75%), followed by providing support for stopping smoking (35%), and providing a complete smoke free environment in municipality offices (32.4%). Proportions of local governments putting a ban on smoking on public roads (7.5%), giving publicity to restaurants with smoking restrictions (< 5%) and setting no smoking times in the municipality offices (< 5%) were low. Some 70% of municipalities provided anti-smoking education for school children. Very few local governments took measures such as identifying age at purchasing tobacco, removing vending machines and restricting tobacco advertisement. Most municipalities have made much of anti-smoking activities. However, measures for school children were not satisfactorily implemented. The execution rates for anti-smoking activities are low in small-scale municipalities and therefore it is necessary to provide particular support in these cases.

The influence of municipal characteristics on the use of informal home care and home care services by the elderly Flemish.

PubMed

Demaerschalk, Melanie F; Vanden Boer, Lut E; Bronselaer, Joost L; Molenberghs, Geert; Declercq, Anja G

2013-04-01

When explaining the use of care, the context of the care gains importance. This article focuses on the influence of the municipality on the lives of the elderly regarding the usage of different forms of care, whereas controlling for the effect of individual characteristics. Two databases on the individual characteristics of elderly Flemish people living at home were combined with a database on municipal characteristics. The effect of municipal characteristics was measured through multi-level logistic regression. A higher mean income per inhabitant and a lower number of inhabitants/100 km(2) have a positive effect on the use of informal home care. The use of home care services is positively influenced by a higher family care index and an increasing relative number of hours of domestic care provided in the municipality. Receiving care from a general practitioner, medical specialist, dentist, emergency department, community nurse, physiotherapist, home aid, day-care centre or hospital with overnight stay is not influenced by the municipality's characteristics. The use of public welfare services, meals-on-wheels programs or hospital outpatients' services, however, are affected by the municipality, but cannot be fully explained by the model. The municipality that an elderly person lives in has an impact on the amount and the types of care an elderly person receives. Persons with similar care needs and similar individual characteristics can receive very different care when they live in different municipalities. This is quite a challenging finding for researchers, as well as for care providers and policy makers.

Trihalomethanes in drinking water and the risk of death from kidney cancer: does hardness in drinking water matter?

PubMed

Liao, Yen-Hsiung; Chen, Chih-Cheng; Chang, Chih-Ching; Peng, Chiung-Yu; Chiu, Hui-Fen; Wu, Trong-Neng; Yang, Chun-Yuh

2012-01-01

The objectives of this study were to (1) examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of development of kidney cancer and (2) determine whether hardness levels in drinking water modify the effects of TTHM on risk of kidney cancer induction. A matched case-control study was used to investigate the relationship between the risk of death attributed to kidney cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All kidney cancer deaths in the 53 municipalities from 1998 through 2007 were obtained. Controls were deaths from other causes and were pair-matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels and levels of hardness in drinking water were also collected. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM and hardness exposure via drinking water. Relative to individuals whose TTHM exposure level was <4.9 ppb, the adjusted OR (95% CI) for kidney cancer was 0.98 (0.77-1.25) for individuals who resided in municipalities served by drinking water with a TTHM exposure ≥4.9 ppb. However, evidence of an interaction was noted between the use of soft water and drinking water TTHM concentrations. Increased knowledge of the interaction between hardness and TTHM levels in reducing risk of kidney cancer development will aid in public policy decision and establishing standards to prevent disease occurrence.

e-Government Readiness, Strategy and Two Different User Groups - in Austria

NASA Astrophysics Data System (ADS)

Edelmann, Noella; Hoechtl, Johann; Parycek, Peter

This paper offers a description of the e-Government Strategy in Austria and its e-Government readiness, and looks at how two different user groups are experiencing e-Government in Austria. Studies conducted show that adolescent citizens are more optimistic and enthusiastic about the possibilities offered whilst the municipalities are more skeptical. The Austrian e-Government strategy, the decisionmakers and IT solution providers must understand the needs of all stakeholders and provide viable solutions accordingly.

Bullying Behavior and Psychosocial Health - A Cross-sectional Study among School Students of Pyuthan Municipality.

PubMed

Mishra, Durga Khadka; Thapa, Tulsi Ram; Marahatta, Sujan Babu; Mahotra, Anita

2018-03-13

Bullying remains as pervasive phenomenon affecting children worldwide. Bullying in school has long been a matter of concern as wide range of adjustment problems including poor mental health and violent behavior in school are associated with it. The present study examined the prevalence of bullying behavior (bullies, victims and bully-victims) and their association with depression and psychosomatic symptoms. A cross-sectional descriptive study was carried out among 8th, 9th and 10th grade students of Pyuthan Municipality, Mid-Western Nepal. A total of 405 students responded to the structured self-administered questionnaire. Data was collected from randomly selected public and private schools. Descriptive and inferential statistics were used for analysis. The result of this study showed higher prevalence of bully (55.8%) among students of Relatively Advantaged Janajati whereas victims (64.86%) belonged to Disadvantaged Janajatis. Students who bully were found more in grade 8 and 10 whilst the students of grade 9 were more victims. Bullying behavior prevailed more in private schools than in public schools. The overall prevalence of bullying behavior (either bully or victim) is 69.14%. The finding bolsters an association between bullying behavior and depression, psychosomatic symptoms and school type. Higher prevalence of bullying behavior suggested by this study portends the alarming consequences among school students. Bullying needs to be addressed fleetly. Effective interventions that reduce bullying practice in school is essential.

ICT and Intellectual Disability: A Survey of Organizational Support at the Municipal Level in Sweden

ERIC Educational Resources Information Center

Ramsten, Camilla; Marmstål Hammar, Lena; Martin, Lene; Göransson, Kerstin

2017-01-01

Background: Young adults today have grown up in a society where information and communication technology (ICT) support empowerment and social participation. Young adults with mild-to-moderate intellectual disability are at risk for marginalization by the digital divide. The aim was to map and describe how municipal organizations in Sweden organize…

A municipal forest report card: Results for California, USA

Treesearch

E.Gregory McPherson; Louren Kotow

2013-01-01

This study integrates two existing computer programs, the Pest Vulnerability Matrix and i-Tree Streets, into a decision-support tool for assessing municipal forest stability and recommending strategies to mitigate risk of loss. A report card concept was developed to communicate levels of performance in terms that managers and the public easily understand. Grades were...

Research challenges in municipal solid waste logistics management.

PubMed

Bing, Xiaoyun; Bloemhof, Jacqueline M; Ramos, Tania Rodrigues Pereira; Barbosa-Povoa, Ana Paula; Wong, Chee Yew; van der Vorst, Jack G A J

2016-02-01

During the last two decades, EU legislation has put increasing pressure on member countries to achieve specified recycling targets for municipal household waste. These targets can be obtained in various ways choosing collection methods, separation methods, decentral or central logistic systems, etc. This paper compares municipal solid waste (MSW) management practices in various EU countries to identify the characteristics and key issues from a waste management and reverse logistics point of view. Further, we investigate literature on modelling municipal solid waste logistics in general. Comparing issues addressed in literature with the identified issues in practice result in a research agenda for modelling municipal solid waste logistics in Europe. We conclude that waste recycling is a multi-disciplinary problem that needs to be considered at different decision levels simultaneously. A holistic view and taking into account the characteristics of different waste types are necessary when modelling a reverse supply chain for MSW recycling. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Intercensal reconstruction of population and descriptive epidemiological measures in Italy: what is the impact on the cancer incidence rates?].

PubMed

Rashid, Ivan; Giacomin, Adriano; Michiara, Maria; Minerba, Sante; Sgargi, Paolo; Mincuzzi, Antonia; Silvestrini, Angela

2016-01-01

to test the effect on cancer incidence rates when using precensal computation (computed population) or intercensal reconstruction of population (reconstructed population). comparison between computed and reconstructed population by area and period in 2002-2011; evaluation of the effect on cancer rates using Italian cancer registries data. Setting e participants: population data from the Italian National Institute for Statistics, cancer data from Italian cancer registries; specific analysis involves data from Parma (Emilia-Romagna Region, Northern Italy) and Taranto (Apulia Region, Southern Italy) cancer registries. ratio between computed and reconstructed population by area, gender, age, and period; ratio between corresponding age-standardized incidence rates. Italian population estimates by precensal computation for years 2002-2011 was generally higher than that obtained by intercensal reconstruction especially in 2011, when this has been found in more than 86% of Italian Municipalities. In the same year a smaller proportion of Municipalities (11%) showed an inverse population ratio. Among the most populated Municipalities, the City of Milan showed the higher precensal to intercensal population ratio (1.076), while the City of Taranto showed the lower precensal to intercensal population ratio (0.956). The ratios between age standardized rates obtained with precensal population to those obtained with intercensal population show similar differences; in particular, for all cancer in males and females they were, respectively, 0.985 and 0.982 in the Province of Parma, 0.974 and 0.968 in the City of Parma, 1.023 and 1.013 in the Province of Taranto, and 1.08 and 1.051 in the City of Taranto. using precensal population as denominator for the year 2002- 2011 produces a remarkable distortion of both temporal trend and geographical comparisons. It is, therefore, necessary that researchers take into account this possible distortion when reporting descriptive measures in the years between the last two censuses in Italy.

[The medical organizational aspects of decreasing of preventable mortality in the case of traffic accident in municipal district].

PubMed

Voloshina, L V; Plutnitskiĭ, A N

2010-01-01

The article deals with the results of the study of such actual issue as decreasing of preventable mortality in the case of traffic accident in municipal district. The analysis was based on the mortality statistical data and the expertise of causes of lethal outcomes of traffic accidents. The results are used to develop the measures of improving the organization and quality of medical care of victims of road accident on the pre-hospital and hospital stages on the level of municipal health care to decrease the human losses caused by traffic accident.

Achievements and future path of Tehran municipality in urban health domain: An Iranian experience

PubMed Central

Damari, Behzad; Riazi-Isfahani, Sahand

2016-01-01

Background: According to national laws and world experiences; provision, maintenance, and improving citizens’ health are considered to be the essential functions of municipalities as a "social institute". In order to equitably promote health conditions at urban level, particularly in marginal areas, since 2004 targeted efforts have been implemented in the municipality of Tehran metropolis. This study was intended to identify and analyze these targeted measures and tries to analyze health interventions in a conceptual framework and propose a future path. Methods: This is a qualitative study with content analysis approach. Reviewing documents and structured interviews with national health policy making and planning experts and executive managers of 22-region municipalities of Tehran metropolis were used to collect data. The data were analyzed on the basis of conceptual framework prepared for urban health in 4 domains including municipal interventions, goal achievements, drivers and obstacles of success, and the way forward. Results: From the viewpoint of interviewees, these new health actions of Tehran municipality are more based on public participation and the municipality was able to prioritize health issue in the programs and policies of Tehran city council. Tehran municipality has accomplished three types of interventions to improve health, which in orders of magnitude are: facilitative, promotional, and mandatory interventions. Development and institutionalization of public participation is the greatest achievement in health-oriented actions; and expansion of environmental and physical health-oriented facilities and promoting a healthy lifestyle are next in ranks. Conclusion: Since management alterations seriously challenges institutionalization of actions and innovations especially in the developing countries, it is suggested that mayors of metropolitan cities like Tehran document and review municipal health measures as soon as possible and while eliminating overlapping of interventions with other sectors, design and approve the charter of "health promoting municipality". The most important role of municipalities in this charter would be coordinating health improvement of citizens. This charter, when approved as a national policy could be used for other cities too. PMID:27390693

[Evaluation of rabies post-exposure prophylaxis in humans injured by dogs and cats in the municipality of Jaboticabal, SP, from 2000 through 2006].

PubMed

Frias, Danila Fernanda Rodrigues; Lages, Sonia Luisa Silva; Carvalho, Adolorata Aparecida Bianco

2011-12-01

The present study aimed to evaluate rabies post-exposure prophylaxis (PEP) in humans in the municipality of Jaboticabal, São Paulo from 2000 through 2006. A descriptive and retrospective study was conducted by collecting data available in patient records. Vaccination costs were also calculated; 2,493 patients injured by animals received PEP, totaling R$ 179,105.14 and 7,108 doses; 2,184 (71.5%) out of the total reports were caused by dogs and cats clinically healthy at the moment of the attack. These animals remained sound throughout the 10-day observation period. The observation was conducted by the victim or by the owner. Considering animal observation and the epidemiological status of rabies in the municipality, all of these patients could have been dismissed from PEP treatment. Instead, only 464 were dismissed, meaning that 1,720 patients were unnecessarily vaccinated. An estimated 4,590 doses and R$114,420.81 could have been saved. In comparison with rates of other municipalities of the State of São Paulo and with the national mean, the number of PEP in Jaboticabal is very high and it became evident that management evaluated neither the health status of the animal nor the epidemiological status of the area for rabies. Permanent awareness and education of public health professionals with respect to rabies epidemiology and the need to perform correct observation of the aggressors are recommended. It is essential that medical and veterinary services be integrated to provide better assessment of cases and safer decisions on the institution of PEP.

Expenditures in the health care system in Brazil: the participation of states and the Federal District in financing the health care system from 2002 to 2013

PubMed Central

de Deus Costa, Renata Maria; da Silva Barbosa, Rafael; Zucchi, Paola

2015-01-01

OBJECTIVE: To analyze the public expenditures of states on health care and the participation of states and the Federal District in financing the Unified Health System, better known by the acronym SUS. To develop the research, two targets were used: “to rescue expenses per government source (federal, state and municipal) during the period from 2002 to 2013” and “to rescue resource transfers from the federal SUS to the states and also to municipalities”. METHODS: This research is bibliographic, documentary and descriptive and used a quantitative approach. Data were extracted from the Information System Public Health Budget, and additional data were collected from the public managers of states, municipalities and the Federal District during the period from 2002 to 2013. Federal data from the Undersecretary of Planning and Budget (originally extracted from the Integrated System of Financial Administration of the Federal Government and available on the Budget Public Health System webpage) were also collected. RESULTS: The data revealed that during the same researched period, the Federal District has maintained the health care system budget, whereas states and municipalities have increased their budgets for the same spending. CONCLUSIONS: By analyzing the results, there is clearly a disparity regarding the investment expended by the entities of the Federation. Although municipalities and states have gradually increased their application of resources to health care, the federal state has maintained the same budget. These results reveal a bit of concern about public health funding. PMID:26017788

[Analysis on funds application of community based organizations involved in HIV/AIDS response and government financial investment in China, 2014].

PubMed

Zhang, G; Zhu, Y X; Wang, P; Liu, P; Li, J F; Sha, S; Yang, W Z; Li, H

2017-03-06

Objective: To understand the government financial investments to community based organizations (CBO) involved in HIV/AIDS Control and Prevention of China and its influencing factors. Methods: Questionnaire of the situation of CBO involved in HIV/AIDS control and prevention were designed, and filled by the staff of Provincial Health Administrative Departments of 31 provinces (autonomous regions and municipalities). The research focused on the fields of CBO involved in HIV/AIDS response in 31 provinces (autonomous regions and municipalities), including intervention on HIV/AIDS high risk population (female sex worker (FSW), man who sex with man (MSM), drug user (DU) and case management and care for people living with HIV/AIDS (PLWH)). 29 valid questionnaires were collecting, with Shanxi Province and Inner Mongolia Autonomous Regions not filled. Questionnaire included financial supports from local governments, transfer payment from central government for CBO involved in HIV/AIDS response in 2014, and unit cost for CBO involved in HIV/AIDS control and prevention. Multivariate analysis was conducted on the project application and financial investment of community based organizations involved in HIV/AIDS control and prevention in 2014. Results: The total amount of CBO to apply for participation in AIDS prevention and control was 64 482 828 Yuan in 2014. The actual total amount of investment was 50 616 367 Yuan, The investment came from the central government funding, the provincial level government funding, the prefecture and county level government funding investment and other sources of funding. 22 of 28 provinces (autonomous regions and municipalities) received the funds from the central government finance, and median of investment funds 500 000 Yuan. 15 provinces (autonomous regions and municipalities) gained the funds from the provincial government finance, and median of investment funds 350 000 Yuan. 12 provinces (autonomous regions and municipalities) got the funds from the prefecture and county level government finance, and median of investment funds 408 750 Yuan. 12 provinces (autonomous regions and municipalities) acquired the funds from other sources, and median of investment funds 228 400 Yuan. The median ( P (25), P (75)) unit costs of intervention for FSW from 16 provinces (autonomous regions and municipalities) was 70 (23, 280) Yuan per year; DU from 14 provinces (autonomous regions and municipalities) was 83 (44, 200 ) Yuan per year; MSM from 16 provinces (autonomous regions and municipalities) was 100 (35, 280) Yuan per year; the follow-up and care for PLWH from 17 provinces (autonomous regions and municipalities) was 200 (45, 500) Yuan per year. Multivariate linear regression analysis results showed that the amount of PLWH in 2014 influenced on the total number of application funds of CBO involved in HIV/AIDS response ( b =178.11, 95% CI: 51.86-305.36) and the amount of PLWH ( b =77.72, 95% CI: 16.28-139.16), and Gross Domestic Product (GDP) per capita of the province ( b =36.20, 95% CI: 4.60-67.80) impacted financial investment to CBO involved in HIV/AIDS response, respectively. Conclusion: Funds application and financial investment of CBO involved in HIV/AIDS control and prevention were huge. Financial investment from government was main resources for CBO in 2014. The amount of financial investment funds from governments was influenced by the HIV/AIDS epidemic situation and the development level of local economic.

Point prevalence of wounds and cost impact in the acute and community setting in Denmark.

PubMed

Gottrup, F; Henneberg, E; Trangbæk, R; Bækmark, N; Zøllner, K; Sørensen, J

2013-08-01

To estimate the wound-care related costs in two hospitals in Denmark. A point-prevalence survey with a focus on resource consumption was carried out during a representative 1-week period in March 20 I 0, in two hospitals in Denmark: Regional Hospital Viborg, in the Viborg Municipality and Hillerod Hospital, in the Horsholm Municipality. Data were collected during a 2-day period for inpatients and outpatients in the hospitals and over a full week in the municipalities. The survey included information on the numbers, types and locations of the wounds, as well as resource consumption related to dressing changes. The estimation of costs was based on representative cost levels, including the salaries of health professionals or nurses and the cost of dressings and hospitalisation provided. In total, 33% (n=830) of inpatients had a wound. The majority of these were surgical/trauma wounds (25%), while pressure ulcers, leg ulcers and diabetic foot ulcers accounted for 3.3%, 1.7% and 1.6%, respectively. In the municipalities, there was a wound patient prevalence of 2.8 per I 000 population(I I I 000 acute wounds, 0.7/ I 000 pressure ulcers, 0.5/ I 000 leg ulcers and 0.3/ I 000 diabetic foot ulcers).The extrapolated figures for nurse time related to wound care per year was equivalent to I 0 full-time nurse positions in Hillerod Hospital, three in Viborg Hospital, 17 in Viborg Municipality and three in Horsholm Municipality. The total annual costs related to wound care was estimated as €3.6 million for Viborg Hospital, €4.1 million for Hillemd Hospital, € 1.2 million for Viborg Municipality and €232 548 for Horsholm Municipality, accounting for approximately 1.8% (Viborg), 1.6% (Hillerod), 2.4% (Viborg) and1.5% (Horsholm) of the total annual budgets. In the survey, 33% of the patients treated in the hospitals had a wound. Primary costs were defined as hospitalisation costs and nurse time related to dressing changes. Total annual costs of treatment, including hospitalisation, were estimated as approximately 1.6-1.8% for the hospitals and 1.5-2.4% for the municipalities. The level of costs support the relevance of increased efforts to secure better wound prevention and treatment to reduce the staff-time consumption and hospitalisation costs.

Waterborne disease outbreak detection: an integrated approach using health administrative databases.

PubMed

Coly, S; Vincent, N; Vaissiere, E; Charras-Garrido, M; Gallay, A; Ducrot, C; Mouly, D

2017-08-01

Hundreds of waterborne disease outbreaks (WBDO) of acute gastroenteritis (AGI) due to contaminated tap water are reported in developed countries each year. Such outbreaks are probably under-detected. The aim of our study was to develop an integrated approach to detect and study clusters of AGI in geographical areas with homogeneous exposure to drinking water. Data for the number of AGI cases are available at the municipality level while exposure to tap water depends on drinking water networks (DWN). These two geographical units do not systematically overlap. This study proposed to develop an algorithm which would match the most relevant grouping of municipalities with a specific DWN, in order that tap water exposure can be taken into account when investigating future disease outbreaks. A space-time detection method was applied to the grouping of municipalities. Seven hundred and fourteen new geographical areas (groupings of municipalities) were obtained compared with the 1,310 municipalities and the 1,706 DWN. Eleven potential WBDO were identified in these groupings of municipalities. For ten of them, additional environmental investigations identified at least one event that could have caused microbiological contamination of DWN in the days previous to the occurrence of a reported WBDO.

Legislative Framework for Landscape Planning in Latvia

NASA Astrophysics Data System (ADS)

Nitavska, Natalija; Zigmunde, Daiga

2017-10-01

With the adoption and the ratification of the European Landscape Convention a legally justified need for a clear landscape policy was grounded in the European countries. It includes the elaboration of the new and the improvement of the existing legislative documents on landscape planning, protection and management. The aim of the particular study is to analyse the existing legislative documents in Latvia influencing landscape planning on different scales / and the implementation of the European Landscape Convention. The study emphasizes the complex structure of the Latvian legislative framework affected by the distribution of the normative documents under the various ministries. Therefore, the main problem is unclear responsibility levels and organizational system for solving the issues regarding landscape planning, protection and management. Thus the various discussions between the involved disciplines and responsible institutions are arising. Two groups of the legislative documents influencing the implementation of the landscape policy in Latvia are detected within the study. The first group is strategic documents determining main landscape planning principles and directions at European, national, regional and professional or sectoral level. The second group is operational documents providing a set of actions for the landscape planning, protection and management at the local or the municipality level. The study concludes that operational documents developed by the municipalities are in high importance because of their direct influence on the landscape planning in Latvia. This often leads to the different landscape planning requirements included in the normative documents of the neighbouring municipalities, although the spatial and ecological borders of the visual landscape do not fit with the formal borders of the municipalities. Thus, it is essential to develop the common principles and actions that would be incumbent on all municipalities to provide the landscape integrity and to protect its values according to the main principles defined in the European Landscape Convention.

Unemployment and disability pension--an 18-year follow-up study of a 40-year-old population in a Norwegian county.

PubMed

Støver, Morten; Pape, Kristine; Johnsen, Roar; Fleten, Nils; Sund, Erik R; Claussen, Bjørgulf; Bjørngaard, Johan H

2012-02-28

This study explored the association of unemployment and an increased risk of receiving disability pension, and the possibility that this risk is attributed to municipality-specific characteristics. A cohort of 7,985 40-42 year olds was followed for 18 years in national registers, identifying new episodes of unemployment and cases of disability pension. The association between an unemployment period and disability pension in the subsequent year was estimated using discrete time multilevel logistic regressions and clustering individuals by municipality. The association between unemployment and disability pension was adjusted for age in the follow up-period, sex, baseline health status, health behaviour and education level. A conditional intra-class correlation coefficient (ICC) was estimated as a measure of inter-municipality variance. In the follow-up period, 2784 (35%) of the participants were granted disability pension. The crude odds ratio for receiving disability pension after unemployment (adjusted for age in follow-up period and sex only) was 1.42 (95% CI 1.1-1.8). Adjusting for baseline health indicators reduced the odds ratio of unemployment to 1.33 (CI 1.1-1.7). A fully adjusted model, including education level, further reduced the odds ratio of unemployment to 1.25 (CI 1.00-1.6). The ICC of the municipality level was approximately 2%. Becoming unemployed increased the risk of receiving subsequent disability pension. However, adjusting for baseline health status, health behaviour and education attenuated this impact considerably. The multilevel analysis indicated that a minor, yet statistically significant, proportion of the risk of disability pension can be attributed to the municipality of residence.

Unemployment and disability pension-an 18-year follow-up study of a 40-year-old population in a Norwegian county

PubMed Central

2012-01-01

Background This study explored the association of unemployment and an increased risk of receiving disability pension, and the possibility that this risk is attributed to municipality-specific characteristics. Methods A cohort of 7,985 40-42 year olds was followed for 18 years in national registers, identifying new episodes of unemployment and cases of disability pension. The association between an unemployment period and disability pension in the subsequent year was estimated using discrete time multilevel logistic regressions and clustering individuals by municipality. The association between unemployment and disability pension was adjusted for age in the follow up-period, sex, baseline health status, health behaviour and education level. A conditional intra-class correlation coefficient (ICC) was estimated as a measure of inter-municipality variance. Results In the follow-up period, 2784 (35%) of the participants were granted disability pension. The crude odds ratio for receiving disability pension after unemployment (adjusted for age in follow-up period and sex only) was 1.42 (95% CI 1.1-1.8). Adjusting for baseline health indicators reduced the odds ratio of unemployment to 1.33 (CI 1.1-1.7). A fully adjusted model, including education level, further reduced the odds ratio of unemployment to 1.25 (CI 1.00-1.6). The ICC of the municipality level was approximately 2%. Conclusions Becoming unemployed increased the risk of receiving subsequent disability pension. However, adjusting for baseline health status, health behaviour and education attenuated this impact considerably. The multilevel analysis indicated that a minor, yet statistically significant, proportion of the risk of disability pension can be attributed to the municipality of residence. PMID:22369630

Effects of short-term exposure to environmentally relevant concentrations of different pharmaceutical mixtures on the immune response of the pond snail Lymnaea stagnalis.

PubMed

Gust, M; Fortier, M; Garric, J; Fournier, M; Gagné, F

2013-02-15

Pharmaceuticals are pollutants of potential concern in the aquatic environment where they are commonly introduced as complex mixtures via municipal effluents. Many reports underline the effects of pharmaceuticals on immune system of non target species. Four drug mixtures were tested, and regrouped pharmaceuticals by main therapeutic use: psychiatric (venlafaxine, carbamazepine, diazepam), antibiotic (ciprofloxacine, erythromycin, novobiocin, oxytetracycline, sulfamethoxazole, trimethoprim), hypolipemic (atorvastatin, gemfibrozil, benzafibrate) and antihypertensive (atenolol, furosemide, hydrochlorothiazide, lisinopril). Their effects were then compared with a treated municipal effluent known for its contamination, and its effects on the immune response of Lymnaea stagnalis. Adult L. stagnalis were exposed for 3 days to an environmentally relevant concentration of the four mixtures individually and as a global mixture. Effects on immunocompetence (hemocyte viability and count, ROS and thiol levels, phagocytosis) and gene expression were related to the immune response and oxidative stress: catalase (CAT), superoxide dismutase (SOD), glutathione reductase (GR), Selenium-dependent glutathione peroxidase (SeGPx), two isoforms of the nitric oxide synthetase gene (NOS1 and NOS2), molluscan defensive molecule (MDM), Toll-like receptor 4 (TLR4), allograft inflammatory factor-1 (AIF) and heat-shock protein 70 (HSP70). Immunocompetence was differently affected by the therapeutic class mixtures compared to the global mixture, which increased hemocyte count, ROS levels and phagocytosis, and decreased intracellular thiol levels. TLR4 gene expression was the most strongly increased, especially by psychiatric mixture (19-fold), while AIF-1, GR and CAT genes were downregulated. A decision tree analysis revealed that the immunotoxic responses caused by the municipal effluent were comparable to those obtained with the global pharmaceutical mixture, and the latter shared similarity with the antibiotic mixture. This suggests that pharmaceutical mixtures in municipal effluents represent a risk for gastropods at the immunocompetence levels and the antibiotic group could represent a model therapeutic class for municipal effluent toxicity studies in L. stagnalis. Copyright © 2013 Elsevier B.V. All rights reserved.

Public health terminology: Hindrance to a Health in All Policies approach?

PubMed

Synnevåg, Ellen S; Amdam, Roar; Fosse, Elisabeth

2018-02-01

National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach. A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. This paper promotes debate about the appropriateness of using the terms 'public health' and 'public health work' at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local level.

Changes in hormone and stress-inducing activities of municipal wastewater in a conventional activated sludge wastewater treatment plant.

PubMed

Wojnarowicz, Pola; Yang, Wenbo; Zhou, Hongde; Parker, Wayne J; Helbing, Caren C

2014-12-01

Conventional municipal wastewater treatment plants do not efficiently remove contaminants of emerging concern, and so are primary sources for contaminant release into the aquatic environment. Although these contaminants are present in effluents at ng-μg/L concentrations (i.e. microcontaminants), many compounds can act as endocrine disrupting compounds or stress-inducing agents at these levels. Chemical fate analyses indicate that additional levels of wastewater treatment reduce but do not always completely remove all microcontaminants. The removal of microcontaminants from wastewater does not necessarily correspond to a reduction in biological activity, as contaminant metabolites or byproducts may still be biologically active. To evaluate the efficacy of conventional municipal wastewater treatment plants to remove biological activity, we examined the performance of a full scale conventional activated sludge municipal wastewater treatment plant located in Guelph, Ontario, Canada. We assessed reductions in levels of conventional wastewater parameters and thyroid hormone disrupting and stress-inducing activities in wastewater at three phases along the treatment train using a C-fin assay. Wastewater treatment was effective at reducing total suspended solids, chemical and biochemical oxygen demand, and stress-inducing bioactivity. However, only minimal reduction was observed in thyroid hormone disrupting activities. The present study underscores the importance of examining multiple chemical and biological endpoints in evaluating and monitoring the effectiveness of wastewater treatment for removal of microcontaminants. Copyright © 2014 Elsevier Ltd. All rights reserved.

Fifty-Year Flood-Inundation Maps for Santa Rosa de Aguan, Honduras

USGS Publications Warehouse

Mastin, Mark C.; Olsen, T.D.

2002-01-01

After the devastating floods caused by Hurricane Mitch in 1998, maps of the areas and depths of the 50-year-flood inundation at 15 municipalities in Honduras were prepared as a tool for agencies involved in reconstruction and planning. This report, which is one in a series of 15, presents maps of areas in the coastal municipality of Santa Rosa de Aguan that are prone to oceanic storm-surge flooding and wave action. The 50-year flood on the Rio Aguan (4,270 cubic meters per second), would inundate most of the area surveyed for this municipality and beyond. Therefore a detailed numerical hydraulic model was not developed for this municipality as it was for the others. The 50-year storm surge would likely produce higher water levels than the 50-year flood on the river during normal astronomical tides. The elevation of the 50-year storm surge was estimated to be 4.35 meters above normal sea level, based on hurricane probabilities and published storm-surge elevations associated with various hurricane categories. Flood-inundation maps, including areas of wave-action hazard and a color-shaded elevation map, were created from the available data and the estimated 50-year storm tide. Geographic Information System (GIS) coverages of the hazard areas are available on a computer in the municipality of Santa Rosa de Aguan as part of the Municipal GIS project and on the Internet at the Flood Hazard Mapping Data Web page (http://mitchnts1.cr.usgs.gov/projects/floodhazard.html). These coverages allow users to view the maps in much more detail than is possible using the maps in this report.

Preparing for the Profession: Practitioner Perceptions of College Student Preparedness for Entry-Level, Full-Time Employment in Municipal Recreation Agencies

ERIC Educational Resources Information Center

D'Eloia, Melissa H.; Fulthorp, Keith

2016-01-01

Are recent graduates with degrees in parks and recreation adequately prepared to secure full-time employment in municipal recreation? To answer this question, California Parks and Recreation Society members with position titles such as supervisor, manager, director and superintendent (n = 206) were asked: How can recent college graduates be better…

A Basic Accounting of Variation in Municipal Solid-Waste Generation at the County Level in Texas, 2006: Groundwork for Applying Metabolic-Rift Theory to Waste Generation

ERIC Educational Resources Information Center

Clement, Matthew Thomas

2009-01-01

Environmental social scientists debate whether or not modern development reduces society's impact on the biosphere. The empirical research informing the discussion has not yet adequately examined the social determinants of municipal solid-waste (MSW) generation, an increasingly relevant issue, both ecologically and sociologically. A primary…

Influence of municipal policy and individual characteristics on the use of informal and formal domestic help in the Netherlands.

PubMed

Marangos, Anna Maria; Waverijn, Geeke; de Klerk, Mirjam; Iedema, Jurjen; Groenewegen, Peter P

2018-05-24

The responsibility for care and social support in the Netherlands has been decentralized to the municipalities, on the assumption that they are able to organise care and social support more effectively and efficiently. Municipalities are responsible for offering citizens the social support they need. They have policy discretion to decide how and to what extent they encourage and support the use of informal help. This article explored whether the local policy focus on informal or formal help influences the actual take-up of domestic help. Data on 567 physically disabled people who use informal or formal help in the household were linked to local policy data in 167 municipalities. We performed multilevel multinomial regression analyses. Since we expected that local policy will have more influence on people with slight or moderate disabilities, cohabitees and people aged under 75, cross-level interaction terms were included between characteristics of local policy and of individuals. The findings reveal differences between municipalities in their policy on support and differences in the use of formal or informal support between municipalities. We found no relationship between local emphasis on informal help and the use of informal help. Possible explanations: some people have a small social network, people using informal help did not apply for municipality support or even do not know the possibility exists. Copyright © 2018 Elsevier B.V. All rights reserved.

Tabanidae (Diptera) of Maranhão state, Brazil. V. Description of Protosilvius gurupi sp. n. (Pangoniinae, Pangoniini) and key to Protosilvius species

PubMed Central

Rafael, José Albertino; Marques, Dayse Willkenia Almeida; Limeira-de-Oliveira, Francisco

2012-01-01

Abstract Protosilvius gurupi sp. n. (Tabanidae, Pangoniinae) is described and illustrated based on seven female and 53 male specimens collected in the Amazonian region at Reserva Biológica Gurupi, Centro Novo do Maranhão municipality, northwest Maranhão, Brazil. This is the first record of Protosilvius in northern Brazil and in the Amazon Basin. An illustrated key to all Protosilvius species is also presented. PMID:23226962

State Clean Energy Policies Analysis. State, Utility, and Municipal Loan Programs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lantz, Eric

2010-05-01

This report relies on six in-depth interviews with loan program administrators to provide descriptions of existing programs. Findings from the interviews are combined with a review of relevant literature to elicit best practices and lessons learned from existing loan programs. Data collected from each of the loan programs profiled are used to quantify the impacts of these specific loan programs on the commonly cited, overarching state clean energy goals of energy security, economic development, and environmental protection.

Using the salutogenic approach to unravel informal caregivers' resources to health: theory and methodology.

PubMed

Wennerberg, Mia M T; Lundgren, Solveig M; Danielson, Ella

2012-01-01

This article describes the theoretical foundation and methodology used in a study intended to increase knowledge concerning informal caregivers' resources to health (in salutogenesis; General Resistance Resources, GRRs). A detailed description of how the approach derived from salutogenic theory was used and how it permeated the entire study, from design to findings, is provided. How participation in the study was experienced is discussed and methodological improvements and implications suggested. Using an explorative, mixed method design, data was collected through salutogenically guided interviews with 32 Swedish caregivers to older adults. A constant comparative method of analysis was used to identify caregiver-GRRs, content analysis was further used to describe how participation was experienced. The methodology unraveled GRRs caregivers used to obtain positive experiences of caregiving, but also hindrances for such usage contributing to negative experiences. Mixed data made it possible to venture beyond actual findings to derive a synthesis describing the experienced, communal context of the population reliant on these GRRs; Caregivinghood. Participating in the salutogenic data-collection was found to be a reflective, mainly positive, empowering and enlightening experience. The methodology was advantageous, even if time-consuming, as it in one study unravelled caregiver-GRRs and hindrances for their usage on individual, communal and contextual levels. It is suggested that the ability to describe Caregivinghood may be essential when developing health-promoting strategies for caregivers at individual, municipal and national levels. The methodology makes such a description possible and suggested methodological improvements may enhance its usability and adaptability to other populations.

Characterization of Class A low-level radioactive waste 1986--1990. Volume 6: Appendices G--J

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dehmel, J.C.; Loomis, D.; Mauro, J.

1994-01-01

Under contract to the US Nuclear Regulatory Commission, Office of Nuclear Regulatory Research, the firms of S. Cohen & Associates, Inc. (SC&A) and Eastern Research Group (ERG) have compiled a report that describes the physical, chemical, and radiological properties of Class-A low-level radioactive waste. The report also presents information characterizing various methods and facilities used to treat and dispose non-radioactive waste. A database management program was developed for use in accessing, sorting, analyzing, and displaying the electronic data provided by EG&G. The program was used to present and aggregate data characterizing the radiological, physical, and chemical properties of the wastemore » from descriptions contained in shipping manifests. The data thus retrieved are summarized in tables, histograms, and cumulative distribution curves presenting radionuclide concentration distributions in Class-A waste as a function of waste streams, by category of waste generators, and regions of the United States. The report also provides information characterizing methods and facilities used to treat and dispose non-radioactive waste, including industrial, municipal, and hazardous waste regulated under Subparts C and D of the Resource Conservation and Recovery Act (RCRA). The information includes a list of disposal options, the geographical locations of the processing and disposal facilities, and a description of the characteristics of such processing and disposal facilities. Volume 1 contains the Executive Summary, Volume 2 presents the Class-A waste database, Volume 3 presents the information characterizing non-radioactive waste management practices and facilities, and Volumes 4 through 7 contain Appendices A through P with supporting information.« less

Seroepidemiology of helicobacter pylori infection in pregnant women in rural durango, Mexico.

PubMed

Alvarado-Esquivel, Cosme

2013-12-01

The seroepidemiology of Helicobacter pylori infection in pregnant women in Durango, Mexico is largely unknown. The prevalence of anti-H. pylori IgG antibodies was examined in 343 pregnant women living in rural areas in 7 municipalities in Durango State, Mexico, using enzyme-linked immunosorbent assays (ELISA). A correlation of H. pylori seropositivity with socio-demographic, obstetric and behavioral characteristics of pregnant women was also assessed. In total, 179 (52.2%) of the 343 pregnant women (mean age, 24.2 ± 5.9 years) had H. pylori IgG antibodies, 75 (41.9%) of whom had H. pylori IgG antibody levels higher than 100 U/mL. The seroprevalence of H. pylori infection varied from 33.3% to 65% among municipalities. In contrast, the seroprevalence was comparable among women regardless their age, educational level, occupation, socioeconomic status, animal contacts, foreign travel, eating habits, contact with soil, crowding, sanitary conditions at home and educational level of the head of their families. Multivariant analysis of socio-demographic and behavioral variables showed that H. pylori seropositivity was associated with municipality (OR=1.12; 95% CI: 1.01-1.24; P=0.02). Of the obstetric characteristics, the seroprevalence of H. pylori infection increased significantly with the number of pregnancies and deliveries but not with the number of cesarean sections or miscarriages. Rural pregnant women in Durango had a lower seroprevalence of H. pylori infection than those from populations in developing countries. Results support a variability of H. pylori seroprevalence within a region. Further research at a municipal level might help to understand the epidemiology of H. pylori infection.

Assessing the validity of commercial and municipal food environment data sets in Vancouver, Canada.

PubMed

Daepp, Madeleine Ig; Black, Jennifer

2017-10-01

The present study assessed systematic bias and the effects of data set error on the validity of food environment measures in two municipal and two commercial secondary data sets. Sensitivity, positive predictive value (PPV) and concordance were calculated by comparing two municipal and two commercial secondary data sets with ground-truthed data collected within 800 m buffers surrounding twenty-six schools. Logistic regression examined associations of sensitivity and PPV with commercial density and neighbourhood socio-economic deprivation. Kendall's τ estimated correlations between density and proximity of food outlets near schools constructed with secondary data sets v. ground-truthed data. Vancouver, Canada. Food retailers located within 800 m of twenty-six schools RESULTS: All data sets scored relatively poorly across validity measures, although, overall, municipal data sets had higher levels of validity than did commercial data sets. Food outlets were more likely to be missing from municipal health inspections lists and commercial data sets in neighbourhoods with higher commercial density. Still, both proximity and density measures constructed from all secondary data sets were highly correlated (Kendall's τ>0·70) with measures constructed from ground-truthed data. Despite relatively low levels of validity in all secondary data sets examined, food environment measures constructed from secondary data sets remained highly correlated with ground-truthed data. Findings suggest that secondary data sets can be used to measure the food environment, although estimates should be treated with caution in areas with high commercial density.

Mercury contamination and potential impacts from municipal waste incinerator on Samui Island, Thailand.

PubMed

Muenhor, Dudsadee; Satayavivad, Jutamaad; Limpaseni, Wongpun; Parkpian, Preeda; Delaune, R D; Gambrell, R P; Jugsujinda, Aroon

2009-03-01

In recent years, mercury (Hg) pollution generated by municipal waste incinerators (MWIs) has become the subject of serious public concern. On Samui Island, Thailand, a large-scale municipal waste incinerator has been in operation for over 7 years with a capacity of 140 tons/day for meeting the growing demand for municipal waste disposal. This research assessed Hg contamination in environmental matrices adjacent to the waste incinerating plant. Total Hg concentrations were determined in municipal solid waste, soil and sediment within a distance of 100 m to 5 km from the incinerator operation in both wet and dry seasons. Hg analyses conducted in municipal solid waste showed low levels of Hg ranging between 0.15-0.56 mg/kg. The low level was due to the type of waste incinerator. Waste such as electrical appliances, motors and spare parts, rubber tires and hospital wastes are not allowed to feed into the plant. As a result, low Hg levels were also found in fly and bottom ashes (0.1-0.4 mg/kg and

Radon-contaminated drinking water from private wells: an environmental health assessment examining a rural Colorado mountain community's exposure.

PubMed

Cappello, Michael Anthony; Ferraro, Aimee; Mendelsohn, Aaron B; Prehn, Angela Witt

2013-11-01

In the study discussed in this article, 27 private drinking water wells located in a rural Colorado mountain community were sampled for radon contamination and compared against (a) the U.S. Environmental Protection Agency's (U.S. EPA's) proposed maximum contaminant level (MCL), (b) the U.S. EPA proposed alternate maximum contaminate level (AMCL), and (c) the average radon level measured in the local municipal drinking water system. The data from the authors' study found that 100% of the wells within the study population had radon levels in excess of the U.S. EPA MCL, 37% were in excess of the U.S. EPA AMCL, and 100% of wells had radon levels greater than that found in the local municipal drinking water system. Radon contamination in one well was found to be 715 times greater than the U.S. EPA MCL, 54 times greater than the U.S. EPA AMLC, and 36,983 times greater than that found in the local municipal drinking water system. According to the research data and the reviewed literature, the results indicate that this population has a unique and elevated contamination profile and suggest that radon-contaminated drinking water from private wells can present a significant public health concern.

Report: new guidelines for characterization of municipal solid waste: the Portuguese case.

PubMed

da Graça Madeira Martinho, Maria; Silveira, Ana Isabel; Fernandes Duarte Branco, Elsa Maria

2008-10-01

This report proposes a new set of guidelines for the characterization of municipal solid waste. It is based on an analysis of reference methodologies, used internationally, and a case study of Valorsul (a company that handles recovery and treatment of solid waste in the North Lisbon Metropolitan Area). In particular, the suggested guidelines present a new definition of the waste to be analysed, change the sampling unit and establish statistical standards for the results obtained. In these new guidelines, the sampling level is the waste collection vehicle and contamination and moisture are taken into consideration. Finally, focus is on the quality of the resulting data, which is essential for comparability of data between countries. These new guidelines may also be applicable outside Portugal because the methodology includes, besides municipal mixed waste, separately collected fractions of municipal waste. They are a response to the need for information concerning Portugal (e.g. Eurostat or OECD inquiries) and follow European Union municipal solid waste management policies (e.g. packaging waste recovery and recycling targets and the reduction of biodegradable waste going to landfill).

Lessons learned from the Siting Process of an Interim Storage Facility in Spain - 12024

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lamolla, Meritxell Martell

2012-07-01

On 29 December 2009, the Spanish government launched a site selection process to host a centralised interim storage facility for spent fuel and high-level radioactive waste. It was an unprecedented call for voluntarism among Spanish municipalities to site a controversial facility. Two nuclear municipalities, amongst a total of thirteen municipalities from five different regions, presented their candidatures to host the facility in their territories. For two years the government did not make a decision. Only in November 30, 2011, the new government elected on 20 November 2011 officially selected a non-nuclear municipality, Villar de Canas, for hosting this facility. Thismore » paper focuses on analysing the factors facilitating and hindering the siting of controversial facilities, in particular the interim storage facility in Spain. It demonstrates that involving all stakeholders in the decision-making process should not be underestimated. In the case of Spain, all regional governments where there were candidate municipalities willing to host the centralised interim storage facility, publicly opposed to the siting of the facility. (author)« less

Assessments of Stress of Conscience, Perceptions of Conscience, Burnout, and Social Support Before and After Implementation of a Participatory Action-Research-Based Intervention.

PubMed

Ericson-Lidman, Eva; Åhlin, Johan

2017-04-01

Interventions aiming to constructively address stress of conscience are rare. The aim of the study was to compare assessments of stress of conscience, perceptions of conscience, burnout, and social support among health care personnel (HCP) working in municipal residential care of older adults, before and after participation in a participatory action research (PAR) intervention aiming to learn to constructively deal with troubled conscience. Questionnaire data were collected at baseline and at follow-up (1-year interval; n = 29). Descriptive statistics and nonparametric statistical tests were used to make comparisons between baseline and follow-up. HCP gave significantly higher scores to the question, "Are your work achievements appreciated by your immediate superior?" at follow-up compared with baseline. No significant differences in levels of stress of conscience and burnout at follow-up were found. The results suggested that a PAR intervention aiming to learn HCP to deal with their troubled conscience in difficult situations could be partially successful.

Factors associated with functional loss in the elderly living in the city of Maceió, Northeastern Brazil.

PubMed

Costa e Silva, Maria do Desterro da; Guimarães, Helen Arruda; Trindade Filho, Euclides Maurício; Andreoni, Solange; Ramos, Luiz Roberto

2011-12-01

To identify factors associated with functional loss in older adults living in the urban area. A cross-sectional study was carried out with a population-based sample of 319 elderly individuals from the municipality of Maceió (Northeastern Brazil), in 2009. To obtain the functional impairment data the Brazilian Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire was used. A descriptive analysis, the chi-square test and a regression analysis for crude prevalence ratio were used, and the significance level that was adopted was p <0.05. The majority of participants were females (65.8%) and the mean age was 72 years (SD = 8.83). The prevalence of moderate/severe impairment was 45.5%, and the associated factors were being 75 years old or older, having up to four years of schooling, reporting two or more chronic diseases and being single. The characteristics of the elderly with functional impairment reflect inequalities and potential impacts of this population segment on the health services.

Tax revenue in Mississippi communities following implementation of smoke-free ordinances: an examination of tourism and economic development tax revenues.

PubMed

McMillen, Robert; Shackelford, Signe

2012-10-01

There is no safe level of exposure to tobacco smoke. More than 60 Mississippi communities have passed smoke-free ordinances in the past six years. Opponents claim that these ordinances harm local businesses. Mississippi law allows municipalities to place a tourism and economic development (TED) tax on local restaurants and hotels/motels. The objective of this study is to examine the impact of these ordinances on TED tax revenues. This study applies a pre/post quasi-experimental design to compare TED tax revenue before and after implementing ordinances. Descriptive analyses indicated that inflation-adjusted tax revenues increased during the 12 months following implementation of smoke-free ordinances while there was no change in aggregated control communities. Multivariate fixed-effects analyses found no statistically significant effect of smoke-free ordinances on hospitality tax revenue. No evidence was found that smoke-free ordinances have an adverse effect on the local hospitality industry.

Renewable Energy Project Financing: Improved Guidance and Information Sharing Needed for DOD Project-Level Officials

DTIC Science & Technology

2012-04-01

certain energy related military construction projects. The Navy used this authority for its geothermal plant at Naval Air Weapons Station China Lake...electric energy generated from solar, wind, biomass, landfill gas, ocean (including tidal, wave, current, and thermal), geothermal , municipal solid...thermal; geothermal , including electricity and heat pumps; municipal solid waste; new hydroelectric generation capacity achieved from increased

[Nitrate concentrations in tap water in Spain].

PubMed

Vitoria, Isidro; Maraver, Francisco; Sánchez-Valverde, Félix; Armijo, Francisco

2015-01-01

To determine nitrate concentrations in drinking water in a sample of Spanish cities. We used ion chromatography to analyze the nitrate concentrations of public drinking water in 108 Spanish municipalities with more than 50,000 inhabitants (supplying 21,290,707 potential individuals). The samples were collected between January and April 2012. The total number of samples tested was 324. The median nitrate concentration was 3.47 mg/L (range: 0.38-66.76; interquartile range: 4.51). The water from 94% of the municipalities contained less than 15 mg/L. The concentration was higher than 25mg/L in only 3 municipalities and was greater than 50mg/L in one. Nitrate levels in most public drinking water supplies in municipalities inhabited by almost half of the Spanish population are below 15 mg/L. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Master Plan Jakarta, Indonesia: The Giant Seawall and the need for structural treatment of municipal waste water.

PubMed

van der Wulp, Simon A; Dsikowitzky, Larissa; Hesse, Karl Jürgen; Schwarzbauer, Jan

2016-09-30

In order to take actions against the annual flooding in Jakarta, the construction of a Giant Seawall has been proposed in the Master Plan for National Capital Integrated Coastal Development. The seawall provides a combination of technical solutions against flooding, but these will heavily modify the mass transports in the near-coastal area of Jakarta Bay. This study presents numerical simulations of river flux of total nitrogen and N,N-diethyl-m-toluamide, a molecular tracer for municipal waste water for similar scenarios as described in the Master Plan. Model results demonstrate a strong accumulation of municipal wastes and nutrients in the planned reservoirs to extremely high levels which will result in drastic adverse eutrophication effects if the treatment of municipal waste water is not dealt with in the same priority as the construction of the Giant Seawall. Copyright © 2016 Elsevier Ltd. All rights reserved.

Understanding significant processes during work environment interventions to alleviate time pressure and associated sick leave of home care workers--a case study.

PubMed

Andersen, Gunn Robstad; Westgaard, Rolf H

2013-11-15

Ergonomic and work stress interventions rarely show long-term positive effect. The municipality participating in this study received orders from the Norwegian Labour Inspectorate due to an identified unhealthy level of time pressure, and responded by effectuating several work environment interventions. The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention. The study, using a historic prospective mixed-method design, comprised 6 home care units in a municipality in Norway (138 respondents, response rate 76.2%; 17 informants). The study included quantitative estimations, register data of sick leave, a time line of significant events and changes, and qualitative descriptions of employee appraisals of their work situation gathered through semi-structured interviews and open survey responses. The work environment interventions were in general regarded as positive by the home care workers. However, all units were simultaneously subjected to substantial contextual instability, involving new work programs, new technology, restructurings, unit mergers, and management replacements, perceived by the home care workers to be major sources of stress. Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers. Establishment and active utilization of communication channels from workers to managers are recommended in order to increase awareness of putative harmful and interruptive effects of rationalization measures.

Understanding significant processes during work environment interventions to alleviate time pressure and associated sick leave of home care workers – a case study

PubMed Central

2013-01-01

Background Ergonomic and work stress interventions rarely show long-term positive effect. The municipality participating in this study received orders from the Norwegian Labour Inspectorate due to an identified unhealthy level of time pressure, and responded by effectuating several work environment interventions. The study aim is to identify critical factors in the interaction between work environment interventions and independent rationalization measures in order to understand a potential negative interfering effect from concurrent rationalizations on a comprehensive work environment intervention. Methods The study, using a historic prospective mixed-method design, comprised 6 home care units in a municipality in Norway (138 respondents, response rate 76.2%; 17 informants). The study included quantitative estimations, register data of sick leave, a time line of significant events and changes, and qualitative descriptions of employee appraisals of their work situation gathered through semi-structured interviews and open survey responses. Results The work environment interventions were in general regarded as positive by the home care workers. However, all units were simultaneously subjected to substantial contextual instability, involving new work programs, new technology, restructurings, unit mergers, and management replacements, perceived by the home care workers to be major sources of stress. Findings suggest that concurrent changes induced through rationalization resulted in negative exposure effects that negated positive work environment intervention effects, causing an overall deteriorated work situation for the home care workers. Conclusions Establishment and active utilization of communication channels from workers to managers are recommended in order to increase awareness of putative harmful and interruptive effects of rationalization measures. PMID:24238560

Epidemiological profile of suicide in the Santa Catarina Coal Mining Region from 1980 to 2007.

PubMed

Portella, Carolina H; Moretti, Gustavo P; Panatto, Ana P; Rosa, Maria I; Quevedo, João; Simões, Priscyla W T A

2013-01-01

Suicide is a public health problem worldwide. Estimates have indicated that over 1 million people commit suicide every year all over the world. Brazil has a moderate suicide death rate (4.1 per 100,000 inhabitants), but the fact that it is a large country leads to the coexistence of diverse characteristics and levels of development across the different Brazilian regions. In this sense, the South region has been shown to present suicide rates above the national average. To estimate the profile of suicide in municipalities comprising the Santa Catarina Coal Mining Region from 1980 to 2007. This ecological, time-series, descriptive study sought to characterize epidemiological aspects related to suicide method, marital status, sex, age, and occupation in the municipalities of the region in the years 1980 to 2007. A total of 474 suicides occurred in the period, yielding a mean death rate of 10.83 per 100,000 inhabitants. There was a predominance of males, at a 5:1 ratio, and a peak rate in the 55-64-year age group (11.31 per 100,000 inhabitants). The suicide method most commonly used was hanging (72%) and the most frequent occupation was hard labor work (11.60%); in relation to marital status, married subjects (48%) were the ones with the highest rates of suicide. The Santa Catarina Coal Mining Region has suicide mortality rates above the national average. This study highlights specific characteristics of suicide in the region and may contribute to the development of preventive measures.

The Cost of Arbovirus Disease Prevention in Europe: Area-Wide Integrated Control of Tiger Mosquito, Aedes albopictus, in Emilia-Romagna, Northern Italy

PubMed Central

Canali, Massimo; Rivas-Morales, Stefano; Beutels, Philippe; Venturelli, Claudio

2017-01-01

Aedes albopictus (tiger mosquito) has become the most invasive mosquito species worldwide, in addition to being a well-known vector of diseases, with a proven capacity for the transmission of chikungunya and dengue viruses in Europe as well as the Zika virus in Africa and in laboratory settings. This research quantifies the cost that needs to be provided by public-health systems for area-wide prevention of arboviruses in Europe. This cost has been calculated by evaluating the expenditure of the plan for Aedes albopictus control set up in the Emilia-Romagna region (Northern Italy) after a chikungunya outbreak occurred in 2007. This plan involves more than 280 municipalities with a total of 4.2 million inhabitants. Public expenditure for plan implementation in 2008–2011 was examined through simple descriptive statistics. Annual expenditure was calculated to be approximately €1.3 per inhabitant, with a declining trend (from a total of €7.6 million to €5.3 million) and a significant variability at the municipality level. The preventative measures in the plan included antilarval treatments (about 75% of total expenditure), education for citizens and in schools, entomological surveillance, and emergency actions for suspected viremias. Ecological factors and the relevance of tourism showed a correlation with the territorial variability in expenditure. The median cost of one antilarval treatment in public areas was approximately €0.12 per inhabitant. Organizational aspects were also analyzed to identify possible improvements in resource use. PMID:28425959

[Perceptions and attitudes of public health service dentists in the face of family violence in 24 municipalities in the state of São Paulo, Brazil, 2013-2014].

PubMed

Garbin, Cléa Adas Saliba; Rovida, Tânia Adas Saliba; Costa, Adriana Alves; Garbin, Artênio José Isper

2016-01-01

to describe the perceptions and attitudes of dentists working in Primary Healthcare Units in the face of family violence in 24 municipalities in the interior of São Paulo state, Brazil. this is a descriptive study conducted between July 2013 and July 2014; the study population was comprised of 294 professionals; data were collected through a questionnaire containing objective and subjective questions. 111 dentists took part (37.8%), 67.5% of whom were unaware of existing legislation on cases of violence; 70.0% did not know how to report the occurrence of cases; 55.0% reported not having any responsibility for notification; 85.0% were unaware of the notification form; and 60.0% said they should intervene in cases of family violence. the perceptions and attitudes of dentists have shortcomings in relation to notification of family violence and this hinders early diagnosis of the victims of such violence.

Guillain-Barré syndrome and other neurological manifestations possibly related to Zika virus infection in municipalities from Bahia, Brazil, 2015.

PubMed

Malta, Juliane Maria Alves Siqueira; Vargas, Alexander; Leite, Priscila Leal E; Percio, Jadher; Coelho, Giovanini Evelim; Ferraro, Andréa Helena Argolo; Cordeiro, Tânia Maria de Oliveira; Dias, Jesângeli de Sousa; Saad, Eduardo

2017-01-01

to describe the reported cases of Guillain-Barré Syndrome (GBS) and other neurological manifestations with a history of dengue, chikungunya or Zika virus infections, in the Metropolitan Region of Salvador and in the municipality of Feira de Santana, Brazil. this is a descriptive study with data of an investigation conducted by the epidemiological surveillance from March to August 2015; to confirm the neurological manifestations, medical diagnosis records were considered, and to prior infection, clinical and laboratory criteria were used. 138 individuals were investigated, 57 reported infectious process up to 31 days before neurological symptoms - 30 possibly due to Zika, 13 to dengue, 8 to chikungunya and 6 were inconclusive -; GBS was the most frequent neurological condition (n=46), with predominance of male sex (n=32) and the median age was 44. most cases reported a clinical picture consistent with acute Zika virus disease, which preceded the occurrence of neurological symptoms.

Macro-organizational factors, the incidence of work disability, and work ability among the total workforce of home care workers in Sweden.

PubMed

Dellve, Lotta; Karlberg, Catarina; Allebeck, Peter; Herloff, Birgitta; Hagberg, Mats

2006-01-01

To investigate the importance of macro-organizational factors, i.e. organizational sociodemographic and socioeconomic preconditions, of the municipal incidence of long-term sick leave, disability pension, and prevalence of workers with long-term work ability among home care workers. In an ecological study design, data from national databases were combined by record linkage. Descriptive and analytical statistics were used to estimate and interpret macro-organizational factors (economic resources, region, unemployment, employment, occupational rehabilitation, return to work, age structures of inhabitants and home care workers). The incidence of long-term sick leave among female home care workers was twice as high as that of male home care workers, and incidence of disability pension was about four times as high for the women. A great variation in municipal incidence of long-term sick leave, disability pension, and long-term work ability (101-264, 0.6-19.6, and 913-1,279 per 1,000 full-time equivalent workers and year) was also found. The strongest single factor for long-term work ability was a high proportion of part-time or hourly paid employees, which explained 35% of the municipal variation. Macro-organizational factors explained long-term work ability (47-62% explained variance) better than long-term sick leave (33% explained variance). There was a low rehabilitation activity; only 2% received occupational rehabilitation and 5% of those on sick leave longer than 2 weeks returned to work within 30 days. The differences in the municipal proportion of work ability incidence indicate a preventive potential, especially related to employment and return to work after sick leave.

Registered nurses' education and their views on competence development in municipal elderly care in Sweden: a questionnaire survey.

PubMed

Josefsson, Karin; Sonde, Lars; Wahlin, Tarja-Brita Robins

2007-02-01

Recent changes of municipal elderly care in Sweden have resulted in that persons 65 years and older, previously nursed in hospital facilities, are now being cared for in the municipality. This change has had a significant impact on the work situation of registered nurses (RNs) and calls for appropriate educational preparation to enable RNs to undertake their new roles effectively. The main focus was to describe RNs' education and their view of competence development in municipal elderly care. Another aim was to compare RNs working solely in dementia care (DC) with those working in general elder care (GC) of older persons with diverse diagnoses. A non-experimental, descriptive design with a survey research approach was used. Sixty special housing with subunits including those offering daytime activities in a large city in the middle of Sweden. The number of participating RNs was a total of 213, with a response rate of 62.3%. Of the 213 RNs, 95 (44.6%) worked in DC, and 118 (55.4%) in GC. A questionnaire survey. The findings showed that RNs possessed a broad range of competence. The majority lacked a bachelor's degree in nursing. Few had adequate specialist competence. RNs' in DC wanted to invest more in competence development whereas RNs in GC were more motivated to attain greater authority in the making of important decisions and to seek another position. An important future prospect is to develop the competence of RNs in elderly care. In order to ensure high quality and security in elderly care, it is also essential to increase the number of RNs with specialist competence.

COPD prevalence and hospital admissions in Galicia (Spain). An analysis using the potential of new health information systems.

PubMed

Barbosa-Lorenzo, R; Ruano-Ravina, A; Fernández-Villar, A; López-Pardo, E; Carballeira-Roca, C; Barros-Dios, J M

2018-05-05

Chronic obstructive pulmonary disease (COPD) is a major public health problem. The aim of this study was to ascertain the prevalence of COPD and whether such prevalence was positively or negatively associated with COPD admissions, using all the data of a regional health care system. We designed a descriptive cross-sectional study which included all subjects aged over 45 years, diagnosed with COPD in primary care in 2013. We also calculated the number of such patients who had a record of hospital admissions due to this disease. COPD prevalence and incidence of admissions were calculated. Poisson regression models were then used to analyse the association between cases with diagnosis of COPD and admissions due to COPD, by sex, adjusting for socio-demographic variables and distance to hospital. Sensitivity subanalyses were performed by reference to the respective municipal rurality indices. Median municipal prevalence of COPD was 5.29% in men and 2.19% in women. Among patients with COPD, 28.22% of men and 16.00% of women had at least one hospital admission. The relative risk of admission per unit of the standardised prevalence ratio was 0.37 (95% CI 0.34-0.41) for men and 0.39 (95% CI 0.34-0.45) for women. There is a significant negative association between COPD prevalence and hospital admissions due to this disease. The proportion of admissions is lower in municipalities lying furthest from hospitals. There is considerable municipal variability in terms of COPD prevalence and proportion of admissions. In-depth attention should be given to disease-management training programmes. Copyright © 2018 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Next of kin's experiences of information and responsibility during their older relatives' care transitions from hospital to municipal health care.

PubMed

Rustad, Else Cathrine; Seiger Cronfalk, Berit; Furnes, Bodil; Dysvik, Elin

2017-04-01

To gain an understanding of how next of kin experience the transition of their older relatives from hospital to municipal health care. During the care transition of their older relatives, next of kin experience a period of ill-defined roles and expectations. Successful transition lays the ground for postdischarge treatment and care, in which next of kin have important roles. A descriptive, exploratory design was used to gain a greater understanding of the experiences of next of kin during their older relatives' care transitions. We conducted qualitative interviews of 13 next of kin of patients aged ≥80 years who had been discharged from the hospital to municipal care. Qualitative content analysis was used to analyse interviews. The main theme, 'Next of kin balance multiple tasks during older relatives' care transitions', emerged from two subthemes: 'Next of kin strive to fulfil informational needs during care transition' and 'Next of kin take responsibility for the older relative during care transition'. Next of kin have the challenging role of letting their older relative manage self-care during transition, when able, while being prepared to act on behalf of their relative as needed. Insufficient information and significant responsibilities contribute to unnecessary concerns and worries among next of kin. Nurses in both hospitals and municipal health care will benefit from knowing more about the experiences of next of kin; this may ensure continuity of care during transitions and diminish unnecessary worries and concerns. Clinical nurses should be sensitive to the next of kin's need for support so the next of kin can better manage their older relatives' care after homecoming. © 2016 John Wiley & Sons Ltd.

Ground-water monitoring at Santa Barbara, California; Phase 2, Effects of pumping on water levels and on water quality in the Santa Barbara ground-water basin

USGS Publications Warehouse

Martin, Peter

1984-01-01

From July 1978 to January 1980, water levels in the southern part of the Santa Barbara ground-water basin declined more than 100 feet. These water-level declines resulted from increases in municipal pumping since July 1978. The increase in municipal pumping was part of a basin-testing program designed to determine the usable quantity of ground water in storage. The pumping, centered in the city less than 1 mile from the coast, has caused water-level declines to altitudes below sea level in the main water-bearing zones. As a result, the ground-water basin would be subject to saltwater intrusion if the study-period pumpage were maintained or increased. Data indicate that saltwater intrusion has degraded the quality of the water yielded from six coastal wells. During the study period, the six coastal wells all yielded water with chloride concentrations in excess of 250 milligrams per liter, and four of the wells yielded water with chloride concentrations in excess of 1,000 milligrams per liter. Previous investigators believed that saltwater intrusion was limited to the shallow part of the aquifer, directly adjacent to the coast. The possibility of saltwater intrusion into the deeper water-bearing deposits in the aquifer was thought to be remote because an offshore fault truncates these deeper deposits so that they lie against consolidated rocks on the seaward side of the fault. Results of this study indicate, however, that ocean water has intruded the deeper water-bearing deposits, and to a much greater extent than in the shallow part of the aquifer. Apparently the offshore fault is not an effective barrier to saltwater intrusion. No physical barriers are known to exist between the coast and the municipal well field. Therefore, if the pumping rate maintained during the basin-testing program were continued, the degraded water along the coast could move inland and contaminate the municipal supply wells. The time required for the degraded water to move from the coast to the nearest supply well is estimated, using Darcy's equation, to be about 20 years. Management alternatives for controlling saltwater intrusion in the Santa Barbara area include (1) decreasing municipal pumping, (2) increasing the quantity of water available for recharge by releasing surplus water from surface reservoirs to Mission Creek, (3) artificially recharging the basin using injection wells, and (4) locating municipal supply wells farther from the coast and spacing them farther apart in order to minimize drawdown. Continued monitoring of water levels and water quality would enable assessment of the effectiveness of the control measures employed.

Identification of influencing municipal characteristics regarding household waste generation and their forecasting ability in Biscay

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oribe-Garcia, Iraia, E-mail: iraia.oribe@deusto.es; Kamara-Esteban, Oihane; Martin, Cristina

Highlights: • We have modelled household waste generation in Biscay municipalities. • We have identified relevant characteristics regarding household waste generation. • Factor models are used in order to identify the best subset of explicative variables. • Biscay’s municipalities are grouped by means of hierarchical clustering. - Abstract: The planning of waste management strategies needs tools to support decisions at all stages of the process. Accurate quantification of the waste to be generated is essential for both the daily management (short-term) and proper design of facilities (long-term). Designing without rigorous knowledge may have serious economic and environmental consequences. The presentmore » works aims at identifying relevant socio-economic features of municipalities regarding Household Waste (HW) generation by means of factor models. Factor models face two main drawbacks, data collection and identifying relevant explanatory variables within a heterogeneous group. Grouping similar characteristics observations within a group may favour the deduction of more robust models. The methodology followed has been tested with Biscay Province because it stands out for having very different municipalities ranging from very rural to urban ones. Two main models are developed, one for the overall province and a second one after clustering the municipalities. The results prove that relating municipalities with specific characteristics, improves the results in a very heterogeneous situation. The methodology has identified urban morphology, tourism activity, level of education and economic situation as the most influencing characteristics in HW generation.« less

BOD and DO Identification of Jeneberrang-River Water as Water Source

NASA Astrophysics Data System (ADS)

Basir, Basir; Haris, Ibrahim Abdul

2018-05-01

Water is a part of life on the surface of the earth. It is not a new substance which no life on earth can survive without water. This study aims to identify the quality of river water of jeneberang as municipal waterworks (PDAM) raw regarding to turbidity parameters, BOD, and DO. The used methodology is observational with descriptive approach. The sampling technique was done by grasping each sample for turbidity parameter, BOD and DO in four IPAM water inlet of Makassar City. This sampling was conducted at Laboratory of Environmental Health Engineering Center (BTKL) and Disease Control using Nephelometric Turbidity Unit, Titrimetry, and Spectrophotometric method. The results of the examination showed that the turbidity level> 5 NTU, so it is not eligible to be drunk directly. The levels for BOD and eligibles for not exceeding the specified limits are <3 mg / l and <25 mg / l and in DO for Maccini Sombala <4 mg / l region, so it is not eligible. The conclusion in this research that turbidity parameter, BOD and DO qualify as the raw water of PDAM have to be processed so that water can be drunk by society.

Prevalence of older people with intellectual disability in Sweden: a spatial epidemiological analysis.

PubMed

Ng, N; Sandberg, M; Ahlström, G

2015-12-01

The expected increase in longevity of individuals with intellectual disabilities (ID) in many countries of the world is a direct result of medical and social advances, which have also extended the longevity of the general population. It is important to assess the need for social services for people with ID across different administrative levels to ensure sufficient resources are allocated to where they are most needed. This study estimates the annual prevalence of older people with ID from 2004 to 2012 and in different counties and municipalities in Sweden, by sex and age group; identifies proxy indicators related to the care of older people with ID in different counties in 2012 in Sweden and analyses the spatial distribution and clustering of municipalities with a high prevalence of older people with ID. Individuals with ID were identified through the national register based on the Swedish Act concerning Support and Service for Persons with Certain Functional Impairments (the LSS act) and the national death register. This study focuses on older individuals aged 55+ during the period of 2004-2012. The estimated prevalence was calculated at the county and municipality level and plotted on a municipality-level map. Moran's I statistics was used to identify any spatial clustering of municipalities with a large number of individuals with ID. The prevalence of ID among older individuals aged 55+ in Sweden increased from 2004 to 2012. The prevalence was consistently higher among men, and the gender gap increased slightly in recent years. Age-specific prevalence estimates showed ID to be higher in younger age groups, and the gender gap decreased in older age groups. The prevalence was higher in northern counties in Sweden (over 500 individuals per 100 000 population aged 55+). Higher prevalence areas were clustered in northern municipalities, whereas municipalities with high prevalence of older individuals with ID in the middle and southern regions of Sweden demonstrated a more widespread distribution. The existence of clusters of counties with a high prevalence of older individuals with ID necessitates further assessment of how resources have been allocated to different counties and municipalities in Sweden. Investigations of the quality of social services provided to individuals with ID across different counties in Sweden are warranted. It is important to ensure that high quality supports are being provided to older individuals with ID in order to grant them the same right to healthy ageing as their counterparts living without ID throughout their life course. © 2015 The Authors. Journal of Intellectual Disability Research published by MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Is Municipal Solid Waste Recycling Economically Efficient?

NASA Astrophysics Data System (ADS)

Lavee, Doron

2007-12-01

It has traditionally been argued that recycling municipal solid waste (MSW) is usually not economically viable and that only when externalities, long-term dynamic considerations, and/or the entire product life cycle are taken into account, recycling becomes worthwhile from a social point of view. This article explores the results of a wide study conducted in Israel in the years 2000 2004. Our results reveal that recycling is optimal more often than usually claimed, even when externality considerations are ignored. The study is unique in the tools it uses to explore the efficiency of recycling: a computer-based simulation applied to an extensive database. We developed a simulation for assessing the costs of handling and treating MSW under different waste-management systems and used this simulation to explore possible cost reductions obtained by designating some of the waste (otherwise sent to landfill) to recycling. We ran the simulation on data from 79 municipalities in Israel that produce over 60% of MSW in Israel. For each municipality, we were able to arrive at an optimal method of waste management and compare the costs associated with 100% landfilling to the costs born by the municipality when some of the waste is recycled. Our results indicate that for 51% of the municipalities, it would be efficient to adopt recycling, even without accounting for externality costs. We found that by adopting recycling, municipalities would be able to reduce direct costs by an average of 11%. Through interviews conducted with representatives of municipalities, we were also able to identify obstacles to the utilization of recycling, answering in part the question of why actual recycling levels in Israel are lower than our model predicts they should be.

Municipal resilience: A paradigm shift in emergency and continuity management.

PubMed

Solecki, Greg; Luchia, Mike

More than a decade of emergency and continuity management vision was instrumental in providing the unprecedented level of response and recovery from the great flood of 2013. Earlier assessments, planning and validation promulgated development of corporate continuity, emergency and contingency plans along with tactical, strategic and recovery operations centres that all led to a reliable emergency management model that will continue to provide the backbone for municipal resilience.

Overview of EPA tools for supporting local-, state- and regional-level decision makers addressing energy and environmental issues: NYC MARKAL Energy Systems Model and Municipal Solid Waste Decision Support Tool

EPA Science Inventory

A workshop will be conducted to demonstrate and focus on two decision support tools developed at EPA/ORD: 1. Community-scale MARKAL model: an energy-water technology evaluation tool and 2. Municipal Solid Waste Decision Support Tool (MSW DST). The Workshop will be part of Southea...

The challenges for solid waste management in accordance with Agenda 21: a Brazilian case review.

PubMed

Chaves, Gisele de Lorena Diniz; dos Santos, Jorge Luiz; Rocha, Sandra Mara Santana

2014-09-01

This paper aims to evaluate the suitability of the Brazilian solid waste policy (BSWP) with global Agenda 21 and the challenges of implementing the BSWP in municipalities. For this, a review of the principles that guided the creation of this policy was performed to demonstrate that international pressures were important in determining its effectiveness. The contradictory relationship between the satisfactory legal framework that established the Brazilian waste management policy and its weakened implementation in the municipalities is also examined . To illustrate the difficulties faced at the local level, a case study involving municipalities that compose the state of Espírito Santowe was undertaken. In this state, the municipalities signed terms of environmental commitment with supervisory agencies who undertook, within a pre-established schedule, to implement a set of actions to shape the proper management of solid waste, adapted to the requirements of national policy and the guidelines of Agenda 21. Finally, the various difficulties in meeting the requirements are discussed. It is necessary and urgent that Brazil finds a way to coordinate the mechanisms of an innovative and well formulated legal instrument to ensure the successful implementation of solid waste management at the local level to achieve the environmental, economic and social objectives. © The Author(s) 2014.

The Rio de Janeiro Municipality's Services Portfolio and Health Actions in Primary Care in Brazil.

PubMed

Salazar, Bianca Alves; Campos, Mônica Rodrigues; Luiza, Vera Lucia

2017-03-01

This study aimed to identify the provision of actions and procedures by family health teams (FHSt), based on Rio de Janeiro Municipality's (MRJ) Health Services Portfolio (HSP) and the main factors associated with this provision, in the different population strata. Data from the National Program for Improving Access and Quality of Primary Healthcare were used and implemented at the national level into 17,202 FHSts from June to September 2012. Outcome variables were "FHSt belonging to MRJ" and "FHSt providing all nine CS-MRJ procedures". Uni-, bi- and multivariate analysis were performed. A better performance of the MRJ in relation to other major urban centers (EP6#) (p<5%) was noted in 10 of the 14 health actions analyzed. The electronic medical record showed a level of deployment in MRJ's FHSts of 96%, contrasting with 34% in the EP6# and 14% in Brazil. Both the MRJ and EP6# evidenced low supply of mental health services (about 56%). While the supply of low-complexity procedures was a major problem in large cities, the supply of health actions in the different health care lines was a larger problem in small municipalities. Overall, the MRJ showed better performance when compared to the average of large municipalities. The health service portfolio appeared to be an important management tool.

[The functioning of personnel service in municipal polyclinic].

PubMed

2011-01-01

The article deals with the results of study of personnel policy in municipal polyclinics. The characteristics of functioning of municipal polyclinic in the area of social care of population are analyzed. In the general structure of polyclinic visits the higher level of appealability of patients to resolve medical social issues (61.2%) is revealed. This condition determines the significant workload of physicians. This kind of work still has no both manhours standards and cost estimating. Hence, such off-the-books manhours as an overtime work during over and above labor time result in work dissatisfaction among physicians, ungrounded increase of visit numbers and, ultimately, in rise of particular medical service cost and patient discomfort.

Seroepidemiology of Helicobacter Pylori Infection in Pregnant Women in Rural Durango, Mexico

PubMed Central

Alvarado-Esquivel, Cosme

2013-01-01

The seroepidemiology of Helicobacter pylori infection in pregnant women in Durango, Mexico is largely unknown. The prevalence of anti-H. pylori IgG antibodies was examined in 343 pregnant women living in rural areas in 7 municipalities in Durango State, Mexico, using enzyme-linked immunosorbent assays (ELISA). A correlation of H. pylori seropositivity with socio-demographic, obstetric and behavioral characteristics of pregnant women was also assessed. In total, 179 (52.2%) of the 343 pregnant women (mean age, 24.2 ± 5.9 years) had H. pylori IgG antibodies, 75 (41.9%) of whom had H. pylori IgG antibody levels higher than 100 U/mL. The seroprevalence of H. pylori infection varied from 33.3% to 65% among municipalities. In contrast, the seroprevalence was comparable among women regardless their age, educational level, occupation, socioeconomic status, animal contacts, foreign travel, eating habits, contact with soil, crowding, sanitary conditions at home and educational level of the head of their families. Multivariant analysis of socio-demographic and behavioral variables showed that H. pylori seropositivity was associated with municipality (OR=1.12; 95% CI: 1.01–1.24; P=0.02). Of the obstetric characteristics, the seroprevalence of H. pylori infection increased significantly with the number of pregnancies and deliveries but not with the number of cesarean sections or miscarriages. Rural pregnant women in Durango had a lower seroprevalence of H. pylori infection than those from populations in developing countries. Results support a variability of H. pylori seroprevalence within a region. Further research at a municipal level might help to understand the epidemiology of H. pylori infection. PMID:24711758

Comparison of antibiotic prescribing and antimicrobial resistance in urinary tract infections at the municipal level among women in two Nordic regions.

PubMed

Nygaard Jensen, Jette; Melander, Eva; Hedin, Katarina; Bjerrum, Lars; Kornfält Isberg, Helena; Holm, Anne; Neel Jacobsen, Helle; Skovby, Annette; Córdoba Currea, Gloria Cristina; Hyllebusk, Lena; Brogaard, Emma; Arpi, Magnus

2018-05-10

To describe and compare the prescribing of antibiotics used for urinary tract infections and its correlation with resistance in Escherichia coli in urinary samples across two adjacent regions-the Capital Region and the Skaane Region-and their municipalities in Denmark and Sweden. The Capital Region consists of 29 municipalities and 725 960 female inhabitants aged ≥18 years and the Skaane Region consists of 33 municipalities and 515 668 female inhabitants aged ≥18 years. Aggregated data from outpatient care on the prescribing of pivmecillinam, trimethoprim and nitrofurantoin from both regions were analysed. The Department of Clinical Microbiology in both regions provided data on E. coli resistance in urinary samples from women aged ≥18 years. Data were measured as the number of prescriptions/1000 women/year, number of DDDs/1000 women/year and DDDs/prescription. Correlation analyses between antibiotic prescribing and antibiotic resistance rates were performed. Antibiotic prescribing and resistance rates were significantly higher in the Capital Region compared with the Skaane Region. Large variations in prescription and resistance rates were found at the municipal level, but there were no correlations between the antibiotic prescription and resistance rates when each region was analysed separately. Although closely related, there are large differences in antibiotic prescribing and antibiotic resistance. It is suggested that the regional guidelines are an important driver and explanatory factor for the variations; however, further research is needed in this new field and factors such as the influence of cultural aspects should be the target of further research.

Traffic air pollution and risk of death from bladder cancer in Taiwan using petrol station density as a pollutant indicator.

PubMed

Ho, Chi-Kung; Peng, Chiung-Yu; Yang, Chun-Yuh

2010-01-01

To investigate the relationship between air pollution and risk of death from bladder cancer, a matched cancer case-control study was conducted using deaths that occurred in Taiwan from 1997 through 2006. Data for all eligible bladder cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of individuals who died from causes other than cancer or diseases associated with genitourinary problems. The controls were pair matched to the cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Data for the number of petrol stations in study municipalities were collected from the two major petroleum supply companies, Chinese Petroleum Corporation (CPC) and Formosa Petrochemical Corporation (FPCC). The petrol station density (per square kilometer) (PSD) for study municipalities was used as an indicator of a subject's exposure to benzene and other hydrocarbons present in ambient evaporative losses of petrol or to air emissions from motor vehicles. The subjects were divided into tertiles according to PSD in their residential municipality. The present study showed that individuals who resided in municipalities with high PSD levels were at an increased risk of death from bladder cancer compared to subjects living in municipalities with a low PSD level; however, the differences are not statistically significant. The findings of this study warrant further investigation of the role of vehicular air pollutant emissions in the etiology of bladder cancer development.

[Managerial performance in public health services: a case study in Mato Grosso do Sul, Brazil].

PubMed

Barbieri, Ana Rita; Hortale, Virginia Alonso

2005-01-01

This paper presents part of a doctoral dissertation that developed a theoretical model capable of identifying managerial performance in various administrative levels of a Municipal Health Secretariat. The methodology was a case study of the Municipal Health Secretariat in Campo Grande, capital of the State of Mato Grosso do Sul, Brazil. The theoretical model was based on recent debates emphasizing the need to modernize public administration, with an emphasis on efficacy and efficiency in the organizations as a whole. Some 31 interviews were conducted with the objective of identifying the managers' performance, through questions based on their daily practices in planning, organization, direction, and control. Managers from higher hierarchical levels obtained better results, while those in basic health units generally developed activities and complied with decisions passed down by imposition, with limited capacity to plan, organize, or control activities pertaining to their management sphere. These results stem partially from the charismatic leadership and centralizing administration of the current management in the municipal health system.

Tracking persistent pharmaceutical residues from municipal sewage to drinking water

NASA Astrophysics Data System (ADS)

Heberer, Thomas

2002-09-01

In urban areas such as Berlin (Germany) with high municipal sewage water discharges and low surface water flows there is a potential risk of drinking water contamination by polar organic compounds when groundwater recharge is used in drinking water production. Thus, some pharmaceutically active compounds (PhACs) are not eliminated completely in the municipal sewage treatment plants (STPs) and they are discharged as contaminants into the receiving waters. In terms of several monitoring studies carried out in Berlin between 1996 and 2000, PhACs such as clofibric acid, diclofenac, ibuprofen, propyphenazone, primidone and carbamazepine were detected at individual concentrations up to the μg/l-level in influent and effluent samples from STPs and in all surface water samples collected downstream from the STPs. Under recharge conditions, several compounds were also found at individual concentrations up to 7.3 μg/l in samples collected from groundwater aquifers near to contaminated water courses. A few of the PhACs were also identified at the ng/l-level in Berlin tap water samples.

The Archaeological Research In The Region Of The Modern Municipality Of Styra: Old And New Finds

NASA Astrophysics Data System (ADS)

Chidiroglou, M.

This paper offers a brief outline of the results of the salvage excavations undertaken in recent years by the 11th Ephorate of Prehistoric and Classical Antiquities (IA EPKA) in the area of Lefka, Nea Styra, together with a brief description of surface finds in the region of Styra. A more extensive archaeological description and topographical assessment of all known sites, including farm houses, towers, possible sanctuaries, tombs and quarrying areas will be provided in a forthcoming larger study by the author. The brief assessment of old and new data presented here is given as a preliminary summary of the topography of the ancient demos of Styra, which, according to inscriptional data, was incorporated in the Eretrian territory, during the last years of the 5th century B.C.

Experimental and theoretical assessment of the multi-domain flow behaviour in a waste body during leachate infiltration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tinet, A-J., E-mail: tinet@ujf-grenoble.fr; Oxarango, L.; Centre for Research in Environmental, Coastal and Hydrological Engineering, School of Civil Engineering, Surveying and Construction, University of KwaZulu-Natal, Howard College Campus, Durban 4041

2011-08-15

The optimisation of landfill operation is a key challenge for the upcoming years. A promising solution to improve municipal solid waste (MSW) management is the bioreactor technology. A meso-scale (around 1 m{sup 3}) experimental set-up was performed to study the effect of moisture control in low density conditions with different leachate injection operations and bioreactor monitoring including the use of a neutron probe. The moisture content distribution evolution demonstrates a multi-domain flow behaviour. A classic van Genuchten-Mualem description of the connected porosity proved insufficient to correctly describe the observed phenomena. A bimodal description of the connected porosity is proposed asmore » solution and a connected/non-connected porosities numerical model was applied to the results. The model explains the experimental results reasonably well.« less

Ground-water flow and water quality in northeastern Union County, Ohio

USGS Publications Warehouse

Wilson, K.S.

1987-01-01

A study was done by the U.S. Geological Survey, in cooperation with the Village of Richwood, Ohio, to determine directions of ground-water flow, ground-water-level fluctuations, and water quality in the northeastern part of Union County. The topography of the study area generally is featureless, and the land surfaces slopes gently eastward from 985 to 925 feet above sea level. Glacial deposits up to 48 feet thick cover the carbonate-bedrock aquifer. Three municipal wells and an adjoining abandoned landfill are located in an area previously excavated for clay deposits. An agricultural supply company is adjacent to the well field. Ground water flows from west to east with local variation to the northeast and southeast because of the influence of Fulton Creek. Richwood Lake occupies an abandoned sand-and-gravel quarry. Water-level fluctuations indicate that the and gravel deposits beneath the lake may be hydraulically connected to the bedrock aquifer. Water-quality data collected from 14 wells and Richwood Lake indicate that a hard to very hard calcium bicarbonate type water is characteristic of the study area. Dissolved solids ranged from 200 to 720 mg/L (Milligrams per liter) throughout the study area. Potassium ranged from 1.3 to 15 mg/L, with a median concentration of 2.0 mg/L. Concentration of 10 and 15 mg/L at one municipal well were five to eight times greater than the median concentration. Total organic carbon, ammonia, and organic nitrogen were present at every site. Concentrations of ammonia above 1 mg/L as nitrogen were found in water from two municipal wells and one domestic well. Total organic carbon was detected at a municipal well, a landfill well, and a domestic well at concentrations above 5 mg/L. Ground-water quality is similar throughout the study area except in the vicinity of the municipal well field, where water from one well had elevated concentrations of ammonia, dissolved manganese, dissolved chloride, dissolved, sodium, and total organic carbon.

Exploring spatial patterns and drivers of forest fires in Portugal (1980-2014).

PubMed

Nunes, A N; Lourenço, L; Meira, A C Castro

2016-12-15

Information on the spatial incidence of fire ignition density and burnt area, trends and drivers of wildfires is vitally important in providing support for environmental and civil protection policies, designing appropriate prevention measures and allocating firefighting resources. The key objectives of this study were to analyse the geographical incidence and temporal trends for wildfires, as well as the main drivers of fire ignition and burnt area in Portugal on a municipal level. The results show that fires are not distributed uniformly throughout Portuguese territory, both in terms of ignition density and burnt area. One spot in the north-western area is well defined, covering 10% of the municipalities where more than one third of the total fire ignitions are concentrated. In >80% of Portuguese municipalities, ignition density has registered a positive trend since the 1980s. With regard to burnt area, 60% of the municipalities had a nil annual trend, 35% showed a positive trend and 5%, located mainly in the central region, revealed negative trends. Geographically weighted regression proved more efficient in identifying the most relevant physical and anthropogenic drivers of municipal wildfires in comparison with simple linear regression models. Topography, density of population, land cover and livestock were found to be significant in both ignition density and burnt area, although considerable variations were observed in municipal explanatory power. Copyright © 2016 Elsevier B.V. All rights reserved.

Fiscal decentralisation and infant mortality rate: the Colombian case.

PubMed

Soto, Victoria Eugenia; Farfan, Maria Isabel; Lorant, Vincent

2012-05-01

There is a paucity of research analysing the influence of fiscal decentralisation on health outcomes. Colombia is an interesting case study, as health expenditure there has been decentralising since 1993, leading to an improvement in health care insurance. However, it is unclear whether fiscal decentralisation has improved population health. We assess the effect of fiscal decentralisation of health expenditure on infant mortality rates in Colombia. Infant mortality rates for 1080 municipalities over a 10-year period (1998-2007) were related to fiscal decentralisation by using an unbalanced fixed-effect regression model with robust errors. Fiscal decentralisation was measured as the locally controlled health expenditure as a proportion of total health expenditure. We also evaluated the effect of transfers from central government and municipal institutional capacity. In addition, we compared the effect of fiscal decentralisation at different levels of municipal poverty. Fiscal decentralisation decreased infant mortality rates (the elasticity was equal to -0.06). However, this effect was stronger in non-poor municipalities (-0.12) than poor ones (-0.081). We conclude that decentralising the fiscal allocation of responsibilities to municipalities decreased infant mortality rates. However, this improved health outcome effect depended greatly on the socio-economic conditions of the localities. The policy instrument used by the Health Minister to evaluate municipal institutional capacity in the health sector needs to be revised. Copyright © 2012 Elsevier Ltd. All rights reserved.

Assessing the vulnerability of Brazilian municipalities to the vectorial transmission of Trypanosoma cruzi using multi-criteria decision analysis.

PubMed

Vinhaes, Márcio Costa; de Oliveira, Stefan Vilges; Reis, Priscilleyne Ouverney; de Lacerda Sousa, Ana Carolina; Silva, Rafaella Albuquerque E; Obara, Marcos Takashi; Bezerra, Cláudia Mendonça; da Costa, Veruska Maia; Alves, Renato Vieira; Gurgel-Gonçalves, Rodrigo

2014-09-01

Despite the dramatic reduction in Trypanosoma cruzi vectorial transmission in Brazil, acute cases of Chagas disease (CD) continue to be recorded. The identification of areas with greater vulnerability to the occurrence of vector-borne CD is essential to prevention, control, and surveillance activities. In the current study, data on the occurrence of domiciliated triatomines in Brazil (non-Amazonian regions) between 2007 and 2011 were analyzed. Municipalities' vulnerability was assessed based on socioeconomic, demographic, entomological, and environmental indicators using multi-criteria decision analysis (MCDA). Overall, 2275 municipalities were positive for at least one of the six triatomine species analyzed (Panstrongylus megistus, Triatoma infestans, Triatoma brasiliensis, Triatoma pseudomaculata, Triatoma rubrovaria, and Triatoma sordida). The municipalities that were most vulnerable to vector-borne CD were mainly in the northeast region and exhibited a higher occurrence of domiciliated triatomines, lower socioeconomic levels, and more extensive anthropized areas. Most of the 39 new vector-borne CD cases confirmed between 2001 and 2012 in non-Amazonian regions occurred within the more vulnerable municipalities. Thus, MCDA can help to identify the states and municipalities that are most vulnerable to the transmission of T. cruzi by domiciliated triatomines, which is critical for directing adequate surveillance, prevention, and control activities. The methodological approach and results presented here can be used to enhance CD surveillance in Brazil. Copyright © 2014 Elsevier B.V. All rights reserved.

The impact of socioeconomic factors on municipal solid waste generation in São Paulo, Brazil.

PubMed

Vieira, Victor H Argentino de Morais; Matheus, Dácio R

2018-01-01

Social factors have not been sufficiently explored in municipal solid waste management studies. Latin America has produced even fewer studies with this approach; technical and economic investigations have prevailed. We explored the impacts of socioeconomic factors on municipal solid waste generation in Greater Sao Paulo, which includes 39 municipalities. We investigated the relations between municipal solid waste generation and social factors by Pearson's correlation coefficient. The Student's t-test (at p ← 0.01) proved significance, and further regression analysis was performed with significant factors. We considered 10 socioeconomic factors: population, rural population, density, life expectancy, education (secondary, high and undergraduate level), income per capita, inequality and human development. A later multicollinearity analysis resulted in the determination of inequality (r p = 0.625) and income per capita (r p = 0.607) as major drivers. The results showed the relevance of considering social aspects in municipal solid waste management and isolated inequality as an important factor in planning. Inequality must be used as a complementary factor to income, rather than being used exclusively. Inequality may explain differences of waste generation between areas with similar incomes because of consumption patterns. Therefore, unequal realities demand unequal measures to avoid exacerbation, for example, pay-as-you-throw policies instead of uniform fees. Unequal realities also highlight the importance of tiering policies beyond the waste sector, such as sustainable consumption.

Identification of influencing municipal characteristics regarding household waste generation and their forecasting ability in Biscay.

PubMed

Oribe-Garcia, Iraia; Kamara-Esteban, Oihane; Martin, Cristina; Macarulla-Arenaza, Ana M; Alonso-Vicario, Ainhoa

2015-05-01

The planning of waste management strategies needs tools to support decisions at all stages of the process. Accurate quantification of the waste to be generated is essential for both the daily management (short-term) and proper design of facilities (long-term). Designing without rigorous knowledge may have serious economic and environmental consequences. The present works aims at identifying relevant socio-economic features of municipalities regarding Household Waste (HW) generation by means of factor models. Factor models face two main drawbacks, data collection and identifying relevant explanatory variables within a heterogeneous group. Grouping similar characteristics observations within a group may favour the deduction of more robust models. The methodology followed has been tested with Biscay Province because it stands out for having very different municipalities ranging from very rural to urban ones. Two main models are developed, one for the overall province and a second one after clustering the municipalities. The results prove that relating municipalities with specific characteristics, improves the results in a very heterogeneous situation. The methodology has identified urban morphology, tourism activity, level of education and economic situation as the most influencing characteristics in HW generation. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Care coordination in primary health care: an evaluative study in a municipality in the Northeast of Brazil.

PubMed

Aleluia, Italo Ricardo Santos; Medina, Maria Guadalupe; Almeida, Patty Fidelis de; Vilasbôas, Ana Luiza Queiroz

2017-06-01

International and Brazilian studies have highlighted the importance of the coordination of care for the organization of local health systems. This study aimed to analyze the coordination of care by Primary Health Care (PHC) in a municipal health system in the State of Bahia. This study was conducted in the lead municipality of the macro-region and involved two levels of analysis: PHC team and municipal management. Outlining conditions for the study were defined (hypertension and diabetes mellitus) and an objective image corresponding to the coordination of care was developed based on current national and international literature review. Semi-structured interviews with professionals, managers of PHC services were conducted and current documentary sources were also used. It was demonstrated that the coordination of care has not been met by municipal systems, where only 14 of the 22 proposed criteria have been met. The main difficulties and reasons were: a lack of health care protocols and the non-implementation of computer systems and telecommunication technologies. The results and the conceptual framework to assess the coordination of care are relevant contributions to this study, which can be applied to other contexts with similar characteristics.

A Comparative Study of the Influence of Head Teachers Management Styles on Pupils Performance in KCPE in Public and Private Primary Schools in Nakuru Municipality, Kenya

ERIC Educational Resources Information Center

Shibo, Margaret Nekesa

2016-01-01

The purpose of this study was to compare the influence of management styles of head teacher's on pupils' performance in private and public primary schools in Nakuru municipality at Kenya Certificate of Primary Education level. The population comprised of teachers and head teachers in public primary schools. The study adopted the ex post facto…

Performance Analysis of Cofiring Densified Refuse Derived Fuel in a Military Boiler.

DTIC Science & Technology

1981-12-01

Derived Fuel 70 Design Considerations for Municipal Solid Waste Conveyors 71 Densification of Refuse -Derived Fuels: Preparation Properties and Systems...problems could be realized if the system were expanded and if operating demands were increased. 70 DESIGN CONSIDERATIONS FOR MUNICIPAL SOLID WASTE CONVEYORS ...cleanup might be very useful in order to determine the level at which a conveyor design is monetarily accep~table. A scan of conveying technologies for

Stratifying the potential local transmission of Zika in municipalities of Antioquia, Colombia.

PubMed

Ospina, Juan; Hincapie-Palacio, Doracelly; Ochoa, Jesús; Molina, Adriana; Rúa, Guillermo; Pájaro, Dubán; Arrubla, Marcela; Almanza, Rita; Paredes, Marlio; Mubayi, Anuj

2017-10-01

To stratify and understand the potential transmission processes of Zika virus in Colombia, in order to effectively address the efforts on surveillance and disease control. We compare R 0 of Zika for municipalities based on data from the regional surveillance system of Antioquia, Colombia. The basic reproduction number (R 0 ) and its 95% confidence intervals were estimated from an SIR model with implicit vector dynamics, in terms of recovered individuals in each time unit, using an approximate solution. These parameters were estimated fitting the solution of the model to the daily cumulative frequency of each Zika case according to symptoms onset date relative to the index case reported to the local surveillance system. R 0 was estimated for 20 municipalities with a median of 30 000 inhabitants, all located less than 2200 m above sea level. The reported cases ranged from 17 to 347 between these municipalities within 4 months (January to April of 2016). The results suggest that 15 municipalities had a high transmission potential (R 0  > 1), whereas in five municipality transmissions were potentially not sustaining (R 0  < 1), although the upper bound of the confidence interval of the R 0 for 3 of these 5 was greater than one, indicating the possibility of an outbreak later on. The study identified high-risk municipalities (R 0  > 1) and provide a technique to optimise surveillance and control of Zika. Health authorities should promote the collection, analysis, modelling and sharing of anonymous data onto individual cases to estimate R 0 . © 2017 John Wiley & Sons Ltd.

[Mercury Distribution Characteristics and Atmospheric Mercury Emission Factors of Typical Waste Incineration Plants in Chongqing].

PubMed

Duan, Zhen-ya; Su, Hai-tao; Wang, Feng-yang; Zhang, Lei; Wang, Shu-xiao; Yu, Bin

2016-02-15

Waste incineration is one of the important atmospheric mercury emission sources. The aim of this article is to explore the atmospheric mercury pollution level of waste incineration industry from Chongqing. This study investigated the mercury emissions from a municipal solid waste incineration plant and a medical waste incineration plant in Chongqing. The exhaust gas samples in these two incineration plants were obtained using USA EPA 30B method. The mercury concentrations in the fly ash and bottom ash samples were analyzed. The results indicated that the mercury concentrations of the municipal solid waste and medical waste incineration plant in Chongqing were (26.4 +/- 22.7) microg x m(-3) and (3.1 +/- 0.8) microg x m(-3) in exhaust gas respectively, (5279.2 +/- 798.0) microg x kg(-1) and (11,709.5 +/- 460.5) microg x kg(-1) in fly ash respectively. Besides, the distribution proportions of the mercury content from municipal solid waste and medical waste in exhaust gas, fly ash, and bottom ash were 34.0%, 65.3%, 0.7% and 32.3%, 67.5%, 0.2% respectively; The mercury removal efficiencies of municipal solid waste and medical waste incineration plants were 66.0% and 67.7% respectively. The atmospheric mercury emission factors of municipal solid waste and medical waste incineration plants were (126.7 +/- 109.0) microg x kg(-1) and (46.5 +/- 12.0) microg x kg(-1) respectively. Compared with domestic municipal solid waste incineration plants in the Pearl River Delta region, the atmospheric mercury emission factor of municipal solid waste incineration plant in Chongqing was lower.

Assessment of the living and workplace health and safety conditions of site-resident construction workers in Tehran, Iran.

PubMed

Mohseni, Peyman Hossein; Farshad, Ali Asghar; Mirkazemi, Roksana; Orak, Rouhangiz Jamshidi

2015-01-01

The purpose of this study was to assess living and workplace safety conditions of construction workers in Tehran, Iran. This cross-sectional study was conducted among 410 construction sites in a municipal area of Tehran whose municipal building permits were issued in 2011. Data on ventilation, workplace safety and hygiene were collected by direct observation and interviews with site foremen. Noise levels were estimated from 10 sound-level-meter stations in the municipality area. Lack of ventilation in the workers' rooms was abundant. Bathrooms were unhygienic and minimum requirements such as lighting and ventilation did not exist in 80% of the cases. In nearly 50% of large construction sites, sewage and garbage disposal were inappropriate. Elevator safety was poor at all sites and no measures for fall prevention were present in over 88% of active construction sites. This study showed that the mean 24-h equivalent continuous sound level Leq was over 70 dB in 80% of the sites during weekdays. The results of this study revealed poor health and safety living and working conditions of construction workers in Tehran.

Municipal water supplies in Lee County, Florida, 1974

USGS Publications Warehouse

O'Donnell, T. H.

1977-01-01

In 1974 the total pumpage for Lee County, Fla., municipal supplies reached 5,700 Mgal (million gallons annually), an increase of 54 percent over 1970 levels. Pumpage from individual sources included: Caloosahatchee River, 1,312 Mgal; water-table aquifer, 2,171 Mgal; the water-bearing zone in the Tamiami Formation, 340 Mgal; the water-bearing zone in the upper part of the Hawthorn Formation, 1,399 Mgal; the saline water zones in the lower part of the Hawthorn Formation and the Suwannee Limestone, 483 Mgal. Among the various sources, the water-table aquifer showed the greatest increase in municipal pumpage over 1970 levels (60 percent) while the saline zones in the lower part of the Hawthorn Formation and Suwannee Limestone showed the least (40 percent). Intensive pumpage from the water bearing zone in the upper part of the Hawthorn Formation has caused a progressive decline in water levels in wells tapping that zone. The quality of fresh ground water in areas unaffected by intrusion of saline water, generally meets all the recommended limits of the Environmental Protection Agency. The chemical treatment processes utilized by water plants in the county are generally effective in producing finished water that meets EPA preliminary drinking water standards. (Woodard-USGS)

Affordability of residential water tariffs: alternative measurement and explanatory factors in southern Spain.

PubMed

García-Valiñas, Maria A; Martínez-Espiñeira, Roberto; González-Gómez, Francisco

2010-12-01

Using information on a basic or "lifeline" level of domestic water use obtained from a water demand function based on a Stone-Geary utility function, a minimum water threshold of 128 m(3) per household per year was estimated in a sample of municipalities in Southern Spain. As a second objective, water affordability indexes were then calculated that relate the cost of such lifeline to average municipal income levels. The analysis of the factors behind the differences in that ratio across Andalusian municipalities shows that the relative cost of purchasing the lifeline appears inversely related to average income levels, revealing an element of regressivity in the component of water tariffs affecting the least superfluous part of the household's consumption. The main policy recommendation would involve redesigning water tariffs in order to improve access for lower income households to an amount of water sufficient to cover their basic needs. The proposed methodology could be applied to other geographical areas, both from developed and from developing countries, in order to analyze the degree of progressivity of the water tariffs currently in effect and in order to guide the design of more equitable regulatory policies. Copyright © 2010 Elsevier Ltd. All rights reserved.

Fear of childbirth in urban and rural regions of Turkey: Comparison of two resident populations

PubMed Central

Okumus, Filiz; Sahin, Nevin

2017-01-01

OBJECTIVE: Childbirth is a natural physiological event experienced by many women; however, it is frequently also a source of fear in women. Rates of cesarean sections in Turkey are higher in the urban areas than in the rural areas. We hypothesized that lower fear of childbirth (FOC) rates would be observed in the city having the lowest cesarean section rates in Turkey. This study aimed to compare FOC in women in two resident populations: one in a rural area and the other in an urban area. METHODS: This study was conducted on 253 pregnant women in Istanbul, a large urban municipality, and Siirt, a city in rural Turkey. A descriptive information form and the A version of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) were used. RESULTS: Severe FOC levels were recorded in women in the Istanbul sample; moreover, these levels were higher than those recorded in women in the Siirt sample. In addition, women in the Istanbul sample preferred vaginal birth to cesarean section and had greater FOC, a finding which demonstrates that women prefer vaginal birth even though they have a higher FOC level and live in a city with high cesarean section rates. Where women live (rural versus urban areas) affects their perception of birth and consequently, their FOC levels. CONCLUSION: The results of this study suggest that further cross-cultural and regional research is needed for better understanding FOC and factors associated with elevated FOC levels within each cultural setting. PMID:29270574

Primary syphilis cases in Guangdong Province 1995-2008: opportunities for linking syphilis control and regional development.

PubMed

Yang, Li-Gang; Tucker, Joseph D; Yang, Bin; Shen, Song-Ying; Sun, Xi-Feng; Chen, Yong-Feng; Chen, Xiang-Sheng

2010-12-30

Syphilis cases have risen in many parts of China, with developed regions reporting the greatest share of cases. Since syphilis increases in these areas are likely driven by both increased screening and changes in sexual behaviours, distinguishing between these two factors is important. Examining municipal-level primary syphilis cases with spatial analysis allows a more direct understanding of changing sexual behaviours at a more policy-relevant level. In this study we examined all reported primary syphilis cases from Guangdong Province, a southern province in China, since the disease was first incorporated into the mandatory reporting system in 1995. Spatial autocorrelation statistics were used to correlate municipal-level clustering of reported primary syphilis cases and gross domestic product (GDP). A total of 52,036 primary syphilis cases were reported over the period 1995-2008, and the primary syphilis cases increased from 0.88 per 100,000 population in 1995 to 7.61 per 100,000 in 2008. The Pearl River Delta region has a disproportionate share (44.7%) of syphilis cases compared to other regions. Syphilis cases were spatially clustered (p = 0.01) and Moran's I analysis found that syphilis cases were clustered in municipalities with higher GDP (p = 0.004). Primary syphilis cases continue to increase in Guangdong Province, especially in the Pearl River Delta region. Considering the economic impact of syphilis and its tendency to spatially cluster, expanded syphilis testing in specific municipalities and further investigating the costs and benefits of syphilis screening are critical next steps.

Evaluation of Brazil's public health surveillance system within the context of the International Health Regulations (2005).

PubMed

Teixeira, Maria Glória; Costa, Maria C N; Souza, Luís P F; Nascimento, Estela M R; Barreto, Maurício L; Barbosa, Neusa; Carmo, Eduardo Hage

2012-07-01

To evaluate Brazil's public health surveillance system (HSS), identifying its core capacities, shortcomings, and limitations in dealing with public health emergencies, within the context of the International Health Regulations (IHR 2005). In 2008-2009 an evaluative cross-sectional study was conducted using semistructured questionnaires administered to key informants (municipal, state, and national government officials) to assess Brazilian HSS structure (legal framework and resources) and surveillance and response procedures vis-à-vis compliance with the IHR (2005) requirements for management of public health emergencies of national and international concern. Evaluation criteria included the capacity to detect, assess, notify, investigate, intervene, and communicate. Responses were analyzed separately by level of government (municipal health departments, state health departments, and national Ministry of Health). Overall, at all three levels of government, Brazil's HSS has a well-established legal framework (including the essential technical regulations) and the infrastructure, supplies, materials, and mechanisms required for liaison and coordination. However, there are still some weaknesses at the state level, especially in land border areas and small towns. Professionals in the field need to be more familiar with the IHR 2005 Annex 2 decision tool (designed to increase sensitivity and consistency in the notification process). At the state and municipal level, the capacity to detect, assess, and notify is better than the capacity to investigate, intervene, and communicate. Surveillance activities are conducted 24 hours a day, 7 days a week in 40.7% of states and 35.5% of municipalities. There are shortcomings in organizational activities and methods, and in the process of hiring and training personnel. In general, the core capacities of Brazil's HSS are well established and fulfill most of the requisites listed in the IHR 2005 with respect to both structure and surveillance and response procedures, particularly at the national and state levels.

Assessment of health literacy of municipal employees in Shemiranat, Iran.

PubMed

Solhi, Mahnaz; Jormand, Hanieh

2017-12-01

Health literacy is one of the major determinants of health promotion among individuals and within society. The present study is aimed to determine the health literacy status of office employees in Shemiranat using the native instruments of health literacy for Iranian adults (HELIA). The present descriptive-analytical cross-sectional study was done in 2016-17. It was conducted on 360 office employees in Shemiranat. The samples were selected using a multi-stage simple random sampling method. Data collection tools in this study included HELIA questionnaire. The data were imported into SPSS v.18 software and then analyzed using descriptive statistical indices (mean, SD, number, and percentage) and inferential statistics (Chi-square, Pearson's correlation coefficient, Spearman's correlation coefficient, and Kruskal-Wallis test). Written informed consent was obtained from the employees participating in the study and they were assured about confidentiality. Also, they were informed that participation was voluntary. The mean and standard deviation of the total health literacy score among the studied individuals was 125.99±16.01. The mean score of health literacy in the areas of reading (15.36±2.89) and evaluation (5.01±2.8) among the studied individuals was lower than other dimensions of health literacy. Based on the Chi-square test, there was a statistically significant relationship between health literacy and education level, occupational rank, work place, and work experience (p=0.0001 in all the cases). The individuals with medium and good levels of health literacy acquired most of their health-related information through the Internet, friends, relatives, physicians, and health staff. Health literacy status was not sufficient among the studied staff. Thus, it is recommended to perform promotional interventions in order to improve the health literacy status and its dimensions among these staff.

Is the competence of Swedish Registered Nurses working in municipal care of older people merely a question of age and postgraduate education?

PubMed

Karlstedt, Michaela; Wadensten, Barbro; Fagerberg, Ingegerd; Pöder, Ulrika

2015-06-01

Previous studies suggest that not only education but also personal aspects such as experience of working as a registered nurse (RN) and age can influence competence. The objective was to explore the educational and self-rated competence of RNs and their duties within the care of older people. A cross-sectional descriptive design was used. All RNs in two counties in Sweden were asked to complete a written questionnaire: a study specific questionnaire with educational and work related questions using the Nurse Competence Scale. The response rate was 61% (n 344). Higher self-rated satisfaction with own professional competence was related to older age, more years after nursing education and possessing at least one postgraduate education in specialist nursing. Educational needs were related to younger age and fewer years since nursing graduation. Education within elder care, including education about drugs was rated the most urgently needed area of education. The most frequently reported tasks were found in the domain helping role, whereas ensuring quality was less present in their daily work. Educational level, age and years of experience had an impact on RNs' self-perceived competence, which is in accordance with previous descriptions of the concept competence. It seems imperative that RNs working in care of the old and with the demands placed on them are given the opportunity to take a postgraduate specialist education in order to gain a competence level in their desired area of work. It is also important that RNs working in care of the old get tailored education in line with the requirements the organisation places on them. © 2014 Nordic College of Caring Science.

Vehicle-Routing Optimization for Municipal Solid Waste Collection Using Genetic Algorithm: The Case of Southern Nablus City

NASA Astrophysics Data System (ADS)

Assaf, Ramiz; Saleh, Yahya

2017-09-01

Municipalities are responsible for solid waste collectiont for environmental, social and economic purposes. Practices of municipalities should be effective and efficient, with the objectives of reducing the total incurred costs in the solid waste collection network concurrently achieving the highest service level. This study aims at finding the best routes of solid waste collection network in Nablus city-Palestine. More specifically, the study seeks the optimal route that minimizes the total travelled distance by the trucks and hence the resulted costs. The current situation is evaluated and the problem is modelled as a Vehicle Routing Problem (VRP). The VRP is then optimized via a genetic algorithm. Specifically, compared to the current situation, the trucks total travelled distance was reduced by 66%, whereas the collection time was reduced from 7 hours per truck-trip to 2.3 hours. The findings of this study is useful for all municipality policy makers that are responsible for solid waste collection.

Tools to support maintenance strategies under soft soil conditions

NASA Astrophysics Data System (ADS)

Lambert, J. W. M.; van Meerten, J. J.; Woning, M. P.; Eijbersen, M. J.; Huber, M.

2015-11-01

Costs for maintenance of infrastructure in municipalities with soft soil underground conditions, are estimated to be almost 40 % higher than in others. As a result, these municipalities meet financial problems that cause overdue maintenance. In some cases municipalities are even afraid to be unable to offer a minimum service level in future. In common, traditional practice, roads and sewerage systems have been constructed in trenches that consist of sandy material that replaces the upper meters of the soft soil. Under influence of its weight, this causes accelerated settlements of the construction. A number of alternative constructions have been developed, e.g. using light-weight materials to limit settlement velocity. In order to limit future maintenance costs, improvement of maintenance strategies is desired. Tools have been and will be developed to support municipalities in improving their maintenance strategies and save money by doing that. A model (BALANS) that weighs the attractiveness of alternative solutions under different soil, environmental and economic circumstances, will be presented.

[Traffic accidents: a qualitative approach from Campinas, São Paulo, Brazil].

PubMed

Queiroz, Marcos S; Oliveira, Patrícia C P

2002-01-01

This article takes an interdisciplinary qualitative approach to the problem of traffic accidents in Campinas, São Paulo, Brazil. The authors begin by analyzing the "municipalization" (i.e., decentralization to the municipal level) of transport and traffic management in Campinas based on social representations by members of the local government's technical staff. Data demonstrate a significant drop in traffic accident mortality in Campinas in the last ten years. The findings illustrate how new transport and traffic policies had several positive effects. Special attention is given to the objectives, strategies, and obstacles dealt with by local government in the "municipalization" of traffic. The paper concludes by emphasizing the need for specific public policies to revitalize urban mass transportation, including special traffic safety educational programs.

[Family Health Program implementation in municipalities in Mato Grosso State, Brazil].

PubMed

Canesqui, Ana Maria; Spinelli, Maria Angélica do Santos

2008-04-01

This article analysis some key aspects in the implementation of the Family Health Program (FHP): results; conditions; and institutional mechanisms; flow and regularity of funding; organizational structures; and human resources availability and training. The study was conducted in seven municipalities (counties) in the State of Mato Grosso, Brazil, and used secondary data as well as primary data from interviews with different stakeholders. The research design was evaluative, using a quantitative/qualitative analysis. The results showed: varying stages in the implementation process, different FHP models, and adaptation of organizational structures; high level of human resources availability, except for nurse assistants; availability of financial resources, with some difficulties in their flow; and other institutional factors that hinder or facilitate the micro-implementation process in the municipalities.

Social disparities in Disease Management Programmes for coronary heart disease in Germany: a cross-classified multilevel analysis

PubMed Central

Bozorgmehr, Kayvan; Maier, Werner; Brenner, Hermann; Saum, Kai-Uwe; Stock, Christian; Miksch, Antje; Holleczek, Bernd; Szecsenyi, Joachim; Razum, Oliver

2015-01-01

Background Disease Management Programmes (DMPs) aim to improve effectiveness and equity of care but may suffer from selective enrolment. We analysed social disparities in DMP enrolment among elderly patients with coronary heart disease (CHD) in Germany, taking into account contextual effects at municipality and primary care practice levels. Methods Cross-sectional analysis of effects of educational attainment and regional deprivation on physician-reported DMP enrolment in a subsample of a large population-based cohort study in Germany, adjusting for individual-level, practice-level and area-level variables. We calculated OR and their 95% CIs (95% CI) in cross-classified, multilevel logistic regression models. Results Among N=1280 individuals with CHD (37.3% women), DMP enrolment rates were 22.2% (women) and 35% (men). The odds of DMP enrolment were significantly higher for male patients (OR=1.98 (1.50 to 2.62)), even after adjustment for potential confounding by individual-level, practice-level and area-level variables (range: OR=1.60 (1.08 to 2.36) to 2.16 (1.57 to 2.98)). Educational attainment was not significantly associated with DMP enrolment. Compared to patients living in least-deprived municipalities, the adjusted propensity of DMP enrolment was statistically significantly lower for patients living in medium-deprived municipalities (OR=0.41 (0.24 to 0.71)), and it also tended to be lower for patients living in the most-deprived municipalities (OR=0.70 (0.40 to 1.21)). Models controlling for the social situation (instead of health-related behaviour) yielded comparable effect estimates (medium-deprived/most-deprived vs least-deprived areas: OR=0.45 (0.26 to 0.78)/OR=0.68 (0.33 to 1.19)). Controlling for differences in comorbidity attenuated the deprivation effect estimates. Conclusions We found evidence for marked gender, but not educational disparities in DMP enrolment among patients with CHD. Small-area deprivation was associated with DMP enrolment, but the effects were partly explained by differences in comorbidity. Future studies on DMPs should consider contextual effects when analysing programme effectiveness or impacts on equity and efficiency. PMID:26082518

Trihalomethanes in drinking water and the risk of death from esophageal cancer: does hardness in drinking water matter?

PubMed

Tsai, Shang-Shyue; Chiu, Hui-Fen; Yang, Chun-Yuh

2013-01-01

The objectives of this study were to (1) examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of esophageal cancer occurrence and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water modify the effects of TTHM on risk to develop esophageal cancer. A matched case-control study was used to investigate the relationship between the risk of death attributed to esophageal cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All esophageal cancer deaths in the 53 municipalities from 2006 through 2010 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from Taiwan Environmental Protection Administration. Information on the levels of Ca and Mg in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level <4.9 ppb, the adjusted odds ratio (OR) with 95% confidence interval (CI) for esophageal cancer was 1.02 (0.84-1.23) for individuals who resided in municipalities served by drinking water with a TTHM exposure ≥4.9 ppb. There was evidence of an interaction between drinking-water TTHM levels and low Ca and Mg intake. Our findings showed that the correlation between TTHM exposure and risk of esophageal cancer development was influenced by Ca and Mg levels in drinking water. This is the first study to report effect modification by Ca and Mg intake from drinking water on the correlation between TTHM exposure and risk of esophageal cancer occurrence. Increased knowledge of the interaction between Ca, Mg, and TTHM in reducing risk of esophageal cancer development will aid in public policymaking and standard setting for drinking water.

Ground-water levels, water quality, and potential effects of toxic-substance spills or cessation of quarry dewatering near a municipal ground-water supply, southeastern Franklin County, Ohio

USGS Publications Warehouse

Sedam, A.C.; Eberts, S.M.; Bair, E.S.

1989-01-01

A newly completed municipal ground-water supply that produces from a sand and gravel aquifer in southern Franklin County, Ohio, may be susceptible to potential sources of pollution. Among these are spills of toxic substances that could enter recharge areas of the aquifer or be carried by surface drainage and subsequently enter the aquifer by induced infiltration. Ground water of degraded quality also is present in the vicinity of several landfills located upstream from the municipal supply. Local dewatering by quarrying operations has created a ground-water divide which, at present, prevents direct movement of the degraded ground water to the municipal supply. In addition, the dewatering has held water levels at the largest landfills below the base of the landfill. Should the dewatering cease, concern would be raised regarding the rise of water levels at this landfills and transport of contaminants through the aquifer to the Scioto River and subsequently by the river to the well field. From June 1984 through July 1986, the U.S. Geological Survey, in cooperation with the City of Columbus, Ohio, investigated the relations among the ground-water supply and potential sources of contamination by means of an observation-well network and a program of measuring water levels and sampling for water quality. Sample collections included those made to determine the baseline levels of organic chemicals and metals, as well as periodic sampling and analysis for common constituents to evaluate any changes taking place in the system. Finally, a steady-state, three-dimensional numerical model was used to determine ground-water flow directions and average ground-water velocities to asses potential effects of toxic-substance spills. The model also was used to simulate changes in the ground-water flow system that could result if part or all of the quarry dewatering ceased. Few of the organic-chemical and metal constituents analyzed for were present at detectable levels. With respect to chemical analysis of water and soil materials reported in earlier studies, no new problem areas were discovered as a result of either the baseline or periodic samplings. Model simulations suggest that, under March 1986 conditions, a toxic-substance spill along the major highways in the northern two-thirds of the study area eventually could discharge into one of the two quarries being dewatered or into the Scioto River. A toxic-substance spill in the southern one-third of the study area ultimately may discharge into the Scioto River, Big Walnut Creek, or possibly into the municipal ground-water supply. Model simulations also indicate that concentrated landfill leachate probably would not reach the municipal ground-water supply under current or well-field pumping conditions if dewatering ceased at either or both of the quarries.

Operation and model description of a sequencing batch reactor treating reject water for biological nitrogen removal via nitrite.

PubMed

Dosta, J; Galí, A; Benabdallah El-Hadj, T; Macé, S; Mata-Alvarez, J

2007-08-01

The aim of this study was the operation and model description of a sequencing batch reactor (SBR) for biological nitrogen removal (BNR) from a reject water (800-900 mg NH(4)(+)-NL(-1)) from a municipal wastewater treatment plant (WWTP). The SBR was operated with three cycles per day, temperature 30 degrees C, SRT 11 days and HRT 1 day. During the operational cycle, three alternating oxic/anoxic periods were performed to avoid alkalinity restrictions. Oxygen supply and working pH range were controlled to achieve the BNR via nitrite, which makes the process more economical. Under steady state conditions, a total nitrogen removal of 0.87 kg N (m(3)day)(-1) was reached. A four-step nitrogen removal model was developed to describe the process. This model enlarges the IWA activated sludge models for a more detailed description of the nitrogen elimination processes and their inhibitions. A closed intermittent-flow respirometer was set up for the estimation of the most relevant model parameters. Once calibrated, model predictions reproduced experimental data accurately.

[Comparative analysis of malaria detection ability of laboratories in Shanghai City from 2012 to 2015].

PubMed

Zhen-Yu, Wang; Li, Jiang; Yao-Guang, Zhang; Min, Zhu; Xiao-Ping, Zhang; Xiao-Jiang, Ma; Qian, Zhu; Yan-Yan, He; Shou-Fu, Jiang; Li, Cai

2017-02-27

To compare the application effects of three methods, namely microscopic examination, antigen detection (RDT) and nucleic acid test (PCR) in malaria detection between municipal and districts/counties centers for disease control and prevention in Shanghai, and analyze the malaria detection ability of the laboratories in Shanghai. The blood smears, whole blood samples, case review confirmation records and case data of malaria cases and suspected cases in Shanghai from 2012 to 2015 were collected by Shanghai Municipal Center for Disease Control and Prevention, and the detection results were analyzed and compared. A total of 212 samples with complete data were submitted by all districts (counties) in Shanghai from 2012 to 2015, the samples submitted by Jinshan Districts were the most (41.98%), and among the first diagnosis hospitals, those submitted by the tertiary hospitals were the most (82.07%). The submitted samples in the whole year were increased gradually from January to October. All the 212 samples were detected by three methods (the microscopic examination, RDT and PCR) in the laboratory of Shanghai Municipal Center for Disease Control and Prevention, and 167 were tested and confirmed comprehensively as positives, accounting for 78.77%, and 45 were confirmed as negatives, accounting for 21.23%. The samples were detected by the method of microscopy and domestic RDT in the laboratories of the centers for disease control and prevention at district/county level, totally 153 were tested as positives, accounting for 72.17%, 41 were unclassified, accounting for 19.34%, 53 were negative, accounting for 25.00%, and 6 were undetected, accounting for 2.83%. The coincidence of microscopic examination between the report hospitals and the centers for disease control and prevention at district/county level was 78.16%, and the coincidence between centers for disease control and prevention at district/county level and municipal level was 93.20%. The utilization rate of RDT in the laboratory of district/county level was 73.58%. The coincidence of RDT tests between those domestic and imported was 93.59%. Compared with the detection results by municipal center for disease control and prevention, 37 samples were misjudged by the laboratories of district/county level. Almost all (99.37%) of the confirmed malaria cases were imported overseas, including Africa (85.44%), Asia (13.92%) and America (0.63%). The surveillance after malaria elimination in Shanghai should be carried out by combining with different detection methods and resource integration.

The use and costs of health and social services in patients with longstanding substance abuse.

PubMed

Vossius, Corinna; Testad, Ingelin; Skjæveland, Rune; Nesvåg, Sverre

2013-05-22

Persons with longstanding substance abuse might become increasingly dependent on help by the public, eventually requiring permanent care. In 2006 the municipality of Stavanger established a so-called addiction ward for these clients, comprising 17 beds at the largest municipal nursing home. We assumed that the residents of this ward were high consumers of health care and social services during the last months preceding their admission. The aim of the study was to register the type and extent of services that were claimed by this client group during the last six months prior to admission, and to calculate the costs that were caused. Further, we estimated the incremental costs for nursing home placement. In 15 residents from the addiction ward the use of all welfare services during the six months prior to admission were registered. Costs were calculated by unit costs from a municipal, national and societal perspective. Mean total costs during this period were €32 474. Approximately half of these costs were borne by state-funded institutions, and half were borne by the municipality. The clients used a great variety of services aimed at subsistence, health care and support in independent living, while services aimed at drug withdrawal were not claimed. There was no correlation between costs and the level of functioning. The incremental costs for nursing home admission were borne by the municipalities. Persons with longstanding substance abuse represent a group with a high use of welfare resources and hence cause high costs. However, our findings do not indicate any correlation between the amount of services rendered and the level of functioning. Further research should focus on the identification of the clients' need for support in order to facilitate targeted interventions that might prevent further deterioration and, finally, the need for permanent care.

A Swiss paradox? Higher income inequality of municipalities is associated with lower mortality in Switzerland.

PubMed

Clough-Gorr, Kerri M; Egger, Matthias; Spoerri, Adrian

2015-08-01

It has long been surmised that income inequality within a society negatively affects public health. However, more recent studies suggest there is no association, especially when analyzing small areas. This study aimed to evaluate the effect of income inequality on mortality in Switzerland using the Gini index on municipality level. The study population included all individuals >30 years at the 2000 Swiss census (N = 4,689,545) living in 2,740 municipalities with 35.5 million person-years of follow-up and 456,211 deaths over follow-up. Cox proportional hazard regression models were adjusted for age, gender, marital status, nationality, urbanization, and language region. Results were reported as hazard ratios (HR) with 95% confidence intervals. The mean Gini index across all municipalities was 0.377 (standard deviation 0.062, range 0.202-0.785). Larger cities, high-income municipalities and tourist areas had higher Gini indices. Higher income inequality was consistently associated with lower mortality risk, except for death from external causes. Adjusting for sex, marital status, nationality, urbanization and language region only slightly attenuated effects. In fully adjusted models, hazards of all-cause mortality by increasing Gini index quintile were HR = 0.99 (0.98-1.00), HR = 0.98 (0.97-0.99), HR = 0.95 (0.94-0.96), HR = 0.91 (0.90-0.92) compared to the lowest quintile. The relationship of income inequality with mortality in Switzerland is contradictory to what has been found in other developed high-income countries. Our results challenge current beliefs about the effect of income inequality on mortality on small area level. Further investigation is required to expose the underlying relationship between income inequality and population health.

Where does distance matter? Distance to the closest maternity unit and risk of foetal and neonatal mortality in France.

PubMed

Pilkington, Hugo; Blondel, Béatrice; Drewniak, Nicolas; Zeitlin, Jennifer

2014-12-01

The number of maternity units has declined in France, raising concerns about the possible impact of increasing travel distances on perinatal health outcomes. We investigated impact of distance to closest maternity unit on perinatal mortality. Data from the French National Vital Statistics Registry were used to construct foetal and neonatal mortality rates over 2001-08 by distance from mother's municipality of residence and the closest municipality with a maternity unit. Data from French neonatal mortality certificates were used to compute neonatal death rates after out-of-hospital birth. Relative risks by distance were estimated, adjusting for individual and municipal-level characteristics. Seven percent of births occurred to women residing at ≥30 km from a maternity unit and 1% at ≥45 km. Foetal and neonatal mortality rates were highest for women living at <5 km from a maternity unit. For foetal mortality, rates increased at ≥45 km compared with 5-45 km. In adjusted models, long distance to a maternity unit had no impact on overall mortality but women living closer to a maternity unit had a higher risk of neonatal mortality. Neonatal deaths associated with out-of-hospital birth were rare but more frequent at longer distances. At the municipal-level, higher percentages of unemployment and foreign-born residents were associated with increased mortality. Overall mortality was not associated with living far from a maternity unit. Mortality was elevated in municipalities with social risk factors and located closest to a maternity unit, reflecting the location of maternity units in deprived areas with risk factors for poor outcome. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association.

A study of tritium in municipal solid waste leachate and gas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mutch Jr, R. D.; Manhattan College, Riverdale, NY; Columbia Univ., New York, NY

2008-07-15

It has become increasingly clear in the last few years that the vast majority of municipal solid waste landfills produce leachate that contains elevated levels of tritium. The authors recently conducted a study of landfills in New York and New Jersey and found that the mean concentration of tritium in the leachate from ten municipal solid waste (MSW) landfills was 33,800 pCi/L with a peak value of 192,000 pCi/L. A 2003 study in California reported a mean tritium concentration of 99,000 pCi/L with a peak value of 304,000 pCi/L. Studies in Pennsylvania and the UK produced similar results. The USEPAmore » MCL for tritium is 20,000 pCi/L. Tritium is also manifesting itself as landfill gas and landfill gas condensate. Landfill gas condensate samples from landfills in the UK and California were found to have tritium concentrations as high as 54,400 and 513,000 pCi/L, respectively. The tritium found in MSW leachate is believed to derive principally from gaseous tritium lighting devices used in some emergency exit signs, compasses, watches, and even novelty items, such as 'glow stick' key chains. This study reports the findings of recent surveys of leachate from a number of municipal solid waste landfills, both open and closed, from throughout the United States and Europe. The study evaluates the human health and ecological risks posed by elevated tritium levels in municipal solid waste leachate and landfill gas and the implications to their safe management. We also assess the potential risks posed to solid waste management facility workers exposed to tritium-containing waste materials in transfer stations and other solid waste management facilities. (authors)« less

Community level effects of gender inequality on intimate partner violence and unintended pregnancy in Colombia: testing the feminist perspective.

PubMed

Pallitto, Christina C; O'Campo, Patricia

2005-05-01

Violence against women, especially by intimate partners, is a serious public health problem that is associated with physical, reproductive, and mental health consequences. The effect of intimate partner violence on women's ability to control their fertility and the mechanisms through which these phenomena are related merit further investigation. Building on findings from a previous analysis in which a statistically significant relationship between intimate partner violence and unintended pregnancy in Colombia was found, this analysis examines the effect of gender inequality on this association using data from the 2000 Colombian Demographic and Health Survey. Specifically, the objective of this analysis is to explore whether gender inequality (as measured by women's autonomy, women's status, male patriarchal control, and intimate partner violence) in municipalities partially explains the association between intimate partner violence and unintended pregnancy in Colombia. Results of logistic regression analysis with multi-level data show that living in a municipality with high rates of male patriarchal control significantly increased women's odds of having an unintended pregnancy by almost four times. Also, living in a municipality with high rates of intimate partner violence increased one's odds of unintended pregnancy by more than 2.5 times, and non-abused women living in municipalities with high rates of intimate partner violence were at a significantly increased risk of unintended pregnancy. In addition, abused women living in a municipality with high personal female decision-making autonomy had more than a fourfold increased risk of having an unintended pregnancy. These findings demonstrate the need for reproductive health programs to target areas at particularly high risk for unintended pregnancy by reducing intimate partner violence and gender inequality.

Seroprevalence and correlates of Toxoplasma gondii infection in domestic sheep in Michoacán State, Mexico.

PubMed

Alvarado-Esquivel, Cosme; Silva-Aguilar, Dante; Villena, Isabelle; Dubey, Jitender P

2013-11-01

Toxoplasma gondii infection in sheep is of public health and economic importance. Seroprevalence of T. gondii infection and correlates were determined in 405 sheep from 7 farms in 4 geographical regions in Michoacán State, Mexico using the modified agglutination test (MAT). General sheep and environmental characteristics were obtained by a questionnaire. All sheep were raised in semi-extensive conditions in temperate climate. Antibodies to T. gondii were found in 121 (29.9%) of the 405 sheep with MAT titers of 1:25 in 46, 1:50 in 20, 1:100 in 7, 1:200 in 5, 1:400 in 7, 1:800 in 11, 1:1600 in 5, and 1:3200 or higher in 20. Seropositivity did not vary significantly with age, sex or breed. In contrast, seroprevalence varied among farms, geographic region, municipality, altitude, mean annual temperature, and mean annual rainfall. The median seroprevalence in farms was 32.6% (range 7.1-71.4%). Sheep raised in farms at ≥1900 m above sea level had a higher seroprevalence (44.1%) than those in farms at lower sea level (16.3%). Sheep raised in municipalities with ≤17.7 °C mean annual temperature had a higher seroprevalence (37.2%) than those in municipalities with higher mean annual temperature (14.1%). Sheep raised in a municipality with 600 mm of mean annual rainfall had a higher seroprevalence (71.4%) than municipalities with higher mean annual rainfall (29.1%). This is the first report on the seroprevalence and correlates of T. gondii infection in sheep in Michoacán State, Mexico. The role of environmental characteristics for T. gondii infection in sheep deserves further research. Copyright © 2013 Elsevier B.V. All rights reserved.

Towards sustainable structures for neighbourhood development? Healthy city research in four Swedish municipalities 2003-2009.

PubMed

Fröding, Karin; Geidne, Jonny; Elander, Ingemar; Eriksson, Charli

2013-01-01

A vehicle to reduce health inequalities and improve public health has been provided by programmes at a neighbourhood level. The purpose of this paper is to analyse the development processes in four municipalities for achieving sustainable structures in area-based development programmes during and after a formal partnership period. A case-study database was compiled based on the strategic and local work of four municipalities and four municipal housing companies who cooperated in the Partnership for Sustainable Welfare Development 2003-2009. The case-study database includes nine in-depth studies with interviews (n = 68), participant observations (n = 125), a survey (n = 1,160), and documents. The data are analysed using three theoretical concepts: political support, alliances, and citizen participation. Political support, alliances, and citizen participation are important building blocks in neighbourhood development work. However, when the partnership ended there was little left that could function as a sustainable structure. Political support seems to be a means to reach the target, including ensuring a consistent approach and allocation of resources. However, the support must continue also after the intervention period, when the formal partnership collaboration ends, otherwise the established structure will soon decompose. Citizen participation is another precondition for a sustainable structure able to continue despite reduced municipal support. Alliances have the best chance of forming sustainable structures when they involve both the strategic and the operational level. Even though many evaluations have been conducted to capture the process of interventions, little attention has been given to the challenges facing the outcomes of the intervention when it comes to making permanent the activities for reducing health inequalities. This paper is an attempt to deal with these challenges.

Brazil - the Challenge of Development

DTIC Science & Technology

1990-03-07

bloodshed. This occurred through political and legal negotiations that led to a general amnesty, a new constitution, and direct elections at municipal ...state and national levels during the last five years. Brazil had municipal elections in 1985 and 1986. In 1987 it convened a National Constituent...34 computer and Digital will soon produce its Microvax. (Ŕ Mercado Mata a Lei," Veja, 20 Dec 89, pp. 141-142.) 6. Jose Sarney, p. 2. 7. Juan de Onis, p. 128

Marketization of refuse collection in Denmark: social and environmental quality jeopardized.

PubMed

Busck, Ole

2007-08-01

Refuse collection has been the main public service to be outsourced in Denmark since the E.U. guidelines on public procurement came into force in 1993. The contracting activities of the municipalities are framed by a complex set of ideologies and objectives, in addition to regulations. At both EU level and at national level, the demands for marketization of the public sector are counterbalanced by demands for social and environmental considerations. The procurement directive reflects the balance legalizing the inclusion of such requirements by contracting. The Danish experiences, however, tell a grim tale of subordination of social requirements in municipal contracting practices with implications for the quality of the service. The results of a recent study of developments in the working conditions at commercial collection companies show deterioration in respect of health and safety, competence building and job security concurrent with the increase in outsourcing and competition in the sector. In the analysis of the results, a combination of municipal cost-saving strategies, harsh market forces and cultural influences are identified as causal factors. Drawing on a brief institutional analysis, it is concluded that the existing normative and regulative framework of municipal contracting needs reinforcement if societal intentions of qualified public services and acceptable working conditions are to be effective. Initiatives to simultaneously improve working conditions and environmental results of collection are called for.

Private sector contribution to childhood immunization: Sri Lankan experience.

PubMed

Agampodi, S B; Amarasinghe, D A C L

2007-04-01

The main service provider for childhood immunization in Sri Lanka is the government sector. However, utilization of private sector for childhood immunization is increasing rapidly. Existing national immunization data does not routinely include statistics on private sector immunization delivery adequately. To estimate the proportion of children immunized in the private sector; describe socio-demographic characteristics of private sector users and compare these with government sector users. A community-based crosssectional descriptive study was conducted using a pre-tested interviewer-administered structured questionnaire. This was done in the Colombo municipal council area using the WHO 30 cluster methodology. The total number of households in the sample was 553. Out of the 5,028 total immunizations reported in the present study, around one-third (2,544) was obtained through the private sector. Nineteen percent (104) of children were exclusively immunized from the private sector. The distribution of usual immunization provider was - government sector 72.3% (400) and private sector 27.7% (153). Significant differences were observed (P < 0.001) between private and government sector users with regard to family income, social class, ethnicity, religion and educational level of the mother. The age-appropriate immunization among the 12- to 23-month age group was 92.3% (144) in the government sector, whereas it was 95% (38) in the private sector. Among the 24- to 35-month age group, it was 91.7% (121) and 92.7% (76) respectively. The age-adjusted immunization coverage rates were almost same among the government and private sector users except for the measles vaccine, where the private sector users had significantly (P = 0.016) higher coverage. Utilization of private sector immunization services is high in the Colombo municipal council area.

[Shigellosis outbreak with 146 cases related to a fair].

PubMed

Castell Monsalve, Juan; Gutiérrez Avila, Gonzalo; Rodolfo Saavedra, Remedios; Santos Azorín, Antonia

2008-01-01

On September 3, 2005, the Ciudad Real Public Health Service (Spain) received a report of 20 cases of gastroenteritis in the municipality of Daimiel. We conducted an investigation to determine the cause or causes of the outbreak and to implement control measures. Most of the cases involved young people who visited the municipality's fair. We carried out a descriptive study and an analytic case-control study. In the descriptive study, all variables of interest available in the medical records were included. In the case-control study, each case was matched with a control by age (plus or minus 5 years), gender, and attendance at the fair. Sixty-five cases and 65 controls were finally included in the study. Samples of foods and stools from food handlers were taken. We found 196 cases, 146 of which were confirmed. The epidemic curve suggested a common source of infection with a short period of activity. The case-control study showed an association between infection and eating potatoes with a sauce at any of the fair's five food stalls (OR = 20.56; 95%CI, 6.15-75.93; p < 0.0001). Logistic regression analysis showed an association with eating potatoes in food stall number 2 (OR = 6.38; 95%CI, 1.70-23.90; p < 0.0059). Neither samples of foods nor stools from food handlers yielded any positive results. However, Shigella sonnei was isolated from stool samples from 20 cases. The epidemiological study suggested that the most probable cause of the outbreak was a sauce, handmade with garlic, milk, and oil and served with the potatoes.

Establishing a culturally specific nursing home for Finnish-speaking older persons in Sweden: A case study.

PubMed

Hadziabdic, Emina; Hjelm, Katarina

2018-04-01

The study aims to describe the establishment of a culturally specific nursing home for Finnish-speaking older persons in Sweden. A descriptive qualitative study. A descriptive case study based on a review of 14 public documents and individual interviews with two experts in the area, analysed with qualitative content analysis. This study found that shared language, preservation of customs and habits and collaboration between the representatives of the municipality, Finnish-speaking migrant associations and staff at the nursing home influenced the development of the culturally specific nursing home for older Finnish-speaking people intended to avoid loneliness, isolation and misunderstandings among older Finnish-speaking. Collaboration between healthcare service for older persons and minority people resulted in an optimal culturally specific nursing home, simultaneously encountering the majority culture. Nursing and healthcare services need to be aware of positive effects of collaboration with stakeholders to achieve optimal culturally specific nursing homes.

Advertisement call of Dendropsophus studerae (Carvalho-e-Silva, Carvalho-e-Silva and Izecksohn, 2003) (Anura: Hylidae), with new record and geographic distribution extension.

PubMed

Napoli, Marcelo Felgueiras; De Abreu, Rafael Oliveira; Cruz, Deise; Herrera, Jocilene Brandão; Petersen, Emanuela; Klein, Wilfried

2014-10-30

The treefrog genus Dendropsophus Fitzinger comprises 95 species, with geographic distribution from northern Argentina and Uruguay north through tropical South and Central America to tropical southern Mexico (Frost 2014). Dendropsophus studerae was included in the D. microcephalus clade by Faivovich et al. (2005), which currently consists of 39 species (Frost 2014). The species that most resembles D. studerae is D. bipunctatus (Spix), as already stated in the original description of the former (Carvalho-e-Silva et al. 2003). Thus far, Dendropsophus studerae was only known from its type locality, in the municipality of Quebrangulo (09º19'08"S, 36º28'16"W), State of Alagoas, northeastern Brazil. The original description of the species also included data on its eggs, tadpole (oral disc and external morphology) and some natural history information of adults and larvae, but its advertisement call remains undescribed. 

Computer-based information collection and feedback for Norwegian municipal health and social services.

PubMed

Yang, J J

1995-01-01

Norway is governed by a three-tier parliamentary system where each tier is governed by a popularly selected body: the national parliament, the county councils, and the municipality councils. This three-tier system is in many ways also reflected in the organization, management, and financing of health and social services. A large amount of information (e.g.,statistics and annual reports) flows between the three levels of management. In order to have a proper and efficient information flow, The Norwegian Ministry of Health and Social Affairs has, since 1992, been conducting a nation-wide project for information collection from and feedback to municipal health and social services (see Figure 1). In this presentation, we will present the basic idea behind The Wheel. We will also discuss some of the major activities in and experiences from the project of using Information Technology to implement an electronic Wheel. The following are basic issues to consider in implementing such a system, related to the following basic issues in implementing such a system [1]: Obtaining a unified information basis to: increase the data quality, and compile "definition catalogs" that contain commonly agreed-upon definitions of central concepts and data sets that are used in the municipal health and social services [2]. Achieving electronic data collection, both in terms of the automatic selection and aggregation of relevant data from operational systems in the municipalities and in terms of using Electronic Forms. Experiments with various ways of electronically feeding back the statistics and other comparative data to the municipalities. Providing the municipal users with appropriate tools for using the statistics that are fed back.

Comparison of sick leave patterns between Norway and Denmark in the health and care sector: a register study.

PubMed

Krane, Line; Fleten, Nils; Stapelfeldt, Christina M; Nielsen, Claus Vinther; Jensen, Chris; Johnsen, Roar; Braaten, Tonje

2013-11-01

Sickness absence is of considerable concern in both Norway and Denmark. Labour Force Surveys indicate that absence in Norway is about twice that in Denmark and twice that of the mean reported by the Organisation for Economic Co-operation and Development. This study compares absence patterns according to age, percentage of employment, and occupation between municipal employees in the health and care sectors in two municipalities in Norway and Denmark. Data recorded in the personnel registers of the municipalities of Kristiansand, Norway and Aarhus, Denmark were extracted for the years 2004 and 2008, revealing 3498 and 7751 employee-years, respectively. We calculated absence rates together with number of sick leave episodes, and their association with the above-mentioned covariates. Gender-specific comparative descriptive statistics and negative binomial regression analysis were performed. The sickness absence rate in women was 11.3% in Norway (95% confidence interval [CI] 11.2-11.4) and 7.0% in Denmark (95% CI 7.0-7.1) whereas mean number of sick leave episodes among women was 2.4 in Denmark, compared to 2.3 in Norway (p = 0.02). Young employees in Denmark had more sick leave episodes than in Norway. Proportion of absentees was higher in Denmark compared to Norway (p < 0.0001). The finding of that more employees in Denmark have more frequent, but shorter sick leave episodes compared to Norway, for whatever reasons, may indicate that more frequent sick leaves episodes prevent higher sick leaves rates.

Planning future care services: Analyses of investments in Norwegian municipalities.

PubMed

Hagen, Terje P; Tingvold, Laila

2018-06-01

To analyse whether the Norwegian Central Government's goal of subsidizing 12,000 places in nursing homes or sheltered housing using an earmarked grant was reached and to determine towards which group of users the planned investments were targeted. Data from the investment plans at municipal level were provided by the Norwegian Housing Bank and linked to variables describing the municipalities' financial situation as well as variables describing the local needs for services provided by Statistics Norway. Using regression analyses we estimated the associations between municipal characteristics and planned investments in total and by type of care place. The Norwegian Central Government reached its goal of giving subsidies to 12,000 new or rebuilt places in nursing homes and sheltered housing. A total of 54% of the subsidies (6878 places) were given to places in nursing homes. About 7500 places were available by the end of the planning period and the rest were under construction. About 50% of the places were planned for user groups aged <67 years and 23% of the places for users aged <25 years. One-third of the places were planned for users with intellectual disabilities. Investments in nursing homes were correlated with the share of the population older than 80 years and investments in sheltered houses were correlated with the share of users with intellectual disabilities. Earmarked grants to municipalities can be adequate measures to affect local resource allocation and thereby stimulate investments in future care. With the current institutional setup the municipalities adapt investments to local needs.

The challenges of primary health care nurse leaders in the wake of New Health Care Reform in Norway.

PubMed

Tingvoll, Wivi-Ann; Sæterstrand, Torill; McClusky, Leon Mendel

2016-01-01

The local municipality, whose management style is largely inspired by the New Public Management (NPM) model, has administrative responsibilities for primary health care in Norway. Those responsible for health care at the local level often find themselves torn between their professional responsibilities and the municipality's market-oriented funding system. The introduction of the new health care reform process known as the Coordination Reform in January 2012 prioritises primary health care while simultaneously promoting a more collaborative and multidisciplinary approach to health care. Nurse leaders experience constant cross-pressure in their roles as members of the municipal executive team, the execution of their professional and administrative duties, and the overall political aims of the new reform. The aim of this article is to illuminate some of the major challenges facing nurse leaders in charge of nursing homes and to draw attention to their professional concerns about the quality of nursing care with the introduction of the new reform and its implementation under NPM-inspired municipal executive leadership. This study employs a qualitative design. In-depth interviews were conducted with 10 nurse leaders in 10 municipalities, with a phenomenological-hermeneutic approach used for data analysis and interpretation. Findings highlighted the increasingly complex challenges facing nurse leaders operating in the context of the municipality's hierarchical NPM management structure, while they are required to exercise collaborative professional interactions as per the guidelines of the new Coordination Reform. The interview findings were interpreted out of three sub-themes 1) importance of support for the nurse leader, 2) concerns about overall service quality, and 3) increased tasks unrelated to nursing leadership. The priorities of municipal senior management and the focus of the municipality's care service need clarification in the light of this reform. The voices of those at the frontlines of the caring services need to be heard as the restructuring of the caring services may have implications both for funding allocation and for the quality of patient care.

Antimicrobial-Resistant Bacterial Populations and Antimicrobial Resistance Genes Obtained from Environments Impacted by Livestock and Municipal Waste

PubMed Central

Durso, Lisa M.; Harhay, Dayna M.; Schmidt, John W.

2015-01-01

This study compared the populations of antimicrobial-resistant bacteria and the repertoire of antimicrobial resistance genes in four environments: effluent of three municipal wastewater treatment facilities, three cattle feedlot runoff catchment ponds, three swine waste lagoons, and two “low impact” environments (an urban lake and a relict prairie). Multiple liquid and solid samples were collected from each environment. The prevalences and concentrations of antimicrobial-resistant (AMR) Gram-negative (Escherichia coli and Salmonella enterica) and Gram-positive (enterococci) bacteria were determined from individual samples (n = 174). The prevalences of 84 antimicrobial resistance genes in metagenomic DNA isolated from samples pooled (n = 44) by collection date, location, and sample type were determined. The prevalences and concentrations of AMR E. coli and Salmonella were similar among the livestock and municipal sample sources. The levels of erythromycin-resistant enterococci were significantly higher in liquid samples from cattle catchment ponds and swine waste lagoons than in liquid samples from municipal wastewater treatment facilities, but solid samples from these environments did not differ significantly. Similarly, trimethoprim/sulfamethoxazole-resistant E. coli concentrations were significantly higher in swine liquid than in municipal liquid samples, but there was no difference in solid samples. Multivariate analysis of the distribution of antimicrobial resistance genes using principal coordinate analysis showed distinct clustering of samples with livestock (cattle and swine), low impact environment and municipal samples forming three separate clusters. The numbers of class A beta-lactamase, class C beta-lactamase, and fluoroquinolone resistance genes detected were significantly higher (P < 0.05) in municipal samples than in cattle runoff or swine lagoon samples. In conclusion, we report that AMR is a very widespread phenomenon and that similar prevalences and concentrations of antimicrobial-resistant bacteria and antimicrobial resistance genes exist in cattle, human, and swine waste streams, but a higher diversity of antimicrobial resistance genes are present in treated human waste discharged from municipal wastewater treatment plants than in livestock environments. PMID:26197056

Antimicrobial-Resistant Bacterial Populations and Antimicrobial Resistance Genes Obtained from Environments Impacted by Livestock and Municipal Waste.

PubMed

Agga, Getahun E; Arthur, Terrance M; Durso, Lisa M; Harhay, Dayna M; Schmidt, John W

2015-01-01

This study compared the populations of antimicrobial-resistant bacteria and the repertoire of antimicrobial resistance genes in four environments: effluent of three municipal wastewater treatment facilities, three cattle feedlot runoff catchment ponds, three swine waste lagoons, and two "low impact" environments (an urban lake and a relict prairie). Multiple liquid and solid samples were collected from each environment. The prevalences and concentrations of antimicrobial-resistant (AMR) Gram-negative (Escherichia coli and Salmonella enterica) and Gram-positive (enterococci) bacteria were determined from individual samples (n = 174). The prevalences of 84 antimicrobial resistance genes in metagenomic DNA isolated from samples pooled (n = 44) by collection date, location, and sample type were determined. The prevalences and concentrations of AMR E. coli and Salmonella were similar among the livestock and municipal sample sources. The levels of erythromycin-resistant enterococci were significantly higher in liquid samples from cattle catchment ponds and swine waste lagoons than in liquid samples from municipal wastewater treatment facilities, but solid samples from these environments did not differ significantly. Similarly, trimethoprim/sulfamethoxazole-resistant E. coli concentrations were significantly higher in swine liquid than in municipal liquid samples, but there was no difference in solid samples. Multivariate analysis of the distribution of antimicrobial resistance genes using principal coordinate analysis showed distinct clustering of samples with livestock (cattle and swine), low impact environment and municipal samples forming three separate clusters. The numbers of class A beta-lactamase, class C beta-lactamase, and fluoroquinolone resistance genes detected were significantly higher (P < 0.05) in municipal samples than in cattle runoff or swine lagoon samples. In conclusion, we report that AMR is a very widespread phenomenon and that similar prevalences and concentrations of antimicrobial-resistant bacteria and antimicrobial resistance genes exist in cattle, human, and swine waste streams, but a higher diversity of antimicrobial resistance genes are present in treated human waste discharged from municipal wastewater treatment plants than in livestock environments.

Social capital and administrative contextual determinants of lack of access to a regular doctor: a multilevel analysis in southern Sweden.

PubMed

Lindström, Martin; Axén, Elin; Lindström, Christine; Beckman, Anders; Moghaddassi, Mahnaz; Merlo, Juan

2006-12-01

The aim of this study was to investigate the influence of contextual (social capital and administrative/neo-materialist) and individual factors on lack of access to a regular doctor. The 2000 public health survey in Scania is a cross-sectional study. A total of 13,715 persons answered a postal questionnaire, which is 59% of the random sample. A multilevel logistic regression model, with individuals at the first level and municipalities at the second, was performed. The effect (intra-class correlations, cross-level modification and odds ratios) of individual and municipality (social capital and health care district) factors on lack of access to a regular doctor was analysed using simulation method. The Deviance Information Criterion (DIC) was used as information criterion for the models. The second level municipality variance in lack of access to a regular doctor is substantial even in the final models with all individual and contextual variables included. The model that results in the largest reduction in DIC is the model including age, sex and individual social participation (which is a network aspect of social capital), but the models which include administrative and social capital second level factors also reduced the DIC values. This study suggests that both administrative health care district and social capital may partly explain the individual's self reported lack of access to a regular doctor.

The influence of spent household batteries to the organic fraction of municipal solid wastes during composting.

PubMed

Komilis, Dimitrios; Bandi, Dimitra; Kakaronis, Georgios; Zouppouris, Georgios

2011-06-01

The objective of this work was to investigate the potential transfer of 9 heavy metals from spent household batteries (zinc-carbon and alkaline-manganese batteries) to the organic fraction of municipal solid wastes during active composting. Six runs were performed including one control and 2 replications. Eleven types of alkaline and non-alkaline batteries were added at 3 different levels to the organic fraction of municipal solid wastes, namely at percentages equal to 0.98% w/w (low), 5.2% w/w (medium) and 10.6% w/w (high). Experiments were performed in 230 l insulated plastic aerobic bioreactors under a dynamic air flow regime for up to 60 days. Iron, copper and nickel masses contained in the organic fraction of the wastes were found significantly higher in the high level runs compared to the corresponding masses in the control. No metal transfer was obtained in the low and medium level runs. Metal mass balance closures ranged from 51% to 176%. Metals' concentrations in the leachates were below 10 mg l⁻¹ for most metals, except iron, while an increasing concentration trend versus time was measured in the leachates of the high level runs. In all cases, the contents of 5 regulated heavy metals in all end products were below the Hellenic limits. Copyright © 2011 Elsevier B.V. All rights reserved.

Relationship Between Body Mass Index and Workers' Compensation Claims and Costs: Results From the North Carolina League of Municipalities Database.

PubMed

Chenoweth, David H; Rager, Robin C; Haynes, Robert G

2015-09-01

To determine whether a relationship exists between elevated levels of body mass index (BMI) and workers' compensation measures. This was a retrospective analysis of 3951 workers' compensation claimants between 1981 and 2009 representing municipal workplaces. A BMI scale composed of seven levels, including two overweight tiers, was used. Higher BMI levels were related to more lost workdays, indemnity costs, and total costs. Medical care costs were virtually the same in overweight and obese claimants and moderately higher than claimants with recommended BMIs. Males were more likely to incur workers' compensation claims than females across all BMI tiers; yet, obese females incurred twice as many lost workdays and indemnity costs, and nearly 50% higher medical costs and total costs than obese men. Elevated levels of BMI negatively influence several workers' compensation outcome measures.

Ground and surface water developmental toxicity at a municipal landfill--Description and weather-related variation

USGS Publications Warehouse

Bruner, M.A.; Rao, M.; Dumont, J.N.; Hull, M.; Jones, T.; Bantle, J.A.

1998-01-01

Contaminated groundwater poses a significant health hazard and may also impact wildlife such as amphibians when it surfaces. Using FETAX (Frog Embryo Teratogenesis Assay-Xenopus), the developmental toxicity of ground and surface water samples near a closed municipal landfill at Norman, OK, were evaluated. The groundwater samples were taken from a network of wells in a shallow, unconfined aquifer downgradient from the landfill. Surface water samples were obtained from a pond and small stream adjacent to the landfill. Surface water samples from a reference site in similar habitat were also analyzed. Groundwater samples were highly toxic in the area near the landfill, indicating a plume of toxicants. Surface water samples from the landfill site demonstrated elevated developmental toxicity. This toxicity was temporally variable and was significantly correlated with weather conditions during the 3 days prior to sampling. Mortality was negatively correlated with cumulative rain and relative humidity. Mortality was positively correlated with solar radiation and net radiation. No significant correlations were observed between mortality and weather parameters for days 4–7 preceding sampling.

Effect modification of the association between trihalomethanes and pancreatic cancer by drinking water hardness: evidence from an ecological study.

PubMed

Chiu, Hui-Fen; Tsai, Shang-Shyue; Wu, Trong-Neng; Yang, Chun-Yuh

2010-07-01

The objective of this study was to examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of pancreatic cancer and to determine whether calcium (Ca) and magnesium (Mg) levels in drinking water modify the effects of TTHM on risk to develop pancreatic cancer. A matched case-control study was used to investigate the relationship between the risk of death attributed to pancreatic cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All pancreatic cancer deaths in the 53 municipalities from 1998 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from Taiwan Environmental Protection Administration. Information on the levels of Ca and Mg in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level < 4.9ppb, the adjusted OR (95% CI) for pancreatic cancer was 1.01 (0.85-1.21) for individuals who resided in municipalities served by drinking water with a TTHM exposure > 4.9ppb. There was no evidence of an interaction of drinking water TTHM levels with low Ca intake via drinking water. However, we observed evidence of an interaction between drinking water TTHM concentrations and Mg intake via drinking water. Our findings showed that the correlation between TTHM exposure and risk of pancreatic cancer is influenced by Mg in drinking water. Increased knowledge of the interaction between Mg and TTHM in reducing pancreatic cancer risk will aid in public policy making and standard setting. 2010 Elsevier Inc. All rights reserved.

Trihalomethanes in drinking water and the risk of death from rectal cancer: does hardness in drinking water matter?

PubMed

Kuo, Hsin-Wei; Chen, Pei-Shih; Ho, Shu-Chen; Wang, Li-Yu; Yang, Chun-Yuh

2010-01-01

The objectives of this study were (1) to examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of rectal cancer development and (2) to determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of TTHM on risk of developing rectal cancer. A matched cancer case-control study was used to investigate the relationship between the risk of death attributed to rectal cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All rectal cancer deaths in the 53 municipalities from 1998 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from the Taiwan Environmental Protection Administration. Information on the levels of Ca and Mg in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level was <4.9 ppb, the adjusted OR (95% CI) for rectal cancer occurrence was 1.04 (0.88-1.22) for individuals who resided in municipalities served by drinking water with a TTHM exposure >or=4.9 ppb. There was no evidence of an interaction of drinking-water TTHM levels with low Ca intake via drinking water. However, evidence of an interaction was noted between drinking-water TTHM concentrations and Mg intake via drinking water. Our findings showed that the correlation between TTHM exposure and risk of rectal cancer is influenced by Mg in drinking water. Increased knowledge of the interaction between Mg and TTHM in reducing rectal cancer risk will aid in public policymaking and standard setting.

Waste-to-energy plants face costly emissions-control upgrades

DOE Office of Scientific and Technical Information (OSTI.GOV)

McIlvaine, R.W.

1995-06-01

One treatment method of municipal solid waste, incineration, has fallen in and out of public favor. In the 1970s, emerging consciousness of the threat to groundwater posed by leaking landfills made incineration an attractive option. Prompted by disrupted energy supplies and steeply rising prices, more than 100 municipalities began to generate electricity from the heat produced by burning trash. In the 1990s, the pendulum of public enthusiasm has swung away from incineration. Energy prices have declined dramatically, and safety and siting concerns complicate new projects. A recent Supreme Court decision ruled that municipal incinerator ash must be tested as hazardousmore » waste and disposed accordingly if levels of such pollutants as cadmium and lead exceed Resource Conservation and Recovery Act limits. So-called flow control regulations, which allowed municipalities to apportion garbage disposal to ensure steady supplies to incinerators, also have been struck down. EPA is tackling the issue of air emissions from waste-to-energy and non-energy-producing municipal waste combustors. Emissions guidelines for MWCs and new-source performance standards for new units, proposed Sept. 20 under Sec. 129 of the Clean Air Act Amendments of 1990, are the culmination of a stalled and litigated initiative dating back to the CAA Amendments of 1977.« less

Examining the effectiveness of municipal solid waste management systems: An integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weng, Yu-Chi, E-mail: clyde.weng@gmail.com; Fujiwara, Takeshi

2011-06-15

In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBAmore » framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O and M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities.« less

Groundwater arsenic in Chimaltenango, Guatemala.

PubMed

Lotter, Jason T; Lacey, Steven E; Lopez, Ramon; Socoy Set, Genaro; Khodadoust, Amid P; Erdal, Serap

2014-09-01

In the Municipality of Chimaltenango, Guatemala, we sampled groundwater for total inorganic arsenic. In total, 42 samples were collected from 27 (43.5%) of the 62 wells in the municipality, with sites chosen to achieve spatial representation throughout the municipality. Samples were collected from household faucets used for drinking water, and sent to the USA for analysis. The only site found to have a concentration above the 10 μg/L World Health Organization provisional guideline for arsenic in drinking water was Cerro Alto, where the average concentration was 47.5 μg/L. A health risk assessment based on the arsenic levels found in Cerro Alto showed an increase in noncarcinogenic and carcinogenic risks for residents as a result of consuming groundwater as their primary drinking water source. Using data from the US Geological Survey and our global positioning system data of the sample locations, we found Cerro Alto to be the only site sampled within the tertiary volcanic rock layer, a known source of naturally occurring arsenic. Recommendations were made to reduce the levels of arsenic found in the community's drinking water so that the health risks can be managed.

Evaluation of the implementation of entrepreneurial potential (on the example of the Republic of Tatarstan)

NASA Astrophysics Data System (ADS)

Guzelbaeva, G. T.; Rakhmatullina, D. K.; Akhmetshina, E. R.

2017-12-01

Increase in the number of small businesses and the lack of effectiveness of existing support at local and regional level have led to curb the development of entrepreneurial activity. The article presents the methodological tools for assessing the effectiveness, which allows to identify existing municipalities in the advantages and disadvantages for the implementation of entrepreneurial potential, including the effectiveness of state and municipal support measures, as well as calculate the degree of progress in the implementation of entrepreneurial potential. In order to evaluate the implementation of the business potential of the Republic of Tatarstan and the impact of their public support at the regional level was calculated indexes of business activity in the municipal districts (MD) of the republic. It should be noted that a major breakthrough in share of small and medium-sized businesses is important to the whole ecosystem. The method of evaluation of the implementation of entrepreneurial potential which is presented in this paper can be used by every competent organization to analyze and form the effective programs of the economic and finance development.

Dental caries prevalence in children up to 36 months of age attending daycare centers in municipalities with different water fluoride content.

PubMed

Tiano, Ana Valéria Pagliari; Moimaz, Suzely Adas Saliba; Saliba, Orlando; Saliba, Nemre Adas

2009-01-01

This study determined the prevalence of cavitated caries lesions (CCL) and early childhood caries (ECC), and the contribution of some variables in children up to 36 months of age attending daycare centers in municipalities with different fluoride levels in the water supply: AFC (adequate fluoride content) and LFC (low fluoride content). After approval of the Ethics Committee, the parents were interviewed. The children were clinically examined using the same codes and criteria established by the WHO (World Health Organization) and the ADA (American Dental Association). Fisher's exact test (p<0.05) was applied for statistical analysis of data. The dmft indices calculated in the LFC and AFC municipalities were 0.57 and 0.68, respectively. Considering all children examined, 17.6% presented CCL and 33.8% ECC. The economic classification, mother's education level and duration of breastfeeding were considered statistically significant with regards to CCL prevalence. The age group, duration of the habit of drinking milk before bedtime and age at which oral hygiene started were considered statistically significant with regards to ECC prevalence.

Site descriptive modeling as a part of site characterization in Sweden - Concluding the surface based investigations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andersson, Johan; Winberg, Anders; Skagius, Kristina

The Swedish Nuclear Fuel and Waste Management Co., SKB, is currently finalizing its surface based site investigations for the final repository for spent nuclear fuel in the municipalities of Oestharmnar (the Forsmark area) and Oskarshamn (the Simpevar/Laxemar area). The investigation data are assessed into a Site Descriptive Model, constituting a synthesis of geology, rock mechanics, thermal properties, hydrogeology, hydro-geochemistry, transport properties and a surface system description. Site data constitute a wide range of different measurement results. These data both need to be checked for consistency and to be interpreted into a format more amenable for three-dimensional modeling. The three-dimensional modelingmore » (i.e. estimating the distribution of parameter values in space) is made in a sequence where the geometrical framework is taken from the geological models and in turn used by the rock mechanics, thermal and hydrogeological modeling. These disciplines in turn are partly interrelated, and also provide feedback to the geological modeling, especially if the geological description appears unreasonable when assessed together with the other data. Procedures for assessing the uncertainties and the confidence in the modeling have been developed during the course of the site modeling. These assessments also provide key input to the completion of the site investigation program. (authors)« less

Individual, family, and community predictors of overweight and obesity among colombian children and adolescents.

PubMed

Gonzalez-Casanova, Ines; Sarmiento, Olga Lucia; Pratt, Michael; Gazmararian, Julie A; Martorell, Reynaldo; Cunningham, Solveig A; Stein, Aryeh

2014-08-07

Information from high-income countries is often used to design childhood obesity prevention interventions in low- and middle-income countries, even though determinants may differ greatly between settings. We examined the associations of individual, family (household), and community (municipality) characteristics with body mass index (BMI) z scores and likelihood of overweight among children aged 5 to 18 years measured for the Colombian National Nutrition surveys of 2005 (n = 9,119) and 2010 (n = 21,520). We used 3-level hierarchical linear models with child as level 1, household as level 2, and municipality as level 3. The prevalence of combined overweight and obesity among Colombian children and adolescents was 15.7% in 2005 and 16.6% in 2010. The household level explained 40% in 2005 and 31% in 2010 of the variability in BMI z scores. Wealth was positively associated with BMI in 2005 (0.09 increase in z score per wealth quintile) and 2010 (0.13 increase in z score per wealth quintile) (P < .01). Children and adolescents from extended families had higher BMI z scores than those from nuclear families; BMI z scores were inversely associated with the number of family members living in the same household. The municipality level explained only between 2% and 3% of the variability in BMI. Income inequality was positively associated with BMI z scores in 2010. These patterns differ from those commonly described in high-income countries and suggest more appropriate opportunities for interventions to prevent child and adolescent obesity in Colombia and other Latin American settings and populations.

Assessment of Heavy Metals in Municipal Sewage Sludge: A Case Study of Limpopo Province, South Africa

PubMed Central

Shamuyarira, Kudakwashe K.; Gumbo, Jabulani R.

2014-01-01

Heavy metals in high concentrations can cause health and environmental damage. Nanosilver is an emerging heavy metal which has a bright future of use in many applications. Here we report on the levels of silver and other heavy metals in municipal sewage sludge. Five towns in Limpopo province of South Africa were selected and the sludge from their wastewater treatment plants (WWTPs) was collected and analysed. The acid digested sewage sludge samples were analysed using Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES) and Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) methods. The concentrations of silver found were low, but significant, in the range 0.22 to 21.93 mg/kg dry mass. The highest concentration of silver was found in Louis Trichardt town with a concentration of 21.93 ± 0.38 mg/kg dry mass while the lowest was Thohoyandou with a concentration of 6.13 ± 0.12 mg/kg dry mass. A control sludge sample from a pit latrine had trace levels of silver at 0.22 ± 0.01 mg/kg dry mass. The result showed that silver was indeed present in the wastewater sewage sludge and at present there is no DWAF guideline standard. The average Cd concentration was 3.10 mg/kg dry mass for Polokwane municipality. Polokwane and Louis Trichardt municipalities exhibited high levels of Pb, in excess DWAF guidelines, in sludge at 102.83 and 171.87 mg/kg respectfully. In all the WWTPs the zinc and copper concentrations were in excess of DWAF guidelines. The presence of heavy metals in the sewage sludge in excess of DWAF guidelines presents environmental hazards should the sludge be applied as a soil ameliorant. PMID:24595211

Poly- and perfluoroalkyl substances in wastewater: Significance of unknown precursors, manufacturing shifts, and likely AFFF impacts.

PubMed

Houtz, Erika F; Sutton, Rebecca; Park, June-Soo; Sedlak, Margaret

2016-05-15

In late 2014, wastewater effluent samples were collected from eight treatment plants that discharge to San Francisco (SF) Bay in order to assess poly- and perfluoroalkyl substances (PFASs) currently released from municipal and industrial sources. In addition to direct measurement of twenty specific PFAS analytes, the total concentration of perfluoroalkyl acid (PFAA) precursors was also indirectly measured by adapting a previously developed oxidation assay. Effluent from six municipal treatment plants contained similar amounts of total PFASs, with highest median concentrations of PFHxA (24 ng/L), followed by PFOA (23 ng/L), PFBA (19 ng/L), and PFOS (15 ng/L). Compared to SF Bay municipal wastewater samples collected in 2009, the short chain perfluorinated carboxylates PFBA and PFHxA rose significantly in concentration. Effluent samples from two treatment plants contained much higher levels of PFASs: over two samplings, wastewater from one municipal plant contained an average of 420 ng/L PFOS and wastewater from an airport industrial treatment plant contained 560 ng/L PFOS, 390 ng/L 6:2 FtS, 570 ng/L PFPeA, and 500 ng/L PFHxA. The elevated levels observed in effluent samples from these two plants are likely related to aqueous film forming foam (AFFF) sources impacting their influent; PFASs attributable to both current use and discontinued AFFF formulations were observed. Indirectly measured PFAA precursor compounds accounted for 33%-63% of the total molar concentration of PFASs across all effluent samples and the PFAA precursors indicated by the oxidation assay were predominately short-chained. PFAS levels in SF Bay effluent samples reflect the manufacturing shifts towards shorter chained PFASs while also demonstrating significant impacts from localized usage of AFFF. Copyright © 2016 Elsevier Ltd. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dehmel, J.C.; Loomis, D.; Mauro, J.

Under contract to the US Nuclear Regulatory Commission, Office of Nuclear Regulatory Research, the firms of S. Cohen & Associates, Inc. (SC&A) and Eastern Research Group (ERG) have compiled a report that describes the physical, chemical, and radiological properties of Class-A low-level radioactive waste. The report also presents information characterizing various methods and facilities used to treat and dispose non-radioactive waste. A database management program was developed for use in accessing, sorting, analyzing, and displaying the electronic data provided by EG&G. The program was used to present and aggregate data characterizing the radiological, physical, and chemical properties of the wastemore » from descriptions contained in shipping manifests. The data thus retrieved are summarized in tables, histograms, and cumulative distribution curves presenting radionuclide concentration distributions in Class-A waste as a function of waste streams, by category of waste generators, and regions of the United States. The report also provides information characterizing methods and facilities used to treat and dispose non-radioactive waste, including industrial, municipal, and hazardous waste regulated under Subparts C and D of the Resource Conservation and Recovery Act (RCRA). The information includes a list of disposal options, the geographical locations of the processing and disposal facilities, and a description of the characteristics of such processing and disposal facilities. Volume 1 contains the Executive Summary, Volume 2 presents the Class-A waste database, Volume 3 presents the information characterizing non-radioactive waste management practices and facilities, and Volumes 4 through 7 contain Appendices A through P with supporting information.« less

Temporo-spatial dynamics and behavioural patterns of 2012 cholera epidemic in the African mega-city of Conakry, Guinea.

PubMed

Blake, Alexandre; Keita, Veronique Sarr; Sauvageot, Delphine; Saliou, Mamadou; Njanpop, Berthe Marie; Sory, Fode; Sudre, Bertrand; Lamine, Koivogui; Mengel, Martin; Gessner, Bradford D; Sakoba, Keita

2018-02-15

Cholera is endemic in Guinea, having suffered consecutive outbreaks from 2004 to 2008 followed by a lull until the 2012 epidemic. Here we describe the temporal-spatial and behavioural characteristics of cholera cases in Conakry during a three-year period, including the large-scale 2012 epidemic. We used the national and African Cholera Surveillance Network (Africhol) surveillance data collected from every cholera treatment centre in Conakry city from August 2011 to December 2013. The prevalence of suspect and confirmed cholera cases, the case fatality ratio (CFR), and the factors associated with suspected cholera were described according to three periods: pre-epidemic (A), epidemic 2012 (B) and post epidemic (C). Weekly attack rates and temporal-spatial clustering were calculated at municipality level for period B. Cholera was confirmed by culture at the cholera national reference laboratory. A total of 4559 suspect cases were reported: 66, 4437, and 66 suspect cases in periods A, B and C, respectively. Among the 204 suspect cases with culture results available, 6%, 60%, and 70% were confirmed in periods A, B, and C, respectively. With 0.3%, the CFR was significantly lower in period B than in periods A (7.6%) and C (7.1%). The overall attack rate was 0.28% in period B, ranging from 0.17% to 0.31% across municipalities. Concomitantly, a cluster of cases was identified in two districts in the northern part of Conakry. At 14%, rice water stools were less frequent in period A than in period B and C (78% and 84%). Dehydration (31% vs 94% and 89%) and coma (0.4% vs 3.1% and 2.9%) were lower during period B than in periods A and C. The treatment of drinking water was less frequent in period A, while there were more reports of recent travel in period C. The epidemic dynamic and the sociological description of suspect cases before, during, and after the large-scale epidemic revealed that the Vibrio cholerae was already present before the epidemic. However, it appeared that infected individuals reacted differently in terms of disease severity as well as their access to treated water and travel habits. Such an in-depth description of cholera epidemics should be systematically carried out in cholera endemic settings in order to prioritize higher risk areas, identify transmission factors, and optimize preventive interventions.

Greenhouse gases accounting and reporting for waste management--a South African perspective.

PubMed

Friedrich, Elena; Trois, Cristina

2010-11-01

This paper investigates how greenhouse gases are accounted and reported in the waste sector in South Africa. Developing countries (including South Africa) do not have binding emission reduction targets, but many of them publish different greenhouse gas emissions data which have been accounted and reported in different ways. Results show that for South Africa, inventories at national and municipal level are the most important tools in the process of accounting and reporting greenhouse gases from waste. For the development of these inventories international initiatives were important catalysts at national and municipal levels, and assisted in developing local expertise, resulting in increased output quality. However, discrepancies in the methodology used to account greenhouse gases from waste between inventories still remain a concern. This is a challenging issue for developing countries, especially African ones, since higher accuracy methods are more data intensive. Analysis of the South African inventories shows that results from the recent inventories can not be compared with older ones due to the use of different accounting methodologies. More recently the use of Clean Development Mechanism (CDM) procedures in Africa, geared towards direct measurements of greenhouse gases from landfill sites, has increased and resulted in an improvement of the quality of greenhouse gas inventories at municipal level. Copyright © 2010 Elsevier Ltd. All rights reserved.

What influences national and foreign physicians' geographic distribution? An analysis of medical doctors' residence location in Portugal.

PubMed

Russo, Giuliano; Ferrinho, Paulo; de Sousa, Bruno; Conceição, Cláudia

2012-07-02

The debate over physicians' geographical distribution has attracted the attention of the economic and public health literature over the last forty years. Nonetheless, it is still to date unclear what influences physicians' location, and whether foreign physicians contribute to fill the geographical gaps left by national doctors in any given country. The present research sets out to investigate the current distribution of national and international physicians in Portugal, with the objective to understand its determinants and provide an evidence base for policy-makers to identify policies to influence it. A cross-sectional study of physicians currently registered in Portugal was conducted to describe the population and explore the association of physician residence patterns with relevant personal and municipality characteristics. Data from the Portuguese Medical Council on physicians' residence and characteristics were analysed, as well as data from the National Institute of Statistics on municipalities' population, living standards and health care network. Descriptive statistics, chi-square tests, negative binomial and logistic regression modelling were applied to determine: (a) municipality characteristics predicting Portuguese and International physicians' geographical distribution, and; (b) doctors' characteristics that could increase the odds of residing outside the country's metropolitan areas. There were 39,473 physicians in Portugal in 2008, 51.1% of whom male, and 40.2% between 41 and 55 years of age. They were predominantly Portuguese (90.5%), with Spanish, Brazilian and African nationalities also represented. Population, Population's Purchasing Power, Nurses per capita and Municipality Development Index (MDI) were the municipality characteristics displaying the strongest association with national physicians' location. For foreign physicians, the MDI was not statistically significant, while municipalities' foreign population applying for residence appeared to be an additional positive factor in their location decisions. In general, being foreigner and male resulted to be the physician characteristics increasing the odds of residing outside the metropolitan areas. However, among the internationals, older doctors were more likely to reside outside metropolitan areas. Being Spanish or Brazilian (but not of African origin) was found to increase the odds of being based outside the Lisbon and Oporto metropolitan areas. The present study showed the relevance of studying one country's physician population to understand the factors driving national and international doctors' location decisions. A more nuanced understanding of national and foreign doctors' location appears to be needed to design more effective policies to reduce the imbalance of medical services across geographical areas.

Prevalence of hepatitis A antibodies in Eastern Bolivia: a population-based study.

PubMed

C, Masuet-Aumatell; J M, Ramon-Torrell; A, Casanova-Rituerto; M, Banqué-Navarro; M, Dávalos-Gamboa; S L, Montaño-Rodríguez

2013-10-01

The seroprevalence of hepatitis A virus (HAV) is changing from high to intermediate endemicity in several Latin American countries, but the pattern in the Andean Latin American countries is unknown. A seroepidemiological survey (n = 436) of HAV in schoolchildren living in the Cochabamba region of Bolivia was conducted in 2010. A questionnaire was completed by parents to obtain demographic, socio-economic, and housing data, and blood samples were collected. The overall prevalence of HAV IgG was 95.4% (95% CI 93.5-97.4). The prevalence was higher in children aged 5-10 years (97%) and pre-adolescents aged 10-13 years (97.9%). The prevalence was also higher in subjects whose parents had a low level of education (99.4-99.5%), who lived in rural areas (98.7%), lived in municipalities with low urban development (99.1-100%), had water delivered at home from a tanker (99.4%), and spoke Quechua at home (99.5%). The descriptive and bivariate analysis suggested that no change in HAV epidemiology has occurred in Cochabamba. Copyright © 2013 Wiley Periodicals, Inc.

Elderly quality of life impacted by traditional chinese medicine techniques

PubMed Central

Figueira, Helena A; Figueira, Olivia A; Figueira, Alan A; Figueira, Joana A; Giani, Tania S; Dantas, Estélio HM

2010-01-01

Background: The shift in age structure is having a profound impact, suggesting that the aged should be consulted as reporters on the quality of their own lives. Objectives: The aim of this research was to establish the possible impact of traditional Chinese medicine (TCM) techniques on the quality of life (QOL) of the elderly. Sample: Two non-selected, volunteer groups of Rio de Janeiro municipality inhabitants: a control group (36 individuals), not using TCM, and an experimental group (28 individuals), using TCM at ABACO/Sohaku-in Institute, Brazil. Methods: A questionnaire on elderly QOL devised by the World Health Organization, the WHOQOL-Old, was adopted and descriptive statistical techniques were used: mean and standard deviation. The Shapiro–Wilk test checked the normality of the distribution. Furthermore, based on its normality distribution for the intergroup comparison, the Student t test was applied to facets 2, 4, 5, 6, and total score, and the Mann–Whitney U rank test to facets 1 and 3, both tests aiming to analyze the P value between experimental and control groups. The significance level utilized was 95% (P < 0.05). Results: The experimental group reported the highest QOL for every facet and the total score. Conclusions: The results suggest that TCM raises the level of QOL. PMID:21103400

Attitudes toward organ donation in rural areas of southeastern Spain.

PubMed

Conesa, C; Ríos, A; Ramírez, P; Cantéras, M; Rodríguez, M M; Parrilla, P

2006-04-01

Rural areas present a worse attitude toward organ donation. However, the factors conditioning this attitude are not well known. Our aim was to determine the profile of the population opposed to donation in rural areas. A random sample stratified by age and sex was obtained from municipalities with less than 10,000 inhabitants. Attitudes toward donation were assessed by a questionnaire which evaluated variables that may influence these attitudes. A descriptive statistical study used the Student t test and chi-square test as well as a logistic regression analysis. Among 181 respondents, 63% were in favor of donation and 37% against or undecided. Among the reasons to be against donation were rejection of body mutilation (43%) and fear of apparent death (41%). The psychosocial variables against donation were age >or=44 years, primary education or below, no previous experience with donation, no prosocial activities, an unfavorable opinion of the partner, and fear of corpse mutilation. The variables persisting in the multivariate analysis were level of education, previous experience, prosocial activities, and fear of corpse manipulation. Among the rural population the profile of a person opposed to donation was someone older than 44 years, with a low level of education and no previous experience with donation, who does not participate in prosocial activities and is opposed to corpse manipulation.

Managers' experience of success criteria and barriers to implementing mobile radiography services in nursing homes in Norway: a qualitative study.

PubMed

Kjelle, Elin; Lysdahl, Kristin Bakke; Olerud, Hilde Merete; Myklebust, Aud Mette

2018-04-25

In order to meet the future challenges posed by ageing populations, new technology, telemedicine and a more personalized healthcare system are needed. Earlier research has shown mobile radiography services to be highly beneficial for nursing home residents in addition to being cost-effective. Despite the benefits, mobile radiography services are uncommon in Europe and Norway. The purpose of this study was to explore success criteria and barriers in the process of implementing mobile radiography services, from the point of view of the hospital and municipal managers. Eleven semi-structured interviews were conducted with managers from five hospitals and six municipalities in Norway where mobile radiography services had been implemented. Core issues in the interview guide were barriers and facilitators in the different phases of implementation. The framework method for thematic analysis was used for analysing the data inductively in a research team. Five main categories were developed through the success criteria and barriers experienced by the participants: national health policy, regional and municipal policy and conditions, inter-organizational implementation projects, experienced outcome, and professional skills and personal characteristics. The categories were allocated into three higher-order classifications: macro, meso and micro levels. The main barriers experienced by the managers were financial, procedural and structural. In particular, the reimbursement system, lack of management across healthcare levels and the lack of compatible information systems acted as barriers. The main facilitators were external funding, enthusiastic individuals in the organizations and good collaboration between hospitals and municipalities. The managers experienced financial, structural and procedural barriers. The main success criteria in the process were external funding, and the support and engagement from the individuals in the organizations. This commitment was mainly facilitated by the intuitive appeal of mobile radiography. Changes in healthcare management and in the financial system might facilitate services across healthcare levels. In addition, compatible information systems across healthcare levels are needed in order to facilitate the use of new technology and mobile services.

Quantify landslide exposure in areas with limited hazard information

NASA Astrophysics Data System (ADS)

Pellicani, R.; Spilotro, G.; Van Westen, C. J.

2012-04-01

In Daunia region, located in the North-western part of Apulia (Southern Italy), landslides are the main source of damage to properties in the urban centers of the area, involving especially transportation system and the foundation stability of buildings. In the last 50 years, the growing demand for physical development of these unstable minor hillside and mountain centers has produced a very rapid expansion of built-up areas, often with poor planning of urban and territorial infrastructures, and invasion of the agricultural soil. Because of the expansion of the built-up towards not safe areas, human activities such as deforestation or excavation of slopes for road cuts and building sites, etc., have become important triggers for landslide occurrence. In the study area, the probability of occurrence of landslides is very difficult to predict, as well as the expected magnitude of events, due to the limited data availability on past landslide activity. Because the main limitations concern the availability of temporal data on landslides and triggering events (frequency), run-out distance and landslide magnitude, it was not possible to produce a reliable landslide hazard map and, consequently, a risk map. Given these limitations in data availability and details, a qualitative exposure map has been produced and combined with a landslide susceptibility map, both generated using a spatial multi-criteria evaluation (SMCE) procedure in a GIS system, for obtaining the qualitative landslide risk map. The qualitative analysis has been provided the spatial distribution of the exposure level in the study area; this information could be used in a preliminary stage of regional planning. In order to have a better definition of the risk level in the Daunia territory, the quantification of the economic losses at municipal level was carried out. For transforming these information on economic consequences into landslide risk quantification, it was necessary to assume the temporal probability of landslides, on the basis of the expert knowledge on the landslide phenomena. For each of twenty-five municipalities included in the study area, the expected losses (or consequences), in monetary terms, due to different hazard scenarios have been evaluated. After calculating the economic losses, the total risk at municipal level was evaluated, by generating the risk curves and calculating the area under the curves. The analysis of the risk curves related to the 25 municipalities has showed that the total risk values, expressed in monetary terms, is higher for the bigger municipal areas located in the southern part of the study area where the elevation is lower, as are more numerous the elements at risk distributed on the municipal territory. Finally, this quantitative risk assessment procedure, which calculates the exposure in monetary terms of elements at risk, allows to establish the changes in risk in future with urban development and monetary inflation.

Competence development of registered nurses in municipal elderly care in Sweden: a questionnaire survey.

PubMed

Josefsson, Karin; Sonde, Lars; Wahlin, Tarja-Brita Robins

2008-03-01

Skilled and specialist registered nurses (RNs) are central to evolving elderly care. The past decades' organisational and structural changes have altered RNs' roles and work situations in municipal elderly care in Sweden. This calls for appropriate educational preparation. However, a substantial proportion of RNs in municipal elderly care lack adequate specialist competence. The focus of this study was to describe RNs' perceptions of needs and possibilities for competence development in municipal elderly care and compare the perceptions of RNs' who work solely in dementia care (DC) with those who work in general elder care (GC) where older persons have diverse diagnoses. A non-experimental, descriptive and comparative design was used. Sixty special housing with subunits in a large city in the middle of Sweden. Participating RNs were a total of 213, with a response rate of 62.3%. Of the 213 RNs, 95 (44.6%) worked in DC and 118 (55.4%) in GC. A structured questionnaire that was specifically designed for this study and focused on needs and possibilities for competence development in nursing. The RNs were on average not lacking or were hardly lacking knowledge in examined domains. However, RNs in GC lacked knowledge of dementia, falls, and fall injures to a greater extent than RNs in DC. RNs in DC perceived greater possibilities for competence development at work. Most RNs requested a better organisation for competence development, especially in GC. The majority of RNs had no supervision. The use of RNs' competence was high, although they used their highest competence about half of the working hours. The employers' financial contribution to RNs' continuing education was poor. A better organisation and greater possibilities for RNs' competence development is needed. The employers need to make a greater contribution financially to RNs' continuing education. It is essential to provide RNs with supervision.

Violence in municipal care of older people in Sweden as perceived by registered nurses.

PubMed

Josefsson, Karin; Sonde, Lars; Wahlin, Tarja-Brita Robins

2007-05-01

The main aim was to describe registered nurses' perceptions of violence and threats, as well as their access to prevention measures and routines for handling violent behaviour in municipal care of older people. Another aim was to compare nurses' perceptions working solely in dementia care with those working in general elder care where older people have diverse diagnoses. Violence is often reported in care of older people. The development of dementia units and the implementation of reform have changed care of older people. Dementia disorders have been shown to be a predisposing factor to violence. A non-experimental, descriptive design with a survey research approach was used. The setting was 60 special types of housing with subunits in a large town. The response rate was 62% (n = 213). Forty-five per cent (n = 95) of the nurses worked in dementia care and 55% (118) in general elder care. A questionnaire. Results. Nurses had experienced a high degree indirect threats (dementia care, 45%; general elder care, 51%), direct threats of violent acts (dementia care, 35%; general elder care, 44%) and violent acts (dementia care, 41%; general elder care, 43%). Nurses had witnessed violence and threats towards staff (dementia care, 49%; general elder care, 38%). Even care receivers (dementia care, 20%; general elder care, 19%) were subjected to violence and threats. No statistical differences were found between groups. The nurses in dementia care had more access to education in managing violence and threats, as well as routines for handling violence and a door with a lock to their working unit. Violence occurred frequently in municipal care of older people without any difference between dementia care and general elder care. Nurses in dementia care were more often offered education on how to manage violence and had routines for when violence occurs. Municipal authorities should increase staff education for handling violence and creating safety routines. Violence needs to be taken seriously with a 'zero tolerance' attitude.

An evaluation of rabies vaccination rates among canines and felines involved in biting incidents within the Wellington-Dufferin-Guelph Public Health Department.

PubMed

Bottoms, K; Trotz-Williams, L; Hutchison, S; MacLeod, J; Dixon, J; Berke, O; Poljak, Z

2014-11-01

The objectives of this study were to determine the rate of animal bite incidents occurring in the human population of a local health department, and to determine the proportion of these canines and felines that were not up to date on their rabies vaccination at the time the incident occurred. Data were obtained from animal bite incidents reported to Wellington-Dufferin-Guelph Public Health during 2010 and 2011. Descriptive statistics of 718 eligible reports revealed the average rate of animal biting was 1.55 bites per 1000 residents per year. Approximately 54% of these animals were vaccinated against rabies, 32% were not up to date with their rabies vaccination, and the remaining 14.5% were of unknown status. The unit of analysis was the municipality, and the four outcomes of interest were: (i) number of animal bite incidents per 1000 residents, (ii) number of dog bite incidents per 1000 residents, (iii) proportion of animals involved in bite incidents that were not up to date with their rabies vaccination, and (iv) proportion of dogs that were not up to date. Associations between the outcomes and selected demographic variables were investigated using regression analysis. The number of veterinary clinics per 10,000 residents, and whether the municipality was urban or rural were identified as significant predictors for the number of animal bites per 1000 residents, and the number of dog bites. There were no significant predictors for the proportion of unvaccinated animals or dogs. Spatial clustering and the location of spatial clusters were assessed using the empirical Bayes index and spatial scan test. This analysis identified five municipalities within the health department that have a high rate of biting incidents and a high proportion of animals that were not up to date on their rabies vaccination. Such municipalities are ideal for targeted educational campaigns regarding the importance of vaccination in pets. © 2014 Blackwell Verlag GmbH.

Factors Associated with the Competencies of Public Health Workers in Township Hospitals: A Cross-Sectional Survey in Chongqing Municipality, China

PubMed Central

He, Zhifei; Cheng, Zhaohui; Fu, Hang; Tang, Shangfeng; Fu, Qian; Fang, Haiqing; Xian, Yue; Ming, Hui; Feng, Zhanchun

2015-01-01

Purpose: This study aimed to explore the competencies of public health workers (PHWs) of township hospitals in Chongqing Municipality (China), and determine the related impact factors of the competencies of PHWs; Methods: A cross-sectional research was conducted on 314 PHWs from 27 township hospitals in three districts in Chongqing Municipality (China), from June to August 2014. A self-assessment questionnaire was established on the basis of literature reviews and a competency dictionary. The differences in competencies among the three districts were determined by adopting the chi-square test, t-test, analysis of variance (ANOVA) method, and the impact factors of the competencies of PHWs were determined by adopting stepwise regression analysis. Results: (1) Results of the demographic characteristics of PHWs in three sample districts of Chongqing Municipality showed that a significant difference in age of PHWs (p = 0.021 < 0.05) and the majors of PHWs (p = 0.045 < 0.05); (2) In terms of the self-evaluation competency results of PHWs in township hospitals, seven among the 11 aspects were found to have significant differences in the three districts by the ANOVA test; (3) By adopting the t-test and ANOVA method, results of the relationship between the characteristics of PHWs and their competency scores showed that significant differences were found in the economic level (p = 0.000 < 0.05), age (p = 0.000 < 0.05), years of working (p = 0.000 < 0.05) and title of PHWs (p = 0.000 < 0.05); (4) Stepwise regression analysis was used to determine the impact factors of the competencies of PHWs in township hospitals, including the economic level (p = 0.000 < 0.001), years of working (p = 0.000 < 0.001), title (p = 0.001 < 0.005), and public health major (p = 0.007 < 0.01). Conclusions: The competencies of the township hospital staff in Chongqing Municipality (China), are generally insufficient, therefore, regulating the medical education and training skills of PHWs is crucial to improve the competencies of PHWs in the township hospitals of Chongqing Municipality. The results of this study can be mirrored in other areas of China. PMID:26569273

Chagas Disease Vector Control in a Hyperendemic Setting: The First 11 Years of Intervention in Cochabamba, Bolivia

PubMed Central

Espinoza, Natalisisy; Borrás, Rafael; Abad-Franch, Fernando

2014-01-01

Background Chagas disease has historically been hyperendemic in the Bolivian Department of Cochabamba. In the early 2000s, an extensive vector control program was implemented; 1.34 million dwelling inspections were conducted to ascertain infestation (2000–2001/2003–2011), with blanket insecticide spraying in 2003–2005 and subsequent survey-spraying cycles targeting residual infestation foci. Here, we assess the effects of this program on dwelling infestation rates (DIRs). Methodology/Principal Findings Program records were used to calculate annual, municipality-level aggregate DIRs (39 municipalities); very high values in 2000–2001 (median: 0.77–0.69) dropped to ∼0.03 from 2004 on. A linear mixed model (with municipality as a random factor) suggested that infestation odds decreased, on average, by ∼28% (95% confidence interval [CI95] 6–44%) with each 10-fold increase in control effort. A second, better-fitting mixed model including year as an ordinal predictor disclosed large DIR reductions in 2001–2003 (odds ratio [OR] 0.11, CI95 0.06–0.19) and 2003–2004 (OR 0.22, CI95 0.14–0.34). Except for a moderate decrease in 2005–2006, no significant changes were detected afterwards. In both models, municipality-level DIRs correlated positively with previous-year DIRs and with the extent of municipal territory originally covered by montane dry forests. Conclusions/Significance Insecticide-spraying campaigns had very strong, long-lasting effects on DIRs in Cochabamba. However, post-intervention surveys consistently detected infestation in ∼3% of dwellings, underscoring the need for continuous surveillance; higher DIRs were recorded in the capital city and, more generally, in municipalities dominated by montane dry forest – an eco-region where wild Triatoma infestans are widespread. Traditional strategies combining insecticide spraying and longitudinal surveillance are thus confirmed as very effective means for area-wide Chagas disease vector control; they will be particularly beneficial in highly-endemic settings, but should also be implemented or maintained in other parts of Latin America where domestic infestation by triatomines is still commonplace. PMID:24699407

Factors Associated with the Competencies of Public Health Workers in Township Hospitals: A Cross-Sectional Survey in Chongqing Municipality, China.

PubMed

He, Zhifei; Cheng, Zhaohui; Fu, Hang; Tang, Shangfeng; Fu, Qian; Fang, Haiqing; Xian, Yue; Ming, Hui; Feng, Zhanchun

2015-11-09

This study aimed to explore the competencies of public health workers (PHWs) of township hospitals in Chongqing Municipality (China), and determine the related impact factors of the competencies of PHWs; A cross-sectional research was conducted on 314 PHWs from 27 township hospitals in three districts in Chongqing Municipality (China), from June to August 2014. A self-assessment questionnaire was established on the basis of literature reviews and a competency dictionary. The differences in competencies among the three districts were determined by adopting the chi-square test, t-test, analysis of variance (ANOVA) method, and the impact factors of the competencies of PHWs were determined by adopting stepwise regression analysis. (1) RESULTS of the demographic characteristics of PHWs in three sample districts of Chongqing Municipality showed that a significant difference in age of PHWs (p = 0.021 < 0.05) and the majors of PHWs (p = 0.045 < 0.05); (2) In terms of the self-evaluation competency results of PHWs in township hospitals, seven among the 11 aspects were found to have significant differences in the three districts by the ANOVA test; (3) By adopting the t-test and ANOVA method, results of the relationship between the characteristics of PHWs and their competency scores showed that significant differences were found in the economic level (p = 0.000 < 0.05), age (p = 0.000 < 0.05), years of working (p = 0.000 < 0.05) and title of PHWs (p = 0.000 < 0.05); (4) Stepwise regression analysis was used to determine the impact factors of the competencies of PHWs in township hospitals, including the economic level (p = 0.000 < 0.001), years of working (p = 0.000 < 0.001), title (p = 0.001 < 0.005), and public health major (p = 0.007 < 0.01). The competencies of the township hospital staff in Chongqing Municipality (China), are generally insufficient, therefore, regulating the medical education and training skills of PHWs is crucial to improve the competencies of PHWs in the township hospitals of Chongqing Municipality. The results of this study can be mirrored in other areas of China.

Factors Influencing Bacterial Diversity and Community Composition in Municipal Drinking Waters in the Ohio River Basin, USA

PubMed Central

Stanish, Lee F.; Hull, Natalie M.; Robertson, Charles E.; Harris, J. Kirk; Stevens, Mark J.; Spear, John R.; Pace, Norman R.

2016-01-01

The composition and metabolic activities of microbes in drinking water distribution systems can affect water quality and distribution system integrity. In order to understand regional variations in drinking water microbiology in the upper Ohio River watershed, the chemical and microbiological constituents of 17 municipal distribution systems were assessed. While sporadic variations were observed, the microbial diversity was generally dominated by fewer than 10 taxa, and was driven by the amount of disinfectant residual in the water. Overall, Mycobacterium spp. (Actinobacteria), MLE1-12 (phylum Cyanobacteria), Methylobacterium spp., and sphingomonads were the dominant taxa. Shifts in community composition from Alphaproteobacteria and Betaproteobacteria to Firmicutes and Gammaproteobacteria were associated with higher residual chlorine. Alpha- and beta-diversity were higher in systems with higher chlorine loads, which may reflect changes in the ecological processes structuring the communities under different levels of oxidative stress. These results expand the assessment of microbial diversity in municipal distribution systems and demonstrate the value of considering ecological theory to understand the processes controlling microbial makeup. Such understanding may inform the management of municipal drinking water resources. PMID:27362708

Social change or business as usual at city hall? Examining an urban municipal government's response to neighbourhood-level health inequities.

PubMed

Cahuas, Madelaine C; Wakefield, Sarah; Peng, Yun

2015-05-01

There is a renewed interest in the potential of municipal governments working collaboratively with local communities to address health inequities. A growing body of literature has also highlighted the benefits and limitations of participatory approaches in neighbourhood interventions initiated by municipal governments. However, few studies have investigated how neighbourhood interventions tackling health inequities work in real-time and in context, from the perspectives of Community Developers (CDs) who promote community participation. This study uses a process evaluation approach and semi-structured interviews with CDs to explore the challenges they face in implementing a community development, participatory process in the City of Hamilton's strategy to reduce health inequities - Neighbourhood Action. Findings demonstrate that municipal government can facilitate and suppress community participation in complex ways. CDs serve as significant but conflicted intermediaries as they negotiate and navigate power differentials between city and community actors, while also facing structural challenges. We conclude that community participation is important to bottom-up, resident-led social change, and that CDs are central to this work. Copyright © 2014 Elsevier Ltd. All rights reserved.

Income inequality and homicide rates in Rio de Janeiro, Brazil.

PubMed Central

Szwarcwald, C L; Bastos, F I; Viacava, F; de Andrade, C L

1999-01-01

OBJECTIVES: This study determined the effect of income inequality on homicide rates in the state of Rio de Janeiro, Brazil. METHODS: We conducted an ecological study at 2 geographical levels, municipalities in the state of Rio de Janeiro and administrative regions in the municipality of Rio de Janeiro. The association between homicide and income inequality was tested by multiple regression procedures, with adjustment for other socioeconomic indicators. RESULTS: For the municipalities of Rio de Janeiro State, no association between homicide and income concentration was found an outcome that can be explained by the municipalities' different degrees of urbanization. However, for the administrative regions in the city of Rio de Janeiro, the 2 income inequality indicators were strongly correlated with the outcome variable (P < .01). Higher homicide rates were found precisely in the sector of the city that has the greatest concentration of slum residents and the highest degree of income inequality. CONCLUSIONS: The findings suggest that social policies specifically aimed at low-income urban youth, particularly programs to reduce the harmful effects of relative deprivation, may have an important impact on the homicide rate. PMID:10358673

Factors Influencing Bacterial Diversity and Community Composition in Municipal Drinking Waters in the Ohio River Basin, USA.

PubMed

Stanish, Lee F; Hull, Natalie M; Robertson, Charles E; Harris, J Kirk; Stevens, Mark J; Spear, John R; Pace, Norman R

2016-01-01

The composition and metabolic activities of microbes in drinking water distribution systems can affect water quality and distribution system integrity. In order to understand regional variations in drinking water microbiology in the upper Ohio River watershed, the chemical and microbiological constituents of 17 municipal distribution systems were assessed. While sporadic variations were observed, the microbial diversity was generally dominated by fewer than 10 taxa, and was driven by the amount of disinfectant residual in the water. Overall, Mycobacterium spp. (Actinobacteria), MLE1-12 (phylum Cyanobacteria), Methylobacterium spp., and sphingomonads were the dominant taxa. Shifts in community composition from Alphaproteobacteria and Betaproteobacteria to Firmicutes and Gammaproteobacteria were associated with higher residual chlorine. Alpha- and beta-diversity were higher in systems with higher chlorine loads, which may reflect changes in the ecological processes structuring the communities under different levels of oxidative stress. These results expand the assessment of microbial diversity in municipal distribution systems and demonstrate the value of considering ecological theory to understand the processes controlling microbial makeup. Such understanding may inform the management of municipal drinking water resources.

Influence of Environmental Governance on Deforestation in Municipalities of the Brazilian Amazon.

PubMed

Dias, Lilian Fernandes Oliveira; Dias, David Valentim; Magnusson, William Ernest

2015-01-01

It has been argued that measuring governance at scales smaller than global could be an important management tool. However, current studies are conducted on a global scale and use expensive methods. In the present study, we assess whether the reported governance of Amazonian municipalities is related to reductions in deforestation. Economic activity (EA) affected general governance (G) positively (G = 0.81 +1.19 * EA, F1, 98 = 77.36, p < 0.001). Environmental governance (EG) was not affected significantly (p = 0.43) by deforestation before 2000 (PD), but increased significantly (p < 0.001) with general governance (G) (EG = -0.29 + 0.04 PD+0.98*OG, F2,97 = 42.6, p <0.001). Deforestation was not significantly related to environmental governance (p = 0.82). The only indirect effect of significant magnitude was the effect of the density of forest reserves on recent deforestation through deforestation before 2000, which was strongly negative (-0.49). It is possible to assess reported actions to promote municipal governance through official data. However, it is not enough to assume that general governance or environmental governance at the municipal level, as reflected in the official statistics, benefits environmental conservation. In fact, even at the level of nation states, at which most quantification of governance has been undertaken, it seems that the relationship between governance and environmental preservation is only an assumption, because we are aware of no study that supports that hypothesis quantitatively.

Influence of Environmental Governance on Deforestation in Municipalities of the Brazilian Amazon

PubMed Central

Dias, Lilian Fernandes Oliveira; Dias, David Valentim; Magnusson, William Ernest

2015-01-01

It has been argued that measuring governance at scales smaller than global could be an important management tool. However, current studies are conducted on a global scale and use expensive methods. In the present study, we assess whether the reported governance of Amazonian municipalities is related to reductions in deforestation. Economic activity (EA) affected general governance (G) positively (G = 0.81 +1.19 * EA, F1, 98 = 77.36, p < 0.001). Environmental governance (EG) was not affected significantly (p = 0.43) by deforestation before 2000 (PD), but increased significantly (p < 0.001) with general governance (G) (EG = -0.29 + 0.04 PD+0.98*OG, F2,97 = 42.6, p <0.001). Deforestation was not significantly related to environmental governance (p = 0.82). The only indirect effect of significant magnitude was the effect of the density of forest reserves on recent deforestation through deforestation before 2000, which was strongly negative (-0.49). It is possible to assess reported actions to promote municipal governance through official data. However, it is not enough to assume that general governance or environmental governance at the municipal level, as reflected in the official statistics, benefits environmental conservation. In fact, even at the level of nation states, at which most quantification of governance has been undertaken, it seems that the relationship between governance and environmental preservation is only an assumption, because we are aware of no study that supports that hypothesis quantitatively. PMID:26208282

Higher mortality in areas of lower socioeconomic position measured by a single index of deprivation in Japan.

PubMed

Fukuda, Yoshiharu; Nakamura, Keiko; Takano, Takehito

2007-03-01

To formulate an index representing area deprivation and elucidate the relation between the index and mortality in Japan. Ecological study for prefectures (N=47) and municipalities (N=3366) across Japan. Based on socioeconomic indicators of seven domains of deprivation (i.e. unemployment, overcrowding, low social class and poverty, low education, no home ownership, low income and vulnerable group), an index was formulated using the z-scoring method. The relation between the index and mortality was examined by correlation analysis, hierarchical Poisson regression and comparison of standardized mortality ratio according to the index. The deprivation index ranged from -7.48 to 10.98 for prefectures and from -16.97 to 13.82 for municipalities. The index was significantly positively correlated with prefectural mortality, especially in the population aged under 74 years: r=0.65 for men and r=0.41 for women. At the municipal level, hierarchical Poisson regression showed a significant positive coefficient of the index to mortality for both men and women, and excess mortality in the most deprived fifth compared to the least deprived fifth was 26.4% in men and 11.8% in women. We formulated a deprivation index, which was substantially related to mortality at the prefectural and municipal levels. This study highlights the higher risk of dying among populations in socially disadvantaged areas and encourages the use of indices representing area socioeconomic conditions for further studies of area effects on health.

Contextual deprivation, daily travel and road traffic injuries among the young in the Rhône Département (France).

PubMed

Licaj, Idlir; Haddak, Mouloud; Pochet, Pascal; Chiron, Mireille

2011-09-01

This study investigated the effect of the socioeconomic level of the municipality of residence on personal injury road traffic accident risk among young persons of 10-24 years of age in the Rhône Département. This effect was assessed by comparing incidences of injuries (n=2792 casualties) on the basis of three denominators: the resident population of young people, the number of users of each mode and the distances covered by each mode. The results are presented for each type of road users (pedestrians, car passengers, car drivers, motorised two-wheeler riders, cyclists, public transport users). Young persons from deprived municipalities use motorised-two wheelers, bicycles and the car (as passengers and drivers) less frequently, they walk more and take public transports more often than those from other municipalities. When considering injury risk, motorised two wheeler injuries among adolescent males, for example, are significantly less frequent in deprived municipalities. But the motorised two-wheeler riders as well as car passengers from deprived municipalities are characterized by an excess injury risk, whether the selected denominator is the number of users or the kilometres travelled by this mode. For the first time in France, this study has enabled a comparison of the effects of a contextual socioeconomic indicator (the type of municipality of residence, deprived, or not) on daily travel practices and injury incidences among the population, among the users of each mode and per km of travel. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Violence due to Armed Conflict and Prevalence of Mood Disorders, Anxiety and Mental Problems in the Colombian Adult Population].

PubMed

Gómez-Restrepo, Carlos; Tamayo-Martínez, Nathalie; Buitrago, Giancarlo; Guarnizo-Herreño, Carol Cristina; Garzón-Orjuela, Nathaly; Eslava-Schmalbach, Javier; de Vries, Esther; Rengifo, Herney; Rodríguez, Andrea; Rincón, Carlos Javier

2016-12-01

Violence in Colombia has a history of over 50 years. Between 1985 and 2012 an estimated of 220,000 Colombians have died and about 6,000,000 have been displaced by violence. To describe and compare the prevalence of some problems and mental disorders in the adult population in Colombia, taking into account the characteristics of the municipality, as regards its history of violence or armed conflict. The results for adults (over 18 years) of some problems and mental disorders were taken from the ENSM-2015. The municipalities were classified according to the presence and intensity of the conflict using the classification proposed by the CERAC. Disorders were measured using CIDI-CAPI, and problems with AUDIT, modified PCL (Post-Traumatic Stress Disorder Checklist). An estimate was also made of psychoactive substances consumption. A total of 10,870 people were interviewed, of whom 5,429 had not changed residence. There was had permanent conflict in 21.8% of the municipalities, 65.5% had a discontinued conflict, and only 12.7% had been pacified or had no conflict. The intensity of the conflict was reported as high by 31.8% of the people. Violent municipalities have a higher prevalence of anxiety disorders, depression, possible Post-Traumatic Stress Disorder, and smoking. Alcohol consumption was more common in municipalities with less intense conflict. The municipalities classified as having high levels of violence have a higher prevalence of mental disorders and the majority of the mental problems. Copyright © 2016. Publicado por Elsevier España.

Fertility after natural disaster: Hurricane Mitch in Nicaragua

PubMed Central

Davis, Jason

2017-01-01

This investigation evaluates the effect of Hurricane Mitch on women’s reproductive outcomes throughout Nicaragua. This research aim is achieved by analyzing a unique Nicaraguan Living Standards Measurement Study panel dataset that tracks women’s fertility immediately before and at two time points after Hurricane Mitch, combined with satellite-derived municipality-level precipitation data for the 10-day storm period. Results show higher odds of post-disaster fertility in municipalities receiving higher precipitation levels in the immediate post-Hurricane Mitch period. However, fertility normalizes between disaster and non-disaster areas four to six years after the storm. These findings suggest that the disruptive effects of a natural disaster such as Hurricane Mitch can have an initial stimulative effect on fertility but the effect is ephemeral. PMID:28694556

Social disparities in Disease Management Programmes for coronary heart disease in Germany: a cross-classified multilevel analysis.

PubMed

Bozorgmehr, Kayvan; Maier, Werner; Brenner, Hermann; Saum, Kai-Uwe; Stock, Christian; Miksch, Antje; Holleczek, Bernd; Szecsenyi, Joachim; Razum, Oliver

2015-11-01

Disease Management Programmes (DMPs) aim to improve effectiveness and equity of care but may suffer from selective enrolment. We analysed social disparities in DMP enrolment among elderly patients with coronary heart disease (CHD) in Germany, taking into account contextual effects at municipality and primary care practice levels. Cross-sectional analysis of effects of educational attainment and regional deprivation on physician-reported DMP enrolment in a subsample of a large population-based cohort study in Germany, adjusting for individual-level, practice-level and area-level variables. We calculated OR and their 95% CIs (95% CI) in cross-classified, multilevel logistic regression models. Among N=1280 individuals with CHD (37.3% women), DMP enrolment rates were 22.2% (women) and 35% (men). The odds of DMP enrolment were significantly higher for male patients (OR=1.98 (1.50 to 2.62)), even after adjustment for potential confounding by individual-level, practice-level and area-level variables (range: OR=1.60 (1.08 to 2.36) to 2.16 (1.57 to 2.98)). Educational attainment was not significantly associated with DMP enrolment. Compared to patients living in least-deprived municipalities, the adjusted propensity of DMP enrolment was statistically significantly lower for patients living in medium-deprived municipalities (OR=0.41 (0.24 to 0.71)), and it also tended to be lower for patients living in the most-deprived municipalities (OR=0.70 (0.40 to 1.21)). Models controlling for the social situation (instead of health-related behaviour) yielded comparable effect estimates (medium-deprived/most-deprived vs least-deprived areas: OR=0.45 (0.26 to 0.78)/OR=0.68 (0.33 to 1.19)). Controlling for differences in comorbidity attenuated the deprivation effect estimates. We found evidence for marked gender, but not educational disparities in DMP enrolment among patients with CHD. Small-area deprivation was associated with DMP enrolment, but the effects were partly explained by differences in comorbidity. Future studies on DMPs should consider contextual effects when analysing programme effectiveness or impacts on equity and efficiency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Addressing the social determinants of health at the local level: Opportunities and challenges.

PubMed

Fosse, E; Helgesen, M K; Hagen, S; Torp, S

2018-02-01

The gradient in health inequalities reflects a relationship between health and social circumstance, demonstrating that health worsens as you move down the socio-economic scale. For more than a decade, the Norwegian National government has developed policies to reduce social inequalities in health by levelling the social gradient. The adoption of the Public Health Act in 2012 was a further movement towards a comprehensive policy. The main aim of the act is to reduce social health inequalities by adopting a Health in All Policies approach. The municipalities are regarded key in the implementation of the act. The SODEMIFA project aimed to study the development of the new public health policy, with a particular emphasis on its implementation in municipalities. In the SODEMIFA project, a mixed-methods approach was applied, and the data consisted of surveys as well as qualitative interviews. The informants were policymakers at the national and local level. Our findings indicate that the municipalities had a rather vague understanding of the concept of health inequalities, and even more so, the concept of the social gradient in health. The most common understanding was that policy to reduce social inequalities concerned disadvantaged groups. Accordingly, policies and measures would be directed at these groups, rather than addressing the social gradient. A movement towards an increased understanding and adoption of the new, comprehensive public health policy was observed. However, to continue this process, both local and national levels must stay committed to the principles of the act.

What level of estrogenic activity determined by in vitro assays in municipal waste waters can be considered as safe?

PubMed

Jarošová, Barbora; Bláha, Luděk; Giesy, John P; Hilscherová, Klára

2014-03-01

In vitro assays are broadly used tools to evaluate the estrogenic activity in Waste Water Treatment Plant (WWTP) effluents and their receiving rivers. Since potencies of individual estrogens to induce in vitro and in vivo responses can differ it is not possible to directly evaluate risks based on in vitro measures of estrogenic activity. Estrone, 17beta-estradiol, 17alfa-ethinylestradiol and to some extent, estriol have been shown to be responsible for the majority of in vitro estrogenic activity of municipal WWTP effluents. Therefore, in the present study safe concentrations of Estrogenic Equivalents (EEQs-SSE) in municipal WWTP effluents were derived based on simplified assumption that the steroid estrogens are responsible for all estrogenicity determined with particular in vitro assays. EEQs-SSEs were derived using the bioassay and testing protocol-specific in vitro potencies of steroid estrogens, in vivo predicted no effect concentration (PNECs) of these compounds, and their relative contributions to the overall estrogenicity detected in municipal WWTP effluents. EEQs-SSEs for 15 individual bioassays varied from 0.1 to 0.4ng EEQ/L. The EEQs-SSEs are supposed to be increased by use of location-specific dilution factors of WWTP effluents entering receiving rivers. They are applicable to municipal wastewater and rivers close to their discharges, but not to industrial waste waters. Copyright © 2013 Elsevier Ltd. All rights reserved.

Municipal health expectancy in Japan: decreased healthy longevity of older people in socioeconomically disadvantaged areas.

PubMed

Fukuda, Yoshiharu; Nakamura, Keiko; Takano, Takehito

2005-06-14

Little is known about small-area variation in healthy longevity of older people and its socioeconomic correlates. This study aimed to estimate health expectancy at 65 years (HE65) at the municipal level in Japan, and to examine its relation to area socio-demographic conditions. HE65 of municipalities (N = 3361) across Japan was estimated by a linear regression formula with life expectancy at 65 years and the prevalence of those certificated as needing nursing care. The relation between HE65 and area socio-demographic indicators was examined using correlation coefficients. The estimated HE65 (years) ranged from 13.13 to 17.39 for men and from 14.84 to 20.53 for women. HE65 was significantly positively correlated with the proportion of elderly and per capita income, and negatively correlated with the percentage of households of a single elderly person, divorce rate, and unemployment rate. These relations were stronger in large municipalities (with a population of more than 100,000) than in small and medium-size municipalities. A decrease in healthy longevity of older people was associated with a higher percentage of households of a single elderly person and divorce rate, and lower socioeconomic conditions. This study suggests that older people in urban areas are susceptible to socio-demographic factors, and a social support network for older people living in socioeconomically disadvantaged conditions should be encouraged.

Understanding Perceptions of Climate Change, Priorities, and Decision-Making among Municipalities in Lima, Peru to Better Inform Adaptation and Mitigation Planning.

PubMed

Siña, Mariella; Wood, Rachel C; Saldarriaga, Enrique; Lawler, Joshua; Zunt, Joseph; Garcia, Patricia; Cárcamo, César

2016-01-01

Climate change poses multiple risks to the population of Lima, the largest city and capital of Peru, located on the Pacific coast in a desert ecosystem. These risks include increased water scarcity, increased heat, and the introduction and emergence of vector-borne and other climate sensitive diseases. To respond to these threats, it is necessary for the government, at every level, to adopt more mitigation and adaptation strategies. Here, focus groups were conducted with representatives from five Lima municipalities to determine priorities, perception of climate change, and decision-making processes for implementing projects within each municipality. These factors can affect the ability and desire of a community to implement climate change adaptation and mitigation strategies. The results show that climate change and other environmental factors are of relatively low priority, whereas public safety and water and sanitation services are of highest concern. Perhaps most importantly, climate change is not well understood among the municipalities. Participants had trouble distinguishing climate change from other environmental issues and did not fully understand its causes and effects. Greater understanding of what climate change is and why it is important is necessary for it to become a priority for the municipalities. Different aspects of increased climate change awareness seem to be connected to having experienced extreme weather events, whether related or not to climate change, and to higher socioeconomic status.

Examining the effectiveness of municipal solid waste management systems: an integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan.

PubMed

Weng, Yu-Chi; Fujiwara, Takeshi

2011-06-01

In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBA framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O&M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Carbon choices determine US cities committed to futures below sea level

PubMed Central

Strauss, Benjamin H.; Kulp, Scott; Levermann, Anders

2015-01-01

Anthropogenic carbon emissions lock in long-term sea-level rise that greatly exceeds projections for this century, posing profound challenges for coastal development and cultural legacies. Analysis based on previously published relationships linking emissions to warming and warming to rise indicates that unabated carbon emissions up to the year 2100 would commit an eventual global sea-level rise of 4.3–9.9 m. Based on detailed topographic and population data, local high tide lines, and regional long-term sea-level commitment for different carbon emissions and ice sheet stability scenarios, we compute the current population living on endangered land at municipal, state, and national levels within the United States. For unabated climate change, we find that land that is home to more than 20 million people is implicated and is widely distributed among different states and coasts. The total area includes 1,185–1,825 municipalities where land that is home to more than half of the current population would be affected, among them at least 21 cities exceeding 100,000 residents. Under aggressive carbon cuts, more than half of these municipalities would avoid this commitment if the West Antarctic Ice Sheet remains stable. Similarly, more than half of the US population-weighted area under threat could be spared. We provide lists of implicated cities and state populations for different emissions scenarios and with and without a certain collapse of the West Antarctic Ice Sheet. Although past anthropogenic emissions already have caused sea-level commitment that will force coastal cities to adapt, future emissions will determine which areas we can continue to occupy or may have to abandon. PMID:26460051

Carbon choices determine US cities committed to futures below sea level.

PubMed

Strauss, Benjamin H; Kulp, Scott; Levermann, Anders

2015-11-03

Anthropogenic carbon emissions lock in long-term sea-level rise that greatly exceeds projections for this century, posing profound challenges for coastal development and cultural legacies. Analysis based on previously published relationships linking emissions to warming and warming to rise indicates that unabated carbon emissions up to the year 2100 would commit an eventual global sea-level rise of 4.3-9.9 m. Based on detailed topographic and population data, local high tide lines, and regional long-term sea-level commitment for different carbon emissions and ice sheet stability scenarios, we compute the current population living on endangered land at municipal, state, and national levels within the United States. For unabated climate change, we find that land that is home to more than 20 million people is implicated and is widely distributed among different states and coasts. The total area includes 1,185-1,825 municipalities where land that is home to more than half of the current population would be affected, among them at least 21 cities exceeding 100,000 residents. Under aggressive carbon cuts, more than half of these municipalities would avoid this commitment if the West Antarctic Ice Sheet remains stable. Similarly, more than half of the US population-weighted area under threat could be spared. We provide lists of implicated cities and state populations for different emissions scenarios and with and without a certain collapse of the West Antarctic Ice Sheet. Although past anthropogenic emissions already have caused sea-level commitment that will force coastal cities to adapt, future emissions will determine which areas we can continue to occupy or may have to abandon.

EVALUATION OF THE ENVIRONMENTAL NOISE LEVELS IN ABUJA MUNICIPALITY USING MOBILE PHONES

PubMed Central

Ibekwe, T.; Folorunso, D.; Ebuta, A.; Amodu, J.; Nwegbu, M.; Mairami, Z.; Liman, I.; Okebaram, C.; Chimdi, C.; Durogbola, B.; Suleiman, H.; Mamven, H.; Baamlong, N.; Dahilo, E.; Gbujie, I.; Ibekwe, P.; Nwaorgu, O.

2016-01-01

Background: Noise remains a nuisance which impacts negatively on the physical, social and psychological wellbeing of man. It aggravates chronic illnesses like hypertension and other cardiopulmonary diseases. Unfortunately, increased activities from industrialization and technological transfers/drifts have tumultuously led to increased noise pollution in most of our fast growing cities today and hence the need for concerted efforts in monitoring and regulating our environmental noise. Objective: To assess the equivalent noise level (Leq) in Abuja municipality and promote a simple method for regular assessment of Leq within our environment. Method: This is a cross-sectional community based study of the environmental Leq of Abuja municipality conducted between January 2014 and January 2016. The city was divided into 12 segments including residential, business and market areas via the Abuja Geographic Information System. The major markets were captured separately on a different scale. Measurements were taken with the mobile phone softwares having validated this with Extech 407730 digital sound level meter, serial no Z310135. Leq(A) were measured at different points and hours of the day and night. The average Leq(A) were classified according to localities and compared with WHO standard safety levels. Results: LeqD ranged 71-92dB(A); 42-79dB(A) and 69-90dB(A) in business/ parks, residential and market places respectively. The Night measurements were similar 18dB(A)-56dB(A) and the day-night Leq(A)=77.2dB(A) and 90.4dB(A) for residential and business zones. Conclusion: The night noise levels are satisfactory but the day and day-night levels are above the recommended tolerable values by WHO and therefore urgently call for awareness and legislative regulations. PMID:28337089

Changes in reproductive biomarkers in an endangered fish species (bonytail chub, Gila elegans) exposed to low levels of organic wastewater compounds in a controlled experiment.

PubMed

Walker, David B; Paretti, Nicholas V; Cordy, Gail; Gross, Timothy S; Zaugg, Steven D; Furlong, Edward T; Kolpin, Dana W; Matter, William J; Gwinn, Jessica; McIntosh, Dennis

2009-11-08

In arid regions of the southwestern United States, municipal wastewater treatment plants commonly discharge treated effluent directly into streams that would otherwise be dry most of the year. A better understanding is needed of how effluent-dependent waters (EDWs) differ from more natural aquatic ecosystems and the ecological effect of low levels of environmentally persistent organic wastewater compounds (OWCs) with distance from the pollutant source. In a controlled experiment, we found 26 compounds common to municipal effluent in treatment raceways all at concentrations <1.0 microg/L. Male bonytail chub (Gila elegans) in tanks containing municipal effluent had significantly lower levels of 11-ketotestosterone (p=0.021) yet higher levels of 17beta-estradiol (p=0.002) and vitellogenin (p=0.036) compared to control male fish. Female bonytail chub in treatment tanks had significantly lower concentrations of 17beta-estradiol than control females (p=0.001). The normally inverse relationship between primary male and female sex hormones, expected in un-impaired fish, was greatly decreased in treatment (r=0.00) versus control (r=-0.66) female fish. We found a similar, but not as significant, trend between treatment (r=-0.45) and control (r=-0.82) male fish. Measures of fish condition showed no significant differences between male or female fish housed in effluent or clean water. Inter-sex condition did not occur and testicular and ovarian cells appeared normal for the respective developmental stage and we observed no morphological alteration in fish. The population-level impacts of these findings are uncertain. Studies examining the long-term, generational and behavioral effects to aquatic organisms chronically exposed to low levels of OWC mixtures are needed.

Changes in reproductive biomarkers in an endangered fish species (bonytail chub, Gila elegans) exposed to low levels of organic wastewater compounds in a controlled experiment

USGS Publications Warehouse

Walker, D.B.; Paretti, N.V.; Cordy, G.; Gross, T.S.; Zaugg, S.D.; Furlong, E.T.; Kolpin, D.W.; Matter, W.J.; Gwinn, J.; McIntosh, D.

2009-01-01

In arid regions of the southwestern United States, municipal wastewater treatment plants commonly discharge treated effluent directly into streams that would otherwise be dry most of the year. A better understanding is needed of how effluent-dependent waters (EDWs) differ from more natural aquatic ecosystems and the ecological effect of low levels of environmentally persistent organic wastewater compounds (OWCs) with distance from the pollutant source. In a controlled experiment, we found 26 compounds common to municipal effluent in treatment raceways all at concentrations <1.0 ??g/L. Male bonytail chub (Gila elegans) in tanks containing municipal effluent had significantly lower levels of 11-ketotestosterone (p = 0.021) yet higher levels of 17??-estradiol (p = 0.002) and vitellogenin (p = 0.036) compared to control male fish. Female bonytail chub in treatment tanks had significantly lower concentrations of 17??-estradiol than control females (p = 0.001). The normally inverse relationship between primary male and female sex hormones, expected in un-impaired fish, was greatly decreased in treatment (r = 0.00) versus control (r = -0.66) female fish. We found a similar, but not as significant, trend between treatment (r = -0.45) and control (r = -0.82) male fish. Measures of fish condition showed no significant differences between male or female fish housed in effluent or clean water. Inter-sex condition did not occur and testicular and ovarian cells appeared normal for the respective developmental stage and we observed no morphological alteration in fish. The population-level impacts of these findings are uncertain. Studies examining the long-term, generational and behavioral effects to aquatic organisms chronically exposed to low levels of OWC mixtures are needed. ?? 2009 Elsevier B.V.

Changes in reproductive biomarkers in an endangered fish species (bonytail chub, Gila elegans) exposed to low levels of organic wastewater compounds in a controlled experiment

USGS Publications Warehouse

Walker, David B.; Paretti, Nicholas V.; Cordy, Gail; Gross, Timothy S.; Zaugg, Steven D.; Furlong, Edward T.; Kolpin, Dana W.; Matter, William J.; Gwinn, Jessica; McIntosh, Dennis

2009-01-01

In arid regions of the southwestern United States, municipal wastewater treatment plants commonly discharge treated effluent directly into streams that would otherwise be dry most of the year. A better understanding is needed of how effluent-dependent waters (EDWs) differ from more natural aquatic ecosystems and the ecological effect of low levels of environmentally persistent organic wastewater compounds (OWCs) with distance from the pollutant source. In a controlled experiment, we found 26 compounds common to municipal effluent in treatment raceways all at concentrations <1.0 μg/L. Male bonytail chub (Gila elegans) in tanks containing municipal effluent had significantly lower levels of 11-ketotestosterone (p = 0.021) yet higher levels of 17β-estradiol (p = 0.002) and vitellogenin (p = 0.036) compared to control male fish. Female bonytail chub in treatment tanks had significantly lower concentrations of 17β-estradiol than control females (p = 0.001). The normally inverse relationship between primary male and female sex hormones, expected in un-impaired fish, was greatly decreased in treatment (r = 0.00) versus control (r = −0.66) female fish. We found a similar, but not as significant, trend between treatment (r = −0.45) and control (r = −0.82) male fish. Measures of fish condition showed no significant differences between male or female fish housed in effluent or clean water. Inter-sex condition did not occur and testicular and ovarian cells appeared normal for the respective developmental stage and we observed no morphological alteration in fish. The population-level impacts of these findings are uncertain. Studies examining the long-term, generational and behavioral effects to aquatic organisms chronically exposed to low levels of OWC mixtures are needed.

EVALUATION OF THE ENVIRONMENTAL NOISE LEVELS IN ABUJA MUNICIPALITY USING MOBILE PHONES.

PubMed

Ibekwe, T; Folorunso, D; Ebuta, A; Amodu, J; Nwegbu, M; Mairami, Z; Liman, I; Okebaram, C; Chimdi, C; Durogbola, B; Suleiman, H; Mamven, H; Baamlong, N; Dahilo, E; Gbujie, I; Ibekwe, P; Nwaorgu, O

2016-12-01

Noise remains a nuisance which impacts negatively on the physical, social and psychological wellbeing of man. It aggravates chronic illnesses like hypertension and other cardiopulmonary diseases. Unfortunately, increased activities from industrialization and technological transfers/drifts have tumultuously led to increased noise pollution in most of our fast growing cities today and hence the need for concerted efforts in monitoring and regulating our environmental noise. To assess the equivalent noise level (Leq) in Abuja municipality and promote a simple method for regular assessment of Leq within our environment. This is a cross-sectional community based study of the environmental Leq of Abuja municipality conducted between January 2014 and January 2016. The city was divided into 12 segments including residential, business and market areas via the Abuja Geographic Information System. The major markets were captured separately on a different scale. Measurements were taken with the mobile phone softwares having validated this with Extech 407730 digital sound level meter, serial no Z310135 . Leq(A) were measured at different points and hours of the day and night. The average Leq(A) were classified according to localities and compared with WHO standard safety levels. LeqD ranged 71-92dB(A); 42-79dB(A) and 69-90dB(A) in business/ parks, residential and market places respectively. The Night measurements were similar 18dB(A)-56dB(A) and the day-night Leq(A)=77.2dB(A) and 90.4dB(A) for residential and business zones. The night noise levels are satisfactory but the day and day-night levels are above the recommended tolerable values by WHO and therefore urgently call for awareness and legislative regulations.

Flood Disaster Risk Reduction in municipality-scale in Rio de Janeiro State

NASA Astrophysics Data System (ADS)

Japiassú Viana, Viviane; Formiga Johnsson, Rosa Maria; De Gouvello, Bernard

2015-04-01

In Brazil, flood disasters causing human damage, pecuniary loss and environmental damage, are mainly due to greater exposure of the population; urban densification on the riverbanks and margins, incurring vulnerability due to changes in river level and climate changes. This article presents the data and studies required in the Brazilian legal basis and analyzes the scales adopted by planners in contrast to the scales demands by the executing agencies in the context of prevention and adaptation to climate change, particularly to flood disaster reduction in municipality-scale.

Arsenic occurrence in drinking water supply systems in ten municipalities in Vojvodina Region, Serbia.

PubMed

Jovanovic, Dragana; Jakovljević, Branko; Rašić-Milutinović, Zorica; Paunović, Katarina; Peković, Gordana; Knezević, Tanja

2011-02-01

Vojvodina, a northern region of Serbia, belongs to the Pannonian Basin, whose aquifers contain high concentrations of arsenic. This study represents arsenic levels in drinking water in ten municipalities in Serbia. Around 63% of all water samples exceeded Serbian and European standards for arsenic in drinking water. Large variations in arsenic were observed among supply systems. Arsenic concentrations in public water supply systems in Vojvodina were much higher than in other countries in the Pannonian Basin. Copyright © 2010 Elsevier Inc. All rights reserved.

Experiences with Recruitment of Marginalized Groups in a Danish Health Promotion Program: A Document Evaluation Study.

PubMed

Rasmussen, Marianne; Poulsen, Eva Kanstrup; Rytter, Anne Stoffersen; Kristiansen, Tine Mechlenborg; Bak, Carsten Kronborg

2016-01-01

Studies have found that marginalized groups living in deprived neighborhoods are less likely to participate in health programs compared to the majority of society. This study evaluates recruitment approaches conducted during a national government-funded project in 12 deprived neighborhoods across Denmark between 2010 and 2014. The aim of this study was to understand how recruitment approaches could promote participation in health programs within deprived neighborhoods to reach marginalized groups. Documents from all 12 of the included municipalities were collected to conduct a document evaluation. The collected documents consisted of 1,500 pages of written material with 12 project descriptions, three midterm and 10 final evaluations. The collected data were analyzed through a qualitative content analysis. The results are based on the fact that only 10 municipalities have developed evaluations related to recruitment, and only three evaluations provided a description of which marginalized groups were recruited. Challenges related to recruitment consist of difficulties involving the target group, including general distrust, language barriers and a lack of ability to cope with new situations and strangers. Additional geographical challenges emerged, especially in rural areas. Positive experiences with recruitment approaches were mainly related to relationship building and trust building, especially through face-to-face contact and the project employees' presence in the neighborhood. Additionally, adjusting some of the interventions and the recruitment strategy increased participation. This study found that relation and trust between the residents and the project employees is an important factor in the recruitment of marginalized groups in deprived neighborhoods as well as adjusting the health interventions or recruitment strategy to the target groups. In future research, it is necessary to examine which recruitment approaches are effective under which circumstances to increase participation among marginalized groups.

Explaining the Behavioral Intention towards BI Implementation in Public Administrations - A Principal-Agent Theory Approach

NASA Astrophysics Data System (ADS)

Becker, Jörg; Bergener, Philipp; Lis, Łukasz; Niehaves, Björn

Business Intelligence (BI) is an established instrument to support public administrations in their management tasks by increasing their information level. BI is of special interest in the context of introducing accrual accounting in public administrations as this affects the information level of different stakeholders, leading to a possible decrease for municipal councils. The principal-agent theory can help to explain different behavioral intentions of the stakeholders concerning the introduction of BI. We employ a single qualitative case study to analyze these behavioral intentions. It shows that the introduction of accrual accounting did decrease the information level of the municipal council making the principal-agent problems possible. Furthermore, it shows that BI might be a solution for this problem. Therefore, council members show the behavioral intention to support the BI implementation while administration staff members rather resist it. Based on these finding, we discuss implications for practice and future research.

Mapping the lack of public initiative against female genital mutilation in Denmark.

PubMed

Christoffersen, Gro Møller; Bruhn, Peter James; de Neergaard, Rosanna; Engel, Susanne; Naeser, Vibeke

2018-04-07

Female genital mutilation (FGM) is a harmful practice prevalent in 35 countries, mainly in Africa, as well as in some Middle Eastern countries and a few Asian countries. FGM comprises all procedures that involve partial or complete resection of, or other injury to, external female genitalia for non-medical reasons. The practice of FGM has spread to Western countries due to migration. The European Institute for Gender Equality recommend that FGM be combatted by nationally coordinated efforts through implementation of national action plans, guidelines for professionals as well as comprehensive research in the field. FGM was outlawed in Denmark 2003, but no national actions plan has been implemented. Instead, the task of combatting FGM is currently under the responsibility of local governments in the form of the 98 municipalities. The aim of this study is to investigate the Danish municipalities' efforts to prevent FGM on the local level, and whether these initiatives are in accordance with international recommendations and standards. All 98 Danish municipalities were invited to respond to a questionnaire regarding FGM in their respective municipalities. The inclusion process and questionnaire was designed after a pilot study, which included 29 municipalities. The questionnaire consisted of four overall areas of focus: "action plan", "registration", "information material" and "preventive initiatives". Demographic data were gathered from the 2017 census by Statistics Denmark. Risk countries were defined as countries with a tradition for FGM, identified from the 2016 UNICEF definition. A total of 67 municipalities participated in the study. At the time of census, 1.8% of the Danish population was immigrants with origins in risk countries. A total of 10.4% of the responding municipalities indicated to have implemented a specific action plan against FGM. A total of 7,5% had implemented specific preventive initiatives against FGM. Registration of reported FGM cases were indicated to be performed in 73.1% of the responding municipalities; however, only 17.9% stated to perform registration of FGM specifically as such, and not as general child abuse. Our study shows that the current situation of FGM registration and prevention being under local administrative responsibility in the 98 Danish municipalities has led to a severe lack of coordinated public initiative against FGM.

[Involvement of local dietetics professionals in risk communication program on food safety in municipal governments and their attitude towards the program].

PubMed

Akamatsu, Rie; Nomura, Marika; Horiguchi, Itsuko; Tanaka, Hisako; Marui, Eiji

2009-01-01

The objective of this study is to gather statistical references on food safety education that encourages competence of food choice from the view-point of food safety. A survey on the involvement of the risk communication program on food safety in municipal governments and the attitude of local dietetics professionals towards the program was conducted. In November, 2006, self-reported questionnaires were mailed to 1990 local dietetics professionals who worked in municipal governments in Japan. Descriptive statistics and cross tables were used for data analysis. 1162 questionnaires were mailed and 1130 available surveys were returned. Among the respondents, 41.5% answered that they inform the community about food safety, but 49.9% answered that they did not get information from the community. Most of the respondents answered that risk communication of food safety was important; 21.8% answered "extremely agree" and 62.3% answered "rather agree" on a scale of four from "extremely agree" to "do not agree". More than one-half of the dietetics professionals answered that their confidence in conducting risk communication was low; 20.5% answered "no confidence" and 52.5% answered "hardly have confidence" on a scale of four from "without confidence" to "with confidence". More than 80% of the respondents answered that they needed "professional knowledge" and "support from professional agencies". This study suggests that educating local dietetics professionals about professional knowledge on food safety, and obtaining support from special agencies will be essential in the upgrade of risk communication program on food safety in a community.

Inequality in the distribution of rheumatologists in Brazil: correlation with local of medical residency, Gross Domestic Product and Human Development Index.

PubMed

de Albuquerque, Cleandro Pires

2014-01-01

To assess the distribution of rheumatologists in Brazil and their correlation with Medical Residency specialization offer, Gross Domestic Product (Gdp) And Municipal Human Development Index (HDI-M) of units of the federation (UFs). Query to various official databases, data summarization by techniques for descriptive statistics and cross-referenced information. For correlation analysis, we used the Spearman correlation coefficient (r). There were 1229 rheumatologists regularly registered in the country. The Northern region had only 3.6% of the total (n = 44), while the Southeast had 42.2% (n = 519). The State capitals, added to the five largest municipalities in each UF, concentrated 75.8% of these specialists (n = 931). In total, 49.9% of rheumatologists offered treatment at SUS. A general ratio of 157,809 inhabitants per rheumatologist in Brazil was determined, but with wide variation among UFs with respect to this ratio. In the years 2000-2012, there were 593 Rheumatology Residency graduated physicians in Brazil. We observed a positive correlation among number of rheumatologists compared with GDP (r = 0.94), HDI-M of the State capitals (r = 0.77) and number of Rheumatology Residency graduated physicians (r = 0.79) in UFs. We noted a strong concentration of rheumatologists in State capitals and larger municipalities, with noticeable inequalities also between UFs and country regions. The distribution of these professionals accompanied GDP, HDI-M of the State capital and number of Rheumatology Residency graduated physicians, suggesting that factors related to income opportunities and human development and the place of speciality training may influence the geographical fixation of rheumatologists.

40 CFR 81.354 - Northern Mariana Islands.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Rota Municipality Unclassifiable/Attainment. Saipan Municipality Unclassifiable/Attainment. Tinian... Unclassifiable/Attainment. Rota Municipality Unclassifiable/Attainment Unclassifiable/Attainment. Saipan... Municipality Unclassifiable/Attainment. Rota Municipality Unclassifiable/Attainment. Saipan Municipality...

smokeSALUD: exploring the effect of demographic change on the smoking prevalence at municipality level in Austria.

PubMed

Tomintz, Melanie; Kosar, Bernhard; Clarke, Graham

2016-10-07

Reducing the smoking population is still high on the policy agenda, as smoking leads to many preventable diseases, such as lung cancer, heart disease, diabetes, and more. In Austria, data on smoking prevalence only exists at the federal state level. This provides an interesting overview about the current health situation, but for regional planning authorities these data are often insufficient as they can hide pockets of high and low smoking prevalence in certain municipalities. This paper presents a spatial-temporal change of estimated smokers for municipalities from 2001 and 2011. A synthetic dataset of smokers is built by combining individual large-scale survey data and small area census data using a deterministic spatial microsimulation approach. Statistical analysis, including chi-square test and binary logistic regression, are applied to find the best variables for the simulation model and to validate its results. As no easy-to-use spatial microsimulation software for non-programmers is available yet, a flexible web-based spatial microsimulation application for health decision support (called simSALUD) has been developed and used for these analyses. The results of the simulation show in general a decrease of smoking prevalence within municipalities between 2001 and 2011 and differences within areas are identified. These results are especially valuable to policy decision makers for future planning strategies. This case study shows the application of smokeSALUD to model the spatial-temporal changes in the smoking population in Austria between 2001 and 2011. This is important as no data on smoking exists at this geographical scale (municipality). However, spatial microsimulation models are useful tools to estimate small area health data and to overcome these problems. The simulations and analysis should support health decision makers to identify hot spots of smokers and this should help to show where to spend health resources best in order to reduce health inequalities.

The use and costs of health and social services in patients with longstanding substance abuse

PubMed Central

2013-01-01

Background Persons with longstanding substance abuse might become increasingly dependent on help by the public, eventually requiring permanent care. In 2006 the municipality of Stavanger established a so-called addiction ward for these clients, comprising 17 beds at the largest municipal nursing home. We assumed that the residents of this ward were high consumers of health care and social services during the last months preceding their admission. The aim of the study was to register the type and extent of services that were claimed by this client group during the last six months prior to admission, and to calculate the costs that were caused. Further, we estimated the incremental costs for nursing home placement. Methods In 15 residents from the addiction ward the use of all welfare services during the six months prior to admission were registered. Costs were calculated by unit costs from a municipal, national and societal perspective. Results Mean total costs during this period were €32 474. Approximately half of these costs were borne by state-funded institutions, and half were borne by the municipality. The clients used a great variety of services aimed at subsistence, health care and support in independent living, while services aimed at drug withdrawal were not claimed. There was no correlation between costs and the level of functioning. The incremental costs for nursing home admission were borne by the municipalities. Conclusion Persons with longstanding substance abuse represent a group with a high use of welfare resources and hence cause high costs. However, our findings do not indicate any correlation between the amount of services rendered and the level of functioning. Further research should focus on the identification of the clients’ need for support in order to facilitate targeted interventions that might prevent further deterioration and, finally, the need for permanent care. PMID:23692822

Health impact assessment (HIA) of political proposals at the local level: successful introduction, but what has happened 15 years later?

PubMed

Berensson, Karin; Tillgren, Per

2017-06-01

Health impact assessments (HIAs) were first introduced in Sweden in the mid-to-late 1990s, with the aim of placing health issues on the political agenda and helping to reduce health inequalities. In the early 2000s, HIAs entered a second phase and the Swedish Parliament adopted a national public health policy. A national survey conducted in 2001 showed that 10/289 municipalities had begun to use HIA and 55/289 had decided to use HIA or had initiated an adoption process. In a 2013 follow-up study based on a strategic sample of municipalities, 9/36 municipalities reported using HIA and/or similar tools. Corresponding figures for the 21 Swedish regions were 10 regions in 2001 and four in 2013. HIA and similar tools (sustainability analyses, child impact assessments, and others) were applied to the same extent as HIA. Fifteen years after implementation began, HIA is still being used. Regions show a clear decrease in the use of HIA. There are several explanations for this development. One is the political context, and other explanations are shifts in which actors are responsible for HIA and for public health at the local/regional levels.

Fasciola hepatica IN BOVINES IN BRAZIL: DATA AVAILABILITY AND SPATIAL DISTRIBUTION

PubMed Central

Bennema, Sita C.; Scholte, Ronaldo Guilherme Carvalho; Molento, Marcelo Beltrão; Medeiros, Camilla; Carvalho, Omar dos Santos

2014-01-01

Fasciolosis is a disease of importance for both veterinary and public health. For the first time, georeferenced prevalence data of Fasciola hepatica in bovines were collected and mapped for the Brazilian territory and data availability was discussed. Bovine fasciolosis in Brazil is monitored on a Federal, State and Municipal level, and to improve monitoring it is essential to combine the data collected on these three levels into one dataset. Data were collected for 1032 municipalities where livers were condemned by the Federal Inspection Service (MAPA/SIF) because of the presence of F. hepatica. The information was distributed over 11 states: Espírito Santo, Goiás, Minas Gerais, Mato Grosso do Sul, Mato Grosso, Pará, Paraná, Rio de Janeiro, Rio Grande do Sul, Santa Catarina and São Paulo. The highest prevalence of fasciolosis was observed in the southern states, with disease clusters along the coast of Paraná and Santa Catarina and in Rio Grande do Sul. Also, temporal variation of the prevalence was observed. The observed prevalence and the kriged prevalence maps presented in this paper can assist both animal and human health workers in estimating the risk of infection in their state or municipality. PMID:24553606

[Analysis of the geographical distribution of cases of leprosy. Rio de Janeiro, 2001-2012].

PubMed

Gracie, Renata; Peixoto, Julia Novaes de Barros; Soares, Fabiane Bertoni Dos Reis; Hacker, Mariana de Andrea Vilas-Boas

2017-05-01

Studies have demonstrated that the geographical distribution of leprosy is related to different socioeconomic factors. This article aims to study the geographical distribution of leprosy in the state of Rio de Janeiro. The cases of leprosy reported in the 2001-2012 period were mapped according to municipality. Epidemiological and socioeconomic indicators were calculated. The ArcMap program was used for the construction of maps and Earth View to calculate the Bayesian rate. It was observed that leprosy is presented in hyper-endemic levels especially in the metropolitan area. However, there is also a reduction of the detection rate in the most recent study period. In municipalities in the metropolitan region and the north western region detection in children under 15 is high, indicating an active transmission situation. In municipalities in the south-central region and especially in the coastal region, there was a high proportion of cases diagnosed with level II disability, reflecting late diagnosis. There was no linear correlation between socioeconomic indicators and leprosy rate. These results contribute to the analysis of the geographical distribution of leprosy, important for the identification of areas for resource allocation, aiming to control and eliminate the disease.

Landslide susceptibility assessment and validation in the framework of municipal planning in Portugal: the case of Loures Municipality.

PubMed

Guillard, Clemence; Zezere, Jose

2012-10-01

The legislation that demands the evaluation of landslide susceptibility in Portugal at the municipal level is the National Ecological Reserve (NER). A methodology for the evaluation of landslide susceptibility to be used in municipal planning is applied in Loures Municipality (169.3 km²) located north of Lisbon (Portugal). A landslide inventory was made for the whole area interpreting orthophoto maps and aerial photographs and using standard geomorphologic techniques in field work. It consists of 686 polygons, each polygon representing a rotational, a deep translational or a shallow translational slide, and is integrated into a GIS database. Landslide susceptibility is evaluated using algorithms based on statistical/probabilistic analysis (Information Value Method) over unique-condition terrain units in a raster basis. Three susceptibility models are elaborated independently according to the type of slide (rotational, deep translational, shallow translational). The landslide susceptibility maps are prepared by sorting all pixels according to the pixel susceptibility value in descending order. The robustness and accuracy of the landslide susceptibility models are evaluated by prediction-rate curves, which are used for the quantitative interpretation of the landslide susceptibility maps. Unstable slopes that have to be included into the National Ecological Reserve are extracted from the three susceptibility maps following the general rules to draw the NER that state that the area to be included in the NER should guarantee the inclusion of at least 70 % of the landslides identified in the landslide inventory. The obtained results allow us to conclude that 70 % of the future landslides should occur in these areas, classified as most susceptible to landslides corresponding to 20.3 % of the total area of Municipality. Thus, the consideration of these 20.3 % as regards prevention and protection of landslide risk could potentially reduce damage resulting from 70 % of future landslides in the Loures Municipality.

Impact of rotavirus vaccination on diarrhea-related hospitalizations in São Paulo State, Brazil.

PubMed

Fernandes, Eder Gatti; Sato, Helena Keico; Leshem, Eyal; Flannery, Brendan; Konstantyner, Thais Claudia Roma de Oliveira; Veras, Maria Amélia de Sousa Mascena; Patel, Manish M

2014-06-05

Following introduction of routine infant rotavirus vaccination, severe diarrhea hospitalization rates declined among children aged <5 years throughout Brazil. Ensuring equity of rotavirus vaccine impact is important in countries that self-finance immunization programs. The objective of this study was to examine rotavirus vaccine impact on diarrhea admission rates among children aged <5 years in Brazil's public health system, according to area-based measures of human development in the state of São Paulo, Brazil. Ecological analysis of public health system hospitalization rates for acute gastroenteritis among children aged <5 years in the state of São Paulo, Brazil, according to five categories of municipal development based on a modified Human Development Index for municipalities. Acute gastroenteritis hospitalization rates among children aged <5 years after national rotavirus vaccine introduction (2008-2011) were compared to rates in pre-vaccine years (2000-2005) to calculate percent decline in rates (1-rate ratio) and 95% confidence intervals (CI) for each municipal development category. Direct hospitalization costs during the two periods were compared. Annual rates declined by 40% (95% CI, 39-42%) from 631 diarrhea hospitalizations per 100,000 person years pre-rotavirus vaccination to 377 per 100,000 post-vaccination among children aged <5 years and 50% (95% CI, 48-52%) from 1009 to 505 per 100,000 among infants. Highest rates were observed in least developed municipalities. Significant declines of 26-52% among children <5 years and 41-63% among infants were observed in all categories of municipal development. Lower diarrhea hospitalization rates resulted in annual savings of approximately 2 million USD for the state of São Paulo. Savings in direct hospitalization costs benefitted municipalities in all five categories. The introduction of rotavirus vaccination was associated with substantial reductions of diarrhea-related admissions at all levels of municipal development in São Paulo State, Brazil. Copyright © 2014 Elsevier Ltd. All rights reserved.

Exploratory wavelet analysis of dengue seasonal patterns in Colombia.

PubMed

Fernández-Niño, Julián Alfredo; Cárdenas-Cárdenas, Luz Mery; Hernández-Ávila, Juan Eugenio; Palacio-Mejía, Lina Sofía; Castañeda-Orjuela, Carlos Andrés

2015-12-04

Dengue has a seasonal behavior associated with climatic changes, vector cycles, circulating serotypes, and population dynamics. The wavelet analysis makes it possible to separate a very long time series into calendar time and periods. This is the first time this technique is used in an exploratory manner to model the behavior of dengue in Colombia.  To explore the annual seasonal dengue patterns in Colombia and in its five most endemic municipalities for the period 2007 to 2012, and for roughly annual cycles between 1978 and 2013 at the national level.  We made an exploratory wavelet analysis using data from all incident cases of dengue per epidemiological week for the period 2007 to 2012, and per year for 1978 to 2013. We used a first-order autoregressive model as the null hypothesis.  The effect of the 2010 epidemic was evident in both the national time series and the series for the five municipalities. Differences in interannual seasonal patterns were observed among municipalities. In addition, we identified roughly annual cycles of 2 to 5 years since 2004 at a national level.  Wavelet analysis is useful to study a long time series containing changing seasonal patterns, as is the case of dengue in Colombia, and to identify differences among regions. These patterns need to be explored at smaller aggregate levels, and their relationships with different predictive variables need to be investigated.

Approaches to local climate action in Colorado

NASA Astrophysics Data System (ADS)

Huang, Y. D.

2011-12-01

Though climate change is a global problem, the impacts are felt on the local scale; it follows that the solutions must come at the local level. Fortunately, many cities and municipalities are implementing climate mitigation (or climate action) policies and programs. However, they face many procedural and institutional barriers to their efforts, such of lack of expertise or data, limited human and financial resources, and lack of community engagement (Krause 2011). To address the first obstacle, thirteen in-depth case studies were done of successful model practices ("best practices") of climate action programs carried out by various cities, counties, and organizations in Colorado, and one outside Colorado, and developed into "how-to guides" for other municipalities to use. Research was conducted by reading documents (e.g. annual reports, community guides, city websites), email correspondence with program managers and city officials, and via phone interviews. The information gathered was then compiled into a series of reports containing a narrative description of the initiative; an overview of the plan elements (target audience and goals); implementation strategies and any indicators of success to date (e.g. GHG emissions reductions, cost savings); and the adoption or approval process, as well as community engagement efforts and marketing or messaging strategies. The types of programs covered were energy action plans, energy efficiency programs, renewable energy programs, and transportation and land use programs. Between the thirteen case studies, there was a range of approaches to implementing local climate action programs, examined along two dimensions: focus on climate change (whether it was direct/explicit or indirect/implicit) and extent of government authority. This benchmarking exercise affirmed the conventional wisdom propounded by Pitt (2010), that peer pressure (that is, the presence of neighboring jurisdictions with climate initiatives), the level of community engagement and enthusiasm, and most importantly staff members dedicated to the area of climate planning have a significant effect on climate mitigation policy adoption. In addition, it supported the claim asserted by Toly (2008) that an emphasis on economic co-benefits perpetuates the principle that economic growth need not be compromised when addressing climate change and weakens our capacity to shift toward a bolder paradigm in what is politically achievable in climate legislation.

Classification of municipal occupations.

PubMed

Ilmarinen, J; Suurnäkki, T; Nygård, C H; Landau, K

1991-01-01

Eighty-eight job titles were analyzed with the "ergonomic job analysis procedure" [Arbeitswissenschaftliche Erhebungsverfahren zur Tätigkeits-analyse abbreviated (AET) in German]. The objective was to classify the wide range of municipal jobs into homogeneous groups according to job demand and to provide better possibilities to study the relationships between work and health among the aging municipal working population. Altogether 216 items were classified. First, a hierarchical cluster analysis was made, and a dendrogram of the analyzed job titles was drawn. Second, a profile analysis was done in which the single items were grouped into 39 sum items, and a graphic profile was drawn. Finally, the stress factors were listed and drawn in ranking order. The cluster analysis formed 13 groups. Groups exposed to the highest stress factor level were kitchen supervisors, dentists, and physicians. More than 10 stress factors (greater than 50% of the maximum) were found in nursing, administration, installation, transport, and technical supervision.

Spatial modeling of cutaneous leishmaniasis in the Andean region of Colombia.

PubMed

Pérez-Flórez, Mauricio; Ocampo, Clara Beatriz; Valderrama-Ardila, Carlos; Alexander, Neal

2016-06-27

The objective of this research was to identify environmental risk factors for cutaneous leishmaniasis (CL) in Colombia and map high-risk municipalities. The study area was the Colombian Andean region, comprising 715 rural and urban municipalities. We used 10 years of CL surveillance: 2000-2009. We used spatial-temporal analysis - conditional autoregressive Poisson random effects modelling - in a Bayesian framework to model the dependence of municipality-level incidence on land use, climate, elevation and population density. Bivariable spatial analysis identified rainforests, forests and secondary vegetation, temperature, and annual precipitation as positively associated with CL incidence. By contrast, livestock agroecosystems and temperature seasonality were negatively associated. Multivariable analysis identified land use - rainforests and agro-livestock - and climate - temperature, rainfall and temperature seasonality - as best predictors of CL. We conclude that climate and land use can be used to identify areas at high risk of CL and that this approach is potentially applicable elsewhere in Latin America.

[Significant changes in the health system decentralization process in Brazil].

PubMed

Viana, Ana Luiza d'Avila; Heimann, Luiza S; de Lima, Luciana Dias; de Oliveira, Roberta Gondim; Rodrigues, Sergio da Hora

2002-01-01

This article discusses the trends and limits of the Brazilian health system decentralization process, identifying the three elements that constitute the strategic induction performed by the national system administrator in accordance with the guidelines contained in the Operational Norms of the Unified National Health System: systemic rationality, intergovernmental and service provider financing, and health care model. The effects of the Federal regulations are analyzed based on the results of the evaluation study focused on the implementation of the full management scheme at the Municipal level. The decentralization strategy induced by Basic Operational Norm 96 has succeeded in improving institutional conditions, management autonomy, and supply, as measured by the Federal resources transferred, installed capacity, production, and coverage of outpatient and hospital services, with the Municipalities authorized to conduct fully autonomous management, without altering the existing patterns of inequity in the distribution of funds to poorer Municipalities.

Levels of synthetic musk compounds in municipal wastewater for potential estimation of biota exposure in receiving waters.

PubMed

Osemwengie, Lantis I; Gerstenberger, Shawn L

2004-06-01

We analyzed water samples from the confluence of three municipal sewage treatment effluent streams, surface water, and whole carp (Cyprinus carpio) for synthetic musks for a period of 7-12 months. The lipid content of each fish was determined and compared with the concentration of musks in the whole fish tissue. Enhanced methods were used for water sampling and musk extraction. The data presented here provide insight as to the relationship between concentrations of synthetic musks in the municipal effluent and associated biota. This study confirmed the presence of polycyclic and nitro musk compounds in sewage effluent, Lake Mead water, and carp. The concentrations were found to be considerably lower than previous studies conducted in other countries. This study also provides data for polycyclic and nitro musk compounds, as well as some of the nitro musk metabolites in sewage treatment plant effluent, lake water, and carp.

Stuck between a rock and a hard place: the work situation for nurses as leaders in municipal health care

PubMed Central

Nilsen, Etty R; Olafsen, Anja H; Steinsvåg, Anne Grethe; Halvari, Hallgeir; Grov, Ellen K

2016-01-01

Background The paper aims to present how nursing leaders in the municipal health care perceive the interaction with and support from their superiors and peers. The paper further aims to identify the leaders’ vulnerability and strength at work in the current situation of shortage of manpower and other resources in the health care sector. This is seen through the lens of self-determination theory. Methods Qualitative interviews were conducted with nine nursing leaders in nursing homes and home-care services, which, in part, capture the municipal health care service in a time of reform. Results The nursing leaders are highly independent regarding their role as leaders. They act with strength and power in their position as superiors for their own staff, but they lack support and feel left alone by their leader, the municipal health director. The relation between the nursing leaders and their superiors is characterized by controlling structures and lack of autonomy support. As a consequence, the nursing leaders’ relations with subordinates and particularly peers, contribute to satisfy their needs for competence and relatedness, and, to some extent, autonomy. However, this cannot substitute for the lack of support from the superior level. Conclusion The paper maintains a need to increase the consciousness of the value of horizontal support and interaction with peers and subordinates for the municipal nursing leader. Also, the need for increased focus on “the missing link” upward between the municipal health director and the nursing leader is revealed. The impact of extensive controlling structures and lack of autonomy support from superiors might lead to reduced motivation and well-being. PMID:27103816

Inequalities in public water supply fluoridation in Brazil: An ecological study

PubMed Central

Gabardo, Marilisa CL; da Silva, Wander J; Olandoski, Marcia; Moysés, Simone T; Moysés, Samuel J

2008-01-01

Background The literature is scarce on the social and geographic inequalities in the access to and implementation of the fluoridation of public water supplies. This study adds knowledge to the Brazilian experience of the chronic privation of water and wastewater policies, access to potable water and fluoridation in the country. Thus, the aim of this study was to verify possible inequalities in the population's access to fluoridated drinking water in 246 Brazilian municipalities. Methods The information on the process of water fluoridation in the municipalities and in the macro region in which each municipality is located was obtained from the national epidemiological survey which was concluded in 2003. The data relating to the human development index at municipal level (HDI-M) and access to mains water came from the Brazilian Human Development Atlas, whilst the size of the population was obtained from a governmental source. The Fisher exact test (P < 0.05) was employed to identify significant associations between the explanatory variables and their ability to predict the principal outcomes of interest to this study, namely the presence or absence of the water fluoridation process in the municipalities as well as the length of time during which this measure has been implemented. Linear regression was used to observe the associations between the relevant variables in a multivariate environment. Results The results clearly showed that there is a relationship between municipalities with larger populations, located in more socio-economically advantaged regions and with better HDI-M, and where fluoridation is both present and has been implemented for a longer period of time (started before 1990). Conclusion The findings suggest that the aim of treating water with fluoride may not be being adequately achieved, requiring more effective strategies so that access to this measure can be expanded equitably. PMID:18402688

[Prevalence of trachoma in Brazilian schoolchildren].

PubMed

Lopes, Maria de Fátima Costa; Luna, Expedito José de Albuquerque; Medina, Norma Helen; Cardoso, Maria Regina Alves; Freitas, Helen Selma de Abreu; Koizumi, Inês Kazue; Bernardes, Neusa Aparecida Ferreira Alves; Guimarães, José Alfredo

2013-06-01

To estimate the prevalence and describe the distribution of trachoma among schoolchildren in Brazilian municipalities. Cross-sectional study, using cluster sampling, of the schoolchildren population of the Brazilian municipalities with Human Development Index - Municipal lower than the national average. This trachoma prevalence survey was conducted by the Ministry of Health, in the period 2002-2007. There were 119,531 schoolchildren selected from 2,270 schools located in 1,156 municipalities. The selected schoolchildren underwent an external ocular examination, with a magnifying glass (2.5X), to detect clinical signs of trachoma according to the WHO criteria. The prevalence of trachoma, by state and national level, and their respective 95% confidence intervals were estimated. Chi-square and Chi-square for trends tests were used to compare categorical variables. There were 6,030 cases of trachoma detected, resulting in a prevalence of 5.0% (95%CI 4.5;5.4). There was no significant difference between the sexes. The prevalence of trachoma was 8.2% among children under 5 years of age, decreasing among higher age groups (p < 0.01). There was a significant difference in prevalence between urban and rural areas, 4.3% versus 6.2% respectively (p < 0.01). Cases were detected in 901 municipalities (77.7% of the sample), in all regions of the country. In 36.8% of the selected municipalities, the prevalence was higher than 5%. The study shows that trachoma is a significant public health problem in Brazil, contradicting the belief that the disease had been controlled in the country. The survey provides a baseline for evaluating planned interventions aimed at achieving the goal of global certification of elimination of trachoma as a cause of blindness in Brazil by 2020.

Estimating the number of cases of acute gastrointestinal illness (AGI) associated with Canadian municipal drinking water systems.

PubMed

Murphy, H M; Thomas, M K; Medeiros, D T; McFADYEN, S; Pintar, K D M

2016-05-01

The estimated burden of endemic acute gastrointestinal illness (AGI) annually in Canada is 20·5 million cases. Approximately 4 million of these cases are domestically acquired and foodborne, yet the proportion of waterborne cases is unknown. A number of randomized controlled trials have been completed to estimate the influence of tap water from municipal drinking water plants on the burden of AGI. In Canada, 83% of the population (28 521 761 people) consumes tap water from municipal drinking water plants serving >1000 people. The drinking water-related AGI burden associated with the consumption of water from these systems in Canada is unknown. The objective of this research was to estimate the number of AGI cases attributable to consumption of drinking water from large municipal water supplies in Canada, using data from four household drinking water intervention trials. Canadian municipal water treatment systems were ranked into four categories based on source water type and quality, population size served, and treatment capability and barriers. The water treatment plants studied in the four household drinking water intervention trials were also ranked according to the aforementioned criteria, and the Canadian treatment plants were then scored against these criteria to develop four AGI risk groups. The proportion of illnesses attributed to distribution system events vs. source water quality/treatment failures was also estimated, to inform the focus of future intervention efforts. It is estimated that 334 966 cases (90% probability interval 183 006-501 026) of AGI per year are associated with the consumption of tap water from municipal systems that serve >1000 people in Canada. This study provides a framework for estimating the burden of waterborne illness at a national level and identifying existing knowledge gaps for future research and surveillance efforts, in Canada and abroad.

Costs of the Smoking Cessation Program in Brazil

PubMed Central

Mendes, Andréa Cristina Rosa; Toscano, Cristiana Maria; Barcellos, Rosilene Marques de Souza; Ribeiro, Alvaro Luis Pereira; Ritzel, Jonas Bohn; Cunha, Valéria de Souza; Duncan, Bruce Bartholow

2016-01-01

ABSTRACT OBJECTIVE To assess the costs of the Smoking Cessation Program in the Brazilian Unified Health System and estimate the cost of its full implementation in a Brazilian municipality. METHODS The intensive behavioral therapy and treatment for smoking cessation includes consultations, cognitive-behavioral group therapy sessions, and use of medicines. The costs of care and management of the program were estimated using micro-costing methods. The full implementation of the program in the municipality of Goiania, Goias was set as its expansion to meet the demand of all smokers motivated to quit in the municipality that would seek care at Brazilian Unified Health System. We considered direct medical and non-medical costs: human resources, medicines, consumables, general expenses, transport, travels, events, and capital costs. We included costs of federal, state, and municipal levels. The perspective of the analysis was that from the Brazilian Unified Health System. Sensitivity analysis was performed by varying parameters concerning the amount of activities and resources used. Data sources included a sample of primary care health units, municipal and state secretariats of health, and the Brazilian Ministry of Health. The costs were estimated in Brazilian Real (R$) for the year of 2010. RESULTS The cost of the program in Goiania was R$429,079, with 78.0% regarding behavioral therapy and treatment of smoking. The cost per patient was R$534, and, per quitter, R$1,435. The full implementation of the program in the municipality of Goiania would generate a cost of R$20.28 million to attend 35,323 smokers. CONCLUSIONS The Smoking Cessation Program has good performance in terms of cost per patient that quit smoking. In view of the burden of smoking in Brazil, the treatment for smoking cessation must be considered as a priority in allocating health resources. PMID:27849293

Bagged neural network model for prediction of the mean indoor radon concentration in the municipalities in Czech Republic.

PubMed

Timkova, Jana; Fojtikova, Ivana; Pacherova, Petra

2017-01-01

The purpose of the study is to determine radon-prone areas in the Czech Republic based on the measurements of indoor radon concentration and independent predictors (rock type and permeability of the bedrock, gamma dose rate, GPS coordinates and the average age of family houses). The relationship between the mean observed indoor radon concentrations in monitored areas (∼22% municipalities) and the independent predictors was modelled using a bagged neural network. Levels of mean indoor radon concentration in the unmonitored areas were predicted using the bagged neural network model fitted for the monitored areas. The propensity to increased indoor radon was determined by estimated probability of exceeding the action level of 300Bq/m 3 . Copyright © 2016 Elsevier Ltd. All rights reserved.

PCDD/F enviromental impact from municipal solid waste bio-drying plant.

PubMed

Rada, E C; Ragazzi, M; Zardi, D; Laiti, L; Ferrari, A

2011-06-01

The present work indentifies some environmental and health impacts of a municipal solid waste bio-drying plant taking into account the PCDD/F release into the atmosphere, its concentration at ground level and its deposition. Four scenarios are presented for the process air treatment and management: biofilter or regenerative thermal oxidation treatment, at two different heights. A Gaussian dispersion model, AERMOD, was used in order to model the dispersion and deposition of the PCDD/F emissions into the atmosphere. Considerations on health risk, from different exposure pathways are presented using an original approach. The case of biofilter at ground level resulted the most critical, depending on the low dispersion of the pollutants. Suggestions on technical solutions for the optimization of the impact are presented. Copyright © 2011 Elsevier Ltd. All rights reserved.

Dentoalveolar oral surgery in children and adolescents: organization and surgical treatment in a large, Danish municipal dental service.

PubMed

Grønbæk, Anni Birgitte; Petersen, Flemming; Haubek, Dorte; Poulsen, Sven

2017-11-01

To describe a population-based organization of dentoalveolar surgical service for 0 to 18-year old subjects in a Danish municipal dental service, and analyze the type of dentoalveolar surgical interventions needed. The study was conducted in the Municipality of Aarhus, Denmark during five consecutive school-years. An internal referral system was established within the municipality where patients could be referred to colleagues with a higher level of competencies and more experiences with paediatric dentoalveolar surgery. The analysis includes a total of 1812 children and a total of 2854 surgical interventions. Almost 80% of the patients, representing more than 80% of the dentoalveolar surgical interventions needed, were referred internally. Denudations were the most frequent treatment type (40.3%) carried out, followed by removal of third molars (18.0%). Furthermore, 22 odontomas and 100 supernumerary teeth were removed. The need of dentoalveolar surgery in children and adolescents is relatively low, but includes a wide range of interventions. An organizational system, where dentists can refer to colleagues who have developed special competencies in this field, results in most of these surgical patients being referred and treated internally.

Aspects of Equality in Mandatory Partnerships - From the Perspective of Municipal Care in Norway.

PubMed

Kirchhoff, Ralf; Ljunggren, Birgitte

2016-05-18

This paper raises questions about equality in partnerships, since imbalance in partnerships may effect collaboration outcomes in integrated care. We address aspects of equality in mandatory, public-public partnerships, from the perspective of municipal care. We have developed a questionnaire wherein the Norwegian Coordination Reform is an illustrative example. The following research question is addressed: What equality dimensions are important for municipals related to mandatory partnerships with hospitals? Since we did not find any instrument to measure equality in partnerships, an explorative design was chosen. The development of the instrument was based on the theory on partnership and knowledge about the field and context. A national online survey was emitted to all 429 Norwegian municipalities in 2013. The response rate was in total 58 percent (n = 248). The data were mainly analysed using Principal component analysis. It seems that the two dimensions "learning and expertise equality" and "contractual equality" collects reliable and valid data to measure aspects of equality in partnerships. Partnerships are usually based on voluntarism. The results indicate that mandatory partnerships, within a public health care system, can be appropriate to equalize partnerships between health care providers at different care levels.

Design of an innovative, ecological portable waste compressor for in-house recycling of paper, plastic and metal packaging waste.

PubMed

Xevgenos, D; Athanasopoulos, N; Kostazos, P K; Manolakos, D E; Moustakas, K; Malamis, D; Loizidou, M

2015-05-01

Waste management in Greece relies heavily on unsustainable waste practices (mainly landfills and in certain cases uncontrolled dumping of untreated waste). Even though major improvements have been achieved in the recycling of municipal solid waste during recent years, there are some barriers that hinder the achievement of high recycling rates. Source separation of municipal solid waste has been recognised as a promising solution to produce high-quality recycled materials that can be easily directed to secondary materials markets. This article presents an innovative miniature waste separator/compressor that has been designed and developed for the source separation of municipal solid waste at a household level. The design of the system is in line with the Waste Framework Directive (2008/98/EC), since it allows for the separate collection (and compression) of municipal solid waste, namely: plastic (polyethylene terephthalate and high-density polyethylene), paper (cardboard and Tetrapak) and metal (aluminium and tin cans). It has been designed through the use of suitable software tools (LS-DYNA, INVENTROR and COMSOL). The results from the simulations, as well as the whole design process and philosophy, are discussed in this article. © The Author(s) 2015.

Medical geochemistry research in Spissko-Gemerské rudohorie Mts., Slovakia.

PubMed

Rapant, S; Cvecková, V; Dietzová, Z; Khun, M; Letkovicová, M

2009-02-01

This study presents an assessment of the potential impact of geological contamination of the environment on the health of the population in Spissko-Gemerské rudohorie Mts. (SGR Mts.). The concentration levels of potentially toxic elements (mainly As, Cd, Cu, Hg, Pb, Sb, and Zn) were determined in soils, groundwater, surface water, and stream sediments as well as in the food chain (locally grown vegetables). A medical study included some 30 health indicators for all 98 municipalities of the study area. The As and Sb contents in human fluids and tissues were analyzed in one municipality identified to be at the highest risk. Based on element content, environmental and health risks were calculated for respective municipalities. Out of 98 municipalities 14 were characterized with extremely high environmental risk and 10 were characterized with very high carcinogenic risk from arsenic (groundwater). Extensive statistical analysis of geochemical data (element contents in soils, groundwater, surface water, and stream sediments) and health indicators was performed. Significant correlations between element contents in the geological environment and health indicators, mainly cancer and cardiovascular diseases, were identified. Biological monitoring has confirmed the transfer of elements from the geological environment to human fluids and tissues as well as to the local food chain.

Experiences of municipal public health nurses following Japan's earthquake, tsunami, and nuclear disaster.

PubMed

Kayama, Mami; Akiyama, Tsuyoshi; Ohashi, Akiko; Horikoshi, Naoko; Kido, Yoshifumi; Murakata, Tazuko; Kawakami, Norito

2014-01-01

The purpose of this study was to explore the experiences of municipal public health nurses in the wake of the March 2011 massive earthquake and tsunami and resulting nuclear accident in Fukushima, Japan, from the time of the disaster until December 2013. Thirty-two public health nurses working in three cities in Fukushima prefecture were divided into four focus groups and took part in interviews, which were analyzed using a qualitative descriptive method. Two major themes were extracted: (1) experiences of difficulties and dilemmas, and (2) professional challenges and the meaning of excellence as a public health nurse. Subjects recounted their experiences based on the timeline of events. The process of overcoming various dilemmas--between prescribed roles and actual needs on the ground, being both civil servants and private citizens with families, and having to be publicly accountable while lacking adequate information--caused participants to reexamine the meaning of excellence in the practice of public health. The strenuous and complex demands of extended disaster management caused subjects to grow professionally. Helping them process their emotions should also help these nurses give focus to their posttraumatic growth, and strengthen their sense of professionalism. © 2014 Wiley Periodicals, Inc.

Work accidents and self-esteem of nursing professional in hospital settings.

PubMed

Santos, Sérgio Valverde Marques Dos; Macedo, Flávia Ribeiro Martins; Silva, Luiz Almeida da; Resck, Zelia Marilda Rodrigues; Nogueira, Denismar Alves; Terra, Fábio de Souza

2017-04-20

to analyze the occurrence of work accidents and the self-esteem of nurses in hospitals of a municipality of Minas Gerais. descriptive-analytical and cross-sectional study developed with 393 nursing professionals from three hospitals of a municipality in southern Minas Gerais. The Rosenberg Self-Esteem Scale and a questionnaire to characterize the population and work accidents were used for data collection. Data analysis was performed using Person's chi-squared test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. of the professionals studied, 15% had suffered an accident at work and 70.2% presented high self-esteem. Through the analysis, it was observed that smoking, religious belief and an outstanding event in the career were significantly associated with work accidents. In relation to self-esteem, family income, length of time working in the profession and an outstanding event in the career presented significant associations. factors such as smoking, religious belief, family income, length of time working in the profession and an outstanding event in the career can cause professionals to have accidents and/or cause changes in self-esteem, which can compromise their physical and mental health and their quality of life and work.

[Mortality due to pesticide poisoning in Colombia, 1998-2011].

PubMed

Chaparro-Narváez, Pablo; Castañeda-Orjuela, Carlos

2015-08-01

Poisoning due to pesticides is an important public health problem worldwide due its morbidity and mortality. In Colombia, there are no exact data on mortality due to pesticide poisoning. To estimate the trend of mortality rate due to pesticide poisoning in Colombia between 1998 and 2011. We carried out a descriptive analysis with the database reports of death as unintentional poisoning, self-inflicted intentional poisoning, aggression with pesticides, and poisoning with non-identified intentionality, population projections between 1998 and 2011, and rurality indexes. Crude and age-adjusted mortality rates were estimated and trends and Spearman coefficients were evaluated. A total of 4,835 deaths were registered (age-adjusted mortality rate of 2.38 deaths per 100,000 people). Mortality rates were higher in rural areas, for self-inflicted intentional poisoning, in men and in age groups between 15 and 39 years old. The trend has been decreasing since 2002. Municipality mortality rates due to unintentional poisoning and aggression correlated significantly with the rurality index in less rural municipalities. Mortality rates due to pesticide poisoning presented a mild decrease between 1998 and 2011. It is necessary to adjust and reinforce the measures conducive to reducing pesticide exposure in order to avoid poisoning and reduce mortality.

Accidents involving motorcyclists and cyclists in the municipality of São Paulo: characterization and trends☆☆☆

PubMed Central

Rodrigues, Cintia Leci; de Eston Armond, Jane; Gorios, Carlos; Souza, Patricia Colombo

2014-01-01

Objective To describe the characteristics of motorcycle and bicycle accident victims, according to notifications of suspected and confirmed accidents that have occurred in the municipality of São Paulo. Method This was a descriptive epidemiological study. It covered all accidents (12,924) that occurred involving motorcycles (11,366) and bicycles (1558) between January 2011 and October 2013. Data in the Health Department's information system for surveillance of violence and accidents (SIVVA) was surveyed. Results Motorcycle accidents accounted for 52.1% of the cases notified and bicycles, 7.1%. Males predominated in both types of accidents: 81.6% and 80.6%, respectively. In the motorcycle accidents, the predominant age group among the victims was from 20 to 24 years. Both types of accidents occurred during the daytime (7:00–18:00 h): 37.4% and 27.0% respectively. Among the motorcycle accidents, the driver had been using alcohol in 3% and it was not possible to identify whether this had occurred in 67%. Conclusions Public policies prioritizing financial and human resources applied toward reducing these types of accidents need to be brought in. PMID:26229868

Compliance with the consumption of iron and folate supplements by pregnant women in Mafikeng local municipality, North West province, South Africa.

PubMed

Mbhenyane, Xikombiso; Cherane, Matodzi

2017-09-01

Anaemia due to iron deficiency is recognized as one of the major nutritional deficiencies in women and children in developing countries. Daily iron supplementation for pregnant women is recommended in many countries. The aim of the study was to investigate the factors that contribute to compliance to the consumption of iron and folate supplements by pregnant woman in Mafikeng local municipality, North West Province, South Africa. A mixed method of descriptive, exploratory and cross-sectional design was used. Ten clinics were used as a sample frame where 57 pregnant women and 10 health workers were purposefully and conveniently selected. Quantitative techniques were used to collect data on attendance, consumption and nutrition knowledge using the self-reported questionnaire by pregnant women, and structured interview for health workers. Qualitative design was used to conduct in - depth focus-group discussions to gather information on compliance to the consumption of supplements by pregnant women. The findings of the study revealed good antenatal clinic attendance, availability of supplements and 93% compliance to the consumption of iron and folate supplements. High compliance to the consumption of iron and folate supplements by pregnant women was reported, and this should be reinforced.

Work accidents and self-esteem of nursing professional in hospital settings

PubMed Central

dos Santos, Sérgio Valverde Marques; Macedo, Flávia Ribeiro Martins; da Silva, Luiz Almeida; Resck, Zelia Marilda Rodrigues; Nogueira, Denismar Alves; Terra, Fábio de Souza

2017-01-01

Abstract Objective: to analyze the occurrence of work accidents and the self-esteem of nurses in hospitals of a municipality of Minas Gerais. Method: descriptive-analytical and cross-sectional study developed with 393 nursing professionals from three hospitals of a municipality in southern Minas Gerais. The Rosenberg Self-Esteem Scale and a questionnaire to characterize the population and work accidents were used for data collection. Data analysis was performed using Person's chi-squared test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. Results: of the professionals studied, 15% had suffered an accident at work and 70.2% presented high self-esteem. Through the analysis, it was observed that smoking, religious belief and an outstanding event in the career were significantly associated with work accidents. In relation to self-esteem, family income, length of time working in the profession and an outstanding event in the career presented significant associations. Conclusion: factors such as smoking, religious belief, family income, length of time working in the profession and an outstanding event in the career can cause professionals to have accidents and/or cause changes in self-esteem, which can compromise their physical and mental health and their quality of life and work. PMID:28443993

Managing workplace health promotion in municipal organizations: The perspective of senior managers.

PubMed

Larsson, Robert; Åkerlind, Ingemar; Sandmark, Hélène

2015-01-01

Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organizations is needed. The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organizations. A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis. The management of WHP was described as a set of components that together contribute to the organization's capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components. The WHP management approach needs to be broadened to include work environment and organizational factors. Further integration with occupational health and safety and the general management system in the organizations is also needed.

Registered nurses' perceptions of conditions for patient education - focusing on organisational, environmental and professional cooperation aspects.

PubMed

Bergh, Anne-Louise; Karlsson, Jan; Persson, Eva; Friberg, Febe

2012-09-01

To describe nurses' perceptions of conditions for patient education, focusing on organisational, environmental and professional cooperation aspects, and to determine any differences between primary, municipal and hospital care. Although patient education is an important part of daily nursing practice, the conditions for this work are unclear and require clarification. A stratified random sample of 701 (83%) nurses working in primary, municipal and hospital care completed a 60-item questionnaire. The study is part of a larger project. The study items relating to organisation, environment and professional cooperation were analysed using descriptive statistics, non-parametric tests and content analysis. Conditions for patient education differ. Nurses in primary care had better conditions and more managerial support, for example in the allocation of undisturbed time. Conditions related to organisation, environment and cooperation need to be developed further. In this process, managerial support is important, and nurses must ask for better conditions in order to carry through patient education. Managerial support for the development of visible patient education routines (e.g. allocation of time, place and guidelines) is required. One recommendation is to designate a person to oversee educational work. © 2012 Blackwell Publishing Ltd.

Permeability test and slope stability analysis of municipal solid waste in Jiangcungou Landfill, Shaanxi, China.

PubMed

Yang, Rong; Xu, Zengguang; Chai, Junrui; Qin, Yuan; Li, Yanlong

2016-07-01

With the rapid increase of city waste, landfills have become a major method to deals with municipal solid waste. Thus, the safety of landfills has become a valuable research topic. In this paper, Jiangcungou Landfill, located in Shaanxi, China, was investigated and its slope stability was analyzed. Laboratory tests were used to obtain permeability coefficients of municipal solid waste. Based on the results, the distribution of leachate and stability in the landfill was computed and analyzed. These results showed: the range of permeability coefficient was from 1.0 × 10(-7) cm sec(-1) to 6.0 × 10(-3) cm sec(-1) on basis of laboratory test and some parameters of similar landfills. Owing to the existence of intermediate cover layers in the landfill, the perched water level appeared in the landfill with heavy rain. Moreover, the waste was filled with leachate in the top layer, and the range of leachate level was from 2 m to 5 m in depth under the waste surface in other layers. The closer it gets to the surface of landfill, the higher the perched water level of leachate. It is indicated that the minimum safety factors were 1.516 and 0.958 for winter and summer, respectively. Additionally, the slope failure may occur in summer. The research of seepage and stability in landfills may provide a less costly way to reduce accidents. Landslides often occur in the Jiangcungou Landfill because of the high leachate level. Some measures should be implemented to reduce the leachate level. This paper investigated seepage and slope stability of landfills by numerical methods. These results may provide the basis for increasing stability of landfills.

Data on fluoride concentration and health risk assessment of drinking water in Khorasan Razavi province, Iran.

PubMed

Ghaderpoori, Mansour; Najafpoor, Ali Asghar; Ghaderpoury, Afshin; Shams, Mahmoud

2018-06-01

While fluoride (F) is an essential anion to keep the human body healthy, high F intake could lead to serious health problems. The monitoring of F in drinking water as the main route of F intake, is a key factor in preventing its negative health consequences. Here, we present the F levels in drinking water distribution networks of Khorasan Razavi province in Iran which collected during 2016-2017. The non-cancer human risk attributed to F in municipal and rural regions, also, estimated by calculating the chronic daily intake (CDI) and hazard quotient (HQ) for adults and children. Samples taken from drinking water distribution network in 112 different locations across the Khorasan Razavi and the F concentration determined using standard SPADNS Method. Having a minimum of 0.09 and 0.16 and a maximum of 1.7 and 1.1 mg L -1 , the mean F level in municipal and rural samples were 0.74 and 0.59 mg L -1 , respectively. The mean CDI values for F in municipal samples were 1.3×10 -2 , 3.34×10 -4 , and 8.56×10 -6 mg kg -1 day -1 , for men, women, and children, respectively. The CDI for rural samples were 1.51×10 -2 , 3.88×10 -4 , and 9.96×10 -6 mg kg -1 day - 1 , for men, women, and children, respectively. The mean HQ of F for men, women, and children in municipal and rural samples were 2.17×10 -1 , 5.56×10 -3 , and 1.43×10 -4 , and 2.44×10 -1 , 6.26×10 -3 and 1.61×10 -4 , respectively. Locations with a HQ>1, needs appropriate strategies for reducing the F level in drinking water to prevent the potential health risks.

Association between drinking water uranium content and cancer risk in Bavaria, Germany.

PubMed

Radespiel-Tröger, M; Meyer, M

2013-10-01

To evaluate the possible association between uranium (U) content in public drinking water on the one hand and the risk of cancer of the colorectum, lung, female breast, prostate, kidney, and urinary bladder, total cancer, and leukemia on the other hand in Bavaria, an ecologic study on the level of municipalities was performed. Cancer incidence data for the years 2002-2008 were obtained from the population-based cancer registry Bavaria according to sex. Current U content data of public drinking water on the level of municipalities were obtained from a publicly available source. The possible association between drinking water U content and cancer risk adjusted for average socio-economic status was evaluated using Poisson regression. Drinking water U content was below 20 μg/L in 458 out of 461 included municipalities. We found a significantly increased risk of leukemia in men in the intermediate (U level, 1.00-4.99 μg/L; relative risk [RR], 1.14) and in the highest U exposure category (U level, ≥5 μg/L; RR, 1.28). Moreover, in women, a significantly elevated risk was identified with respect to kidney cancer in the highest exposure category (RR, 1.16) and with respect to lung cancer in the intermediate exposure category (RR, 1.12). The slightly increased risk of leukemia in men, kidney cancer in women, and lung cancer in women may require further investigation. If an increased cancer risk is confirmed, preventive measures (e.g., introduction of U filters in public water systems) may be considered.

Understanding Perceptions of Climate Change, Priorities, and Decision-Making among Municipalities in Lima, Peru to Better Inform Adaptation and Mitigation Planning

PubMed Central

Saldarriaga, Enrique; Lawler, Joshua; Zunt, Joseph; Garcia, Patricia; Cárcamo, César

2016-01-01

Climate change poses multiple risks to the population of Lima, the largest city and capital of Peru, located on the Pacific coast in a desert ecosystem. These risks include increased water scarcity, increased heat, and the introduction and emergence of vector-borne and other climate sensitive diseases. To respond to these threats, it is necessary for the government, at every level, to adopt more mitigation and adaptation strategies. Here, focus groups were conducted with representatives from five Lima municipalities to determine priorities, perception of climate change, and decision-making processes for implementing projects within each municipality. These factors can affect the ability and desire of a community to implement climate change adaptation and mitigation strategies. The results show that climate change and other environmental factors are of relatively low priority, whereas public safety and water and sanitation services are of highest concern. Perhaps most importantly, climate change is not well understood among the municipalities. Participants had trouble distinguishing climate change from other environmental issues and did not fully understand its causes and effects. Greater understanding of what climate change is and why it is important is necessary for it to become a priority for the municipalities. Different aspects of increased climate change awareness seem to be connected to having experienced extreme weather events, whether related or not to climate change, and to higher socioeconomic status. PMID:26808087

Solid Waste Management Plan. Revision 4

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1995-04-26

The waste types discussed in this Solid Waste Management Plan are Municipal Solid Waste, Hazardous Waste, Low-Level Mixed Waste, Low-Level Radioactive Waste, and Transuranic Waste. The plan describes for each type of solid waste, the existing waste management facilities, the issues, and the assumptions used to develop the current management plan.

Determination of Trace Level Triclosan in Water by Online Preconcentration and HPLC-UV Diode Array

EPA Science Inventory

An online high performance liquid chromatography (HPLC) method for the detection and quantification of trace levels of triclosan in water is discussed. Triclosan, an anti-bacterial agent, and related compounds have been shown to reach municipal waste waters through the disposal ...

A multi-level biological approach to evaluate impacts of a major municipal effluent in wild St. Lawrence River yellow perch (Perca flavescens).

PubMed

Houde, Magali; Giraudo, Maeva; Douville, Mélanie; Bougas, Bérénice; Couture, Patrice; De Silva, Amila O; Spencer, Christine; Lair, Stéphane; Verreault, Jonathan; Bernatchez, Louis; Gagnon, Christian

2014-11-01

The development of integrated ecotoxicological approaches is of great interest in the investigation of global concerns such as impacts of municipal wastewater effluents on aquatic ecosystems. The objective of this study was to investigate the effects of a major wastewater municipal effluent on fish using a multi-level biological approach, from gene transcription and enzyme activities to histological changes. Yellow perch (Perca flavescens) were selected based on their wide distribution, their commercial and recreational importance, and the availability of a customized microarray. Yellow perch were sampled upstream of a major municipal wastewater treatment plant (WWTP) and 4 km and 10 km downstream from its point of discharge in the St. Lawrence River (Quebec, Canada). Concentrations of perfluoroalkyl substances (PFASs), polybrominated diphenyl ethers (PBDEs) and metals/trace elements in whole body homogenates were comparable to those from other industrialized regions of the world. Genomic results indicated that the transcription level of 177 genes was significantly different (p<0.024) between exposed and non-exposed fish. Among these genes, 38 were found to be differentially transcribed at both downstream sites. Impacted genes were associated with biological processes and molecular functions such as immunity, detoxification, lipid metabolism/energy homeostasis (e.g., peroxisome proliferation), and retinol metabolism suggesting impact of WWTP on these systems. Moreover, antioxidant enzyme activities were more elevated in perch collected at the 4 km site. Biomarkers of lipid metabolism, biosynthetic activity, and aerobic capacities were significantly lower (p<0.05) in fish residing near the outfall of the effluent. Histological examination of the liver indicated no differences between sites. Correlations between PFAS, PBDE, and metal/trace element tissue concentrations and markers of peroxisomal proliferation, oxidative stress, and retinoid metabolism were found at the gene and cellular levels. Present results suggest that relating transcriptomic analyses to phenotypic responses is important to better understand impacts of environmental contamination on wild fish populations. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

Venezuela: from doctrine to dialogue to participation in the processes of regional development.

PubMed

Allor, D J

1984-01-01

The growing toward decentralization and democratization of development planning in Venezuela was discussed. Venezuela has a long tradition of rule by a strong centralized authority. Currently, the Office of the President is vested with considerable power, despite the existence of an elected legislator and an independent judiciary. The president rules by decree. State legislatures are elected, but governors of the states are appointed by the president. There are also elected municipal councils. Both state and municipal governments are almost fully dependent on the federal government for both their operating and capital investment budgets. Development programs are administered through 2 systems. Specific programs are administered by almost 100 different institutes and enterprises. The activities of these various programs are coordinated by administrative bodies at the state and federal level. The 2nd administrative system operates at the regional and federal levels. The administrative body at the federal level is the Central Office for Coordination and Planning and was established by Presidential Decree in 1958. This body prepares and coordinates all national development plans. The administrative bodies at the regional level are the Regional Organizations for Development. These bodies were created in specific regions through a series of legislative acts commencing in 1969 and continuing into the present. The development of these regional bodies represented a 1st step toward decentralization. Decree 478, promulgated in 1980, further promoted the decentalization of developmental planning. The decree established a series of assemblies and councils at various levels. A National Council of Regional Development was created at the federal level, and a Regional Council of Development was established at the regional level. At the state level an Assembly of Participation was organized, and at the municipal level a Committee of Citizen Participation was established. Neighborhood associations were mentioned in the decree, but their role was not formalized. This series of newly established bodies plays a role in both advisory and administrative processes. The advisory process begins at the lowest level, and local concerns are expressed upward through the hierarchy. The administrative process flows in the opposite direction. Participation remains highly formalized and is restricted to the participation of recognized leaders and organizations. For example, members of the Assembly of Participation include the state governor, representatives of municipal councils, and representatives of various industrial and commercial organizations. Despite the formal nature of the participation, the 1980 Decree clearly exhibited the trend toward decentralization predicted by John Freeman in his analysis of Venezuelan political structure and published in a book entitled "venezuela: From doctrine to Dialogue." Increased pressure will now be exerted for broader community participation in the development process, and eventually development planning will focus on the equitable distribution of development benefits rather than on the maximization of economic growth.

Municipal solid waste leachate impact on metabolic activity of wheat (Triticum aestivum L.) seedlings.

PubMed

Awasthi, Abhishek Kumar; Pandey, Akhilesh Kumar; Khan, Jamaluddin

2017-07-01

Municipal solid waste (MSW) contains contaminants that could possibly leach out and pollute the soil, water sources. In this investigation, the MSW leachate toxicity was evaluated using wheat seedling plant bioassay. The eco-toxicity activities of leachate at several time intervals were explored, and the toxicity of these leachates on wheat (Triticum aestivum L.) seed germination and chlorophyll a and chlorophyll b (Chl a and Chl b) levels were determined. The findings showed that leachate can affect the metabolic activity of the wheat plant. Therefore, in order to protect the environment, the polluted leachate should be treated.

Powering Up: Assessing the growing municipal energy resilience building efforts in North America

NASA Astrophysics Data System (ADS)

Schimmelfing, Kara

Energy related shortages and price volatilities can impact all levels of society. With coming fossil fuel depletion related to peak oil, it is expected these shortages and volatilities will increase in frequency, duration, and intensity. Resilience building is a strategy to minimize the effects of these events by modifying systems so they are less impacted and/or recover more quickly from disruptive events. Resilience building is being used, particularly at the municipal scale, to prepare for these coming energy related changes. These municipal efforts have only been in existence for five to ten years, and full implementation is still in progress. Little evaluation has been done of these municipal efforts to date, particularly in North America. Despite this, it is important to begin to assess the effectiveness of these efforts now. As a result, future efforts can be redirected to address weak areas and that lessons learned by vanguard communities can be applied in other communities attempting to build energy resilience in the future. This thesis involved the creation of a hybrid framework to evaluate municipal energy resilience building efforts. The framework drew primarily from planning process and factors identified as important to build resilience in social-ecological systems. It consisted of the following categories to group resilience building efforts: Economy, Resource Systems & Infrastructure, Public Awareness, Social Services, Transportation, Built Environment, and Natural Environment. Within these categories the following process steps should be observed: Context, Goals, Needs, Processes, and Outcomes. This framework was then tested through application to four case-study communities (Bloomington, IN, Hamilton, ON, Oakland, CA, Victoria, BC) currently pursuing energy resilience building efforts in North America. This qualitative research involved document analysis primarily of municipal documents related to energy planning efforts. Supplementary interviews were also conducted to verify the findings from the documents and illuminate anything not captured by them. Once data was collected, categorized and analyzed using the framework, comparisons were made between case-studies. Results showed the framework to be a successful, but time consuming, tool for assessing municipal energy resilience building. Four revisions are recommended for the framework before further research. Analysis of the case study communities' efforts also identified five factors for recommended for other communities attempting energy resilience planning at the municipal scale: consistent support from within the municipality, integration and information sharing, presence of key resources, access to information on energy use, and a two-tier planning process. Ultimately, as this is a preliminary attempt to address a young and growing area of municipal effort, there are many avenues for further research to build on the work of this thesis.

[Health conditions, lifestyles and occupational characteristics of teachers in a city in southern Brazil].

PubMed

dos Santos, Marcio Neres; Marques, Alexandre Carriconde

2013-03-01

Various health complications have been identified among teachers and there is little information available about their lifestyle habits. The scope of this study was to investigate health conditions, lifestyles and occupational characteristics of municipal teachers in Bagé in the south of Brazil. A cross-sectional study involving 414 teachers was conducted by asking the teachers to fill out a standardized questionnaire. Descriptive and bivariate analysis techniques were employed. Most teachers were females (96.1%) and the mean age was 40.1 years (SD 9.4). Average teaching experience was 12.4 years (SD 9.5); 59% of the teachers had a degree; they taught many working hours per week (31.7 hours, SD 10.5) and 62% were absent from work at least once in the last 12 months. Self-rated heath was good (38.5%); 62.5% of them were physically active; 32.3% were overweight and 14.4% obese. They consumed hardly any fruit and vegetables (79.6%), had average stress levels of 14.9 points (SD 6.6) and 20.3% reported hypertension. Self-reported health was associated with teaching time, absenteeism, physical activity, number of meals per day, stress levels and hypertension. The prevalence of teachers who rated their health negatively was low, however several lifestyle issues were identified, which can be prejudicial to the health of these individuals.

The role of social participation in municipal-level health systems: the case of Palencia, Guatemala.

PubMed

Ruano, Ana Lorena

2013-09-10

Social participation has been recognized as an important public health policy since the declaration of Alma-Ata presented it as one of the pillars of primary health care in 1978. Since then, there have been many adaptations to the original policy but participation in health is still seen as a means to make the health system more responsive to local health needs and as a way to bring the health sector and the community closer together. To explore the role that social participation has in a municipal-level health system in Guatemala in order to inform future policies and programs. Documentary analysis was used to study the context of participation in Guatemala. To do this, written records and accounts of Guatemalan history during the 20th century were reviewed. The fieldwork was carried out over 8 months and three field visits were conducted between early January of 2009 and late March of 2010. A total of 38 in-depth interviews with regional health authorities, district health authorities, community representatives, and community health workers (CHWs) were conducted. Data were analyzed using thematic analysis. Guatemala's armed civil struggle was framed in the cold war and the fight against communism. Locally, the war was fed by the growing social, political, and ethnic inequalities that existed in the country. The process of reconstructing the country's social fabric started with the signing of the peace agreements of 1996, and continued with the passing of the 2002 legal framework designed to promote decentralization through social participation. Today, Guatemala is a post-war society that is trying to foster participation in a context full of challenges for the population and for the institutions that promote it. In the municipality of Palencia, there are three different spaces for participation in health: the municipal-level health commission, in community-level social development councils, and in the CHW program. Each of these spaces has participants with specific roles and processes. True participation and collaboration among can only be attained through the promotion and creation of meaningful partnerships between institutional stakeholders and community leaders, as well as with other stakeholders working at the community level. For this to happen, more structured support for the participation process in the form of clear policies, funding and capacity building is needed.

The role of social participation in municipal-level health systems: the case of Palencia, Guatemala

PubMed Central

Ruano, Ana Lorena

2013-01-01

Background Social participation has been recognized as an important public health policy since the declaration of Alma-Ata presented it as one of the pillars of primary health care in 1978. Since then, there have been many adaptations to the original policy but participation in health is still seen as a means to make the health system more responsive to local health needs and as a way to bring the health sector and the community closer together. Objective To explore the role that social participation has in a municipal-level health system in Guatemala in order to inform future policies and programs. Design Documentary analysis was used to study the context of participation in Guatemala. To do this, written records and accounts of Guatemalan history during the 20th century were reviewed. The fieldwork was carried out over 8 months and three field visits were conducted between early January of 2009 and late March of 2010. A total of 38 in-depth interviews with regional health authorities, district health authorities, community representatives, and community health workers (CHWs) were conducted. Data were analyzed using thematic analysis. Results Guatemala's armed civil struggle was framed in the cold war and the fight against communism. Locally, the war was fed by the growing social, political, and ethnic inequalities that existed in the country. The process of reconstructing the country's social fabric started with the signing of the peace agreements of 1996, and continued with the passing of the 2002 legal framework designed to promote decentralization through social participation. Today, Guatemala is a post-war society that is trying to foster participation in a context full of challenges for the population and for the institutions that promote it. In the municipality of Palencia, there are three different spaces for participation in health: the municipal-level health commission, in community-level social development councils, and in the CHW program. Each of these spaces has participants with specific roles and processes. Conclusions True participation and collaboration among can only be attained through the promotion and creation of meaningful partnerships between institutional stakeholders and community leaders, as well as with other stakeholders working at the community level. For this to happen, more structured support for the participation process in the form of clear policies, funding and capacity building is needed. PMID:24028936

Multiple ecosystem services landscape index: a tool for multifunctional landscapes conservation.

PubMed

Rodríguez-Loinaz, Gloria; Alday, Josu G; Onaindia, Miren

2015-01-01

The contribution of ecosystems to human well-being has been widely recognised. Taking into account existing trade-offs between ecosystem services (ES) at the farm scale and the dependence of multiple ES on processes that take place at the landscape scale, long-term preservation of multifunctional landscapes must be a priority. Studies carried out from such perspective, and those that develop appropriate indicators, could provide useful tools for integrating ES in landscape planning. In this study we propose a new integrative environmental indicator based on the ES provided by the landscape and named "multiple ecosystem services landscape index" (MESLI). Because synergies and trade-offs between ES are produced at regional or local levels, being different from those perceived at larger scales, MESLI was developed at municipality level. Furthermore, in order to identify main drivers of change in ES provision at the landscape scale an analysis of the relationship between the environmental and the socioeconomic characteristics of the municipalities was carried out. The study was located in the Basque Country and the results demonstrated that the MESLI index is a good tool to measure landscape multifunctionality at local scales. It is effective evaluating landscapes, distinguishing between municipalities based on ES provision, and identifying the drivers of change and their effects. This information about ES provisioning at the local level is usually lacking; therefore, MESLI would be very useful for policy-makers and land managers because it provides relevant information to local scale decision-making. Copyright © 2014 Elsevier Ltd. All rights reserved.

Environmental Health Problems and Indicators in Tabriz, Iran

PubMed Central

Ghozikali, Mohammad Ghanbari; Mosaferi, Mohammad; Naddafi, Kazem

2013-01-01

Background: Environmental Health Indicators (EHIs) are the most important criteria for evaluation of efficiency and effectiveness of the activities of the health sector. The operations and situation of the health system can be analyzed through surveying the indicators and comparing them during different times. The present study aimed to study the EHIs of Tabriz, using the common environmental health processes and national EHIs of the Ministry of Health. Method: The required information for determination of EHIs was collected from different sources, including mainly the Environmental Health Department of the Health Center of East Azerbaijan Province, Iran and other organizations. Results: We found some important desirable and undesirable EHIs in Tabriz,including high percentage of households with access to safe and reliable drinking water, high safety in microbiological and chemical quality of drinking water, acceptable level of BOD5 and COD in the effluent of wastewater treatment plants (WTP), lack of complete municipal wastewater collection and treatment, relatively poor sanitation and health of food markets and public places, undesirable collection,transportation and disposal of municipal solid waste, low EHIs of some school classrooms, unacceptable disposal of medical waste in some hospitals, and finally high level of noise pollution in the city. Conclusion: Considering the poor condition of some EHIs of Tabriz, implementing proper actions for promotion of the indicators especially development of municipal wastewater collection, improvement of solid waste management,environmental health of some schools and mosques, and finally the noise pollution level of the city is recommended. PMID:24688959

[Quality control in the follow-up of pulmonary tuberculosis contacts in Camagüey, Cuba (2008-2011)].

PubMed

Dair, Roberto; Torres, Etelivar; Rodríguez, Odalys; Cruz, Ramona; Hernández, Lizzie

2014-02-19

Tuberculosis is currently a health problem in the municipality of Camagüey. To assess compliance of guidelines issued by the National Program for the Control of Tuberculosis for the follow-up of contacts of positive cases of pulmonary tuberculosis in the municipality of Camagüey, Cuba. Descriptive cross-sectional design. 1,242 contacts resulting from 39 reported cases of tuberculosis during the study period were included in the municipality of Camagüey between 2008 and 2011. Epidemiological surveys and records of reported cases were reviewed. The results were processed and analyzed in SPSS 17.0 statistical software and subsequently presented in tables and graphs. The results were summarized by percentages. The “follow-up form for contacts of pulmonary tuberculosis” was used as main guideline, which was created by experts of the Investigation and Monitoring of Tuberculosis, Acute Respiratory Infections, and Leprosy Workshop of Tropical Medicine Institute Pedro Kourí. Contacts that had an initial examination and four checkups had 96.2% of acceptability. Contacts that had fewer than four checkups showed less than 10% acceptability (3.3%). All contacts were assessed from the outset and were treated, in accordance with program guidelines. We found adequate compliance of National Program for the Control of the Tuberculosis guidelines for follow-up of contacts of positive cases of pulmonary tuberculosis. Compliance is greater in younger age groups and in the actively employed (25 to 54 years). This evaluation contributed to identify existing weaknesses in follow-up, such as low interest of this population to undergo appropriate testing in the National Program of Control of Tuberculosis.

Elusive implementation: an ethnographic study of intersectoral policymaking for health.

PubMed

Holt, Ditte Heering; Rod, Morten Hulvej; Waldorff, Susanne Boch; Tjørnhøj-Thomsen, Tine

2018-01-30

For more than 30 years policy action across sectors has been celebrated as a necessary and viable way to affect the social factors impacting on health. In particular intersectoral action on the social determinants of health is considered necessary to address social inequalities in health. However, despite growing support for intersectoral policymaking, implementation remains a challenge. Critics argue that public health has remained naïve about the policy process and a better understanding is needed. Based on ethnographic data, this paper conducts an in-depth analysis of a local process of intersectoral policymaking in order to gain a better understanding of the challenges posed by implementation. To help conceptualize the process, we apply the theoretical perspective of organizational neo-institutionalism, in particular the concepts of rationalized myth and decoupling. On the basis of an explorative study among ten Danish municipalities, we conducted an ethnographic study of the development of a municipal-wide implementation strategy for the intersectoral health policy of a medium-sized municipality. The main data sources consist of ethnographic field notes from participant observation and interview transcripts. By providing detailed contextual description, we show how an apparent failure to move from policy to action is played out by the ongoing production of abstract rhetoric and vague plans. We find that idealization of universal intersectoralism, inconsistent demands, and doubts about economic outcomes challenge the notion of implementation as moving from rhetoric to action. We argue that the 'myth' of intersectoralism may be instrumental in avoiding the specification of action to implement the policy, and that the policy instead serves as a way to display and support good intentions and hereby continue the process. On this basis we expand the discussion on implementation challenges regarding intersectoral policymaking for health.

Adolescents alcohol-use and economic conditions: a multilevel analysis of data from a period with big economic changes.

PubMed

Svensson, Mikael; Hagquist, Curt

2010-12-01

This paper examines how the unemployment rate is related to adolescent alcohol use and experience of binge drinking during a time period characterized by big societal changes. The paper uses repeated cross-sectional adolescent survey data from a Swedish region, collected in 1988, 1991, 1995, 1998, 2002 and 2005, and merges this with data on local unemployment rates for the same time periods. Individual level frequency of alcohol use as well as experience of binge drinking is connected to local level unemployment rate to estimate the relationship using multilevel modeling. The model includes municipality effects controlling for time-invariant differences between municipalities as well as year fixed effects controlling for municipality-invariant changes over time in alcohol use. The results show that the unemployment rate is negatively associated with adolescents' alcohol use and the experience of binge drinking. When the unemployment rate increases, more adolescents do not drink at all. Regular drinking (twice per month or more) is, on the other hand, unrelated to the unemployment rate. Examining gender-differences in the relationship, it is shown that the results are driven by behavior in girls, whereas drinking among boys does not show any significant relationship with changes in the unemployment rate.

VULNERABILITY OF LOW-ARSENIC AQUIFERS TO MUNICIPAL PUMPING IN BANGLADESH

PubMed Central

Knappett, P. S. K.; Mailloux, B. J.; Choudhury, I.; Khan, M. R.; Michael, H. A.; Barua, S.; Mondal, D. R.; Steckler, M. S.; Akhter, S. H.; Ahmed, K. M.; Bostick, B.; Harvey, C. F.; Shamsudduha, M.; Shuai, P.; Mihajlov, I.; Mozumder, R.; van Geen, A.

2017-01-01

Sandy aquifers deposited >12,000 years ago, some as shallow as 30 m, have provided a reliable supply of low-arsenic (As) drinking water in rural Bangladesh. This study concerns the potential risk of contaminating these aquifers in areas surrounding the city of Dhaka where hydraulic heads in aquifers >150 m deep have dropped by 70 m in a few decades due to municipal pumping. Water levels measured continuously from 2012 to 2014 in 12 deep (>150m), 3 intermediate (90–150 m) and 6 shallow (<90 m) community wells, 1 shallow private well, and 1 river piezometer show that the resulting drawdown cone extends 15–35 km east of Dhaka. Water levels in 4 low-As community wells within the 62–147 m depth range closest to Dhaka were inaccessible by suction for up to a third of the year. Lateral hydraulic gradients in the deep aquifer system ranged from 1.7×10−4 to 3.7×10−4 indicating flow towards Dhaka throughout 2012–2014. Vertical recharge on the edge of the drawdown cone was estimated at 0.21±0.06 m/yr. The data suggest that continued municipal pumping in Dhaka could eventually contaminate some relatively shallow community wells. PMID:28966395

Environmental and socio-economic determinants associated with the occurrence of cutaneous leishmaniasis in the northeast of Colombia.

PubMed

Gutierrez, Juan D; Martínez-Vega, Ruth; Ramoni-Perazzi, Josefa; Diaz-Quijano, Fredi A; Gutiérrez, Reinaldo; Ruiz, Freddy J; Botello, Hector A; Gil, María; González, Juan; Palencia, Mario

2017-12-01

Cutaneous leishmaniasis (CL) is a vector-borne disease that is widely distributed in most tropical regions. Colombia has experienced an important increase in its incidence during the last decade. There are CL transmission foci in the Colombian departments of Santander and Norte de Santander. To identify environmental and socio-economic variables associated with CL incidence in the municipalities of the northeast of Colombia between 2007 and 2016. This was an ecological study of CL cases aggregated by municipality. The cases reported during the study period were analyzed with a negative binomial regression to obtain the adjusted incident rate ratio for environmental and socio-economic variables. During the study period, 10 924 cases of CL were reported, and 110 (86.6%) municipalities reported at least one CL case. The coverages of forest (aIRR 1.05, 95% CI 1.03-1.07), heterogeneous agricultural zones (aIRR 1.04, 95% CI 1.02-1.06) and permanent crops (aIRR 1.07, 95% CI 1.02-1.12) were associated with a higher incidence of CL. Conversely, urban functionality (aIRR 0.95, 95% CI 0.92-0.96), minimal-altitude above sea level (aIRR 0.84, 95% CI 0.79-0.90) and shrub coverage (aIRR 0.98, 95% CI 0.95-1.0) were negatively associated with the incidence of CL in the municipality. Our results confirm the importance of environmental determinants, such as height above sea level, and coverage of forest, permanent crops and heterogeneous agricultural zones, for the occurrence of CL; these findings also suggest the importance of shrub coverage. Furthermore, urban functionality was a socio-economic determinant independently associated with CL incidence.

Emergency health planning.

PubMed

HARDMAN, A C

1962-12-01

This paper outlines the development of emergency health planning as a function of government. Ten provinces have the basic responsibility for the organization, preparation and operation of medical, nursing, hospital and public health services in an emergency. The Department of National Health and Welfare is responsible for the provision of advice and assistance to the provincial and municipal governments in such matters. Eight provinces have now hired full-time planning staffs to co-ordinate the health planning of the Provincial Departments of Health and Provincial Emergency Measures Organization.Four major programs have been established. The first program provides for the continuity of leadership and guidance by health authorities at the federal, provincial and municipal level. Essential records have been developed and emergency legislation prepared. This program, however, will be of little use unless health services are organized at the municipal level. In this organizational program, advice and assistance have been provided to existing hospitals and departments of health in the conduct of disaster planning. The efforts of these agencies are co-ordinated by municipal health authorities into a community disaster plan. The third program deals with information and education of the general public and the health workers. This program is designed to make the family unit self-sufficient for up to seven days and the health worker prepared to undertake his emergency role. The first three programs are directed to the organization and training of manpower; the fourth program provides the necessary supplies. From the national medical stockpile of $18,000,000, some $12,000,000 has been received, packaged for long-term storage and distributed to regional depots across the country. To ensure their ready availability in time of emergency an agreement has been reached with seven provinces for the release of hospital disaster kits.

Management of packaging waste in Poland--development agenda and accession to the EU.

PubMed

Grodzińska-Jurczak, Małgorzata; Zakowska, Hanna; Read, Adam

2004-06-01

In recent years the issue of the municipal waste in Poland has become increasingly topical, with a considerable rise in the waste generation, much of which can be attributed to a boom in product packaging (mainly plastic). The annual production of plastics packaging has been constantly increasing over the last 20 to 30 years, and now exceeds 3.7 million tons. Due to a lack of processing technologies and poorly developed selective segregation system, packaging waste is still treated as a part of the municipal solid waste (MSW) stream, most of which is landfilled. As a result of Poland's access to the European Union, previous legal regulations governing municipal waste management have been harmonized with those binding on the member countries. One of the main changes, the most revolutionary one, is to make entrepreneurs liable for environmental risks resulting from the introduction of packaging to the market, and for its recycling. In practice, all entrepreneurs are to ensure recovery, and recycling, of used packaging from products introduced to the market at the required level. In recent year, the required recycling levels were fulfilled for all types of materials but mainly by large institutions using grouped and transport packaging waste for that matter. Household packaging gathered in the selective segregation system at the municipalities was practically left alone. This paper is an attempt to describe the system and assess the first year of functioning of the new, revamped system of packaging waste management in Poland. Recommendations are made relating to those features that need to be included in packaging waste management systems in order to maximize their sustainability and harmonization with the EU legal system.

Quantification of greenhouse gas emissions from waste management processes for municipalities--a comparative review focusing on Africa.

PubMed

Friedrich, Elena; Trois, Cristina

2011-07-01

The amount of greenhouse gases (GHG) emitted due to waste management in the cities of developing countries is predicted to rise considerably in the near future; however, these countries have a series of problems in accounting and reporting these gases. Some of these problems are related to the status quo of waste management in the developing world and some to the lack of a coherent framework for accounting and reporting of greenhouse gases from waste at municipal level. This review summarizes and compares GHG emissions from individual waste management processes which make up a municipal waste management system, with an emphasis on developing countries and, in particular, Africa. It should be seen as a first step towards developing a more holistic GHG accounting model for municipalities. The comparison between these emissions from developed and developing countries at process level, reveals that there is agreement on the magnitude of the emissions expected from each process (generation of waste, collection and transport, disposal and recycling). The highest GHG savings are achieved through recycling, and these savings would be even higher in developing countries which rely on coal for energy production (e.g. South Africa, India and China) and where non-motorized collection and transport is used. The highest emissions are due to the methane released by dumpsites and landfills, and these emissions are predicted to increase significantly, unless more of the methane is captured and either flared or used for energy generation. The clean development mechanism (CDM) projects implemented in the developing world have made some progress in this field; however, African countries lag behind. Copyright © 2011 Elsevier Ltd. All rights reserved.

Estimating the prevalence of 26 health-related indicators at neighbourhood level in the Netherlands using structured additive regression.

PubMed

van de Kassteele, Jan; Zwakhals, Laurens; Breugelmans, Oscar; Ameling, Caroline; van den Brink, Carolien

2017-07-01

Local policy makers increasingly need information on health-related indicators at smaller geographic levels like districts or neighbourhoods. Although more large data sources have become available, direct estimates of the prevalence of a health-related indicator cannot be produced for neighbourhoods for which only small samples or no samples are available. Small area estimation provides a solution, but unit-level models for binary-valued outcomes that can handle both non-linear effects of the predictors and spatially correlated random effects in a unified framework are rarely encountered. We used data on 26 binary-valued health-related indicators collected on 387,195 persons in the Netherlands. We associated the health-related indicators at the individual level with a set of 12 predictors obtained from national registry data. We formulated a structured additive regression model for small area estimation. The model captured potential non-linear relations between the predictors and the outcome through additive terms in a functional form using penalized splines and included a term that accounted for spatially correlated heterogeneity between neighbourhoods. The registry data were used to predict individual outcomes which in turn are aggregated into higher geographical levels, i.e. neighbourhoods. We validated our method by comparing the estimated prevalences with observed prevalences at the individual level and by comparing the estimated prevalences with direct estimates obtained by weighting methods at municipality level. We estimated the prevalence of the 26 health-related indicators for 415 municipalities, 2599 districts and 11,432 neighbourhoods in the Netherlands. We illustrate our method on overweight data and show that there are distinct geographic patterns in the overweight prevalence. Calibration plots show that the estimated prevalences agree very well with observed prevalences at the individual level. The estimated prevalences agree reasonably well with the direct estimates at the municipal level. Structured additive regression is a useful tool to provide small area estimates in a unified framework. We are able to produce valid nationwide small area estimates of 26 health-related indicators at neighbourhood level in the Netherlands. The results can be used for local policy makers to make appropriate health policy decisions.

Decentralization and equity of resource allocation: evidence from Colombia and Chile.

PubMed Central

Bossert, Thomas J.; Larrañaga, Osvaldo; Giedion, Ursula; Arbelaez, José Jesus; Bowser, Diana M.

2003-01-01

OBJECTIVE: To investigate the relation between decentralization and equity of resource allocation in Colombia and Chile. METHODS: The "decision space" approach and analysis of expenditures and utilization rates were used to provide a comparative analysis of decentralization of the health systems of Colombia and Chile. FINDINGS: Evidence from Colombia and Chile suggests that decentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of decentralization--the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization. CONCLUSION: Decentralization can contribute to, or at least maintain, equitable allocation of health resources among municipalities of different incomes. PMID:12751417

Health risk assessment of air emissions from a municipal solid waste incineration plant--a case study.

PubMed

Cangialosi, Federico; Intini, Gianluca; Liberti, Lorenzo; Notarnicola, Michele; Stellacci, Paolo

2008-01-01

A health risk assessment of long-term emissions of carcinogenic and non-carcinogenic air pollutants has been carried out for the municipal solid waste incinerator (MSWI) of the city of Taranto, Italy. Ground level air concentrations and soil deposition of carcinogenic (Polychlorinated Dibenzo-p-Dioxins/Furans and Cd) and non-carcinogenic (Pb and Hg) pollutants have been estimated using a well documented atmospheric dispersion model. Health risk values for air inhalation, dermal contact, soil and food ingestion have been calculated based on a combination of these concentrations and a matrix of environmental exposure factors. Exposure of the surrounding population has been addressed for different release scenarios based on four pollutants, four exposure pathways and two receptor groups (children and adults). Spatial risk distribution and cancer excess cases projected from plant emissions have been compared with background mortality records. Estimated results based on the MSWI emissions show: (1) individual risks well below maximum acceptable levels, (2) very small incremental cancer risk compared with background level.

Luteinizing hormone (LH) levels in male workers exposed to urban stressors.

PubMed

Tomao, Enrico; Tomei, Gianfranco; Rosati, Maria Valeria; Caciari, Tiziana; Danese, Daniele; Gamberale, Daniele; Vacca, Daniele; Palermo, Paola; Anzelmo, Vincenza; Tomei, Francesco

2009-08-01

The aim of the study is to evaluate if occupational exposure to urban stressors could cause alterations in luteinizing hormone (LH) plasma levels in male traffic policemen vs. administrative staff of Municipal Police.After excluding the subjects with the main confounding factors, male traffic police and administrative staff of Municipal Police were matched by age, working life, body mass index (BMI), alcohol drinking habit, cigarette smoking habit and habitual consumption of Italian coffee.In 166 male traffic police mean LH values were significantly higher compared to 166 male administrative employees. The distribution of LH values in traffic police and in administrative employees was statistically significant.Our results suggest that recent exposure to urban stressors (chemical, physical and psycho-social) can alter the plasma concentration of LH. In agreement with our previous research, levels of plasma LH may be used as early biological markers, valuable for the group, used in occupational set before the appearance of the disease.

Same-sample determination of ultratrace levels of polybromodiphenylethers, polybromodibenzo-p-dioxins/furans, and polychlorodibenzo-p-dioxins/furans from combustion flue gas

EPA Science Inventory

The analytical method used for determination of polychlorinated dibenzo-p-dioxins and -furans (PCDDs/Fs) emissions from municipal waste combustors and other stationary sources was modified and validated to enable simultaneous analysis of ultra trace levels of polybrominated diphe...

40 CFR 62.15305 - What records must I keep for continuously monitored pollutants or parameters?

Code of Federal Regulations, 2014 CFR

2014-07-01

... oxides emissions. (4) All 1-hour average concentrations of carbon monoxide emissions. (5) All 1-hour... carbon monoxide emissions. (4) All 4-hour block arithmetic average load levels of your municipal waste... combustion units only, nitrogen oxides emissions. (iii) Carbon monoxide emissions. (iv) Load levels of your...

A Cross-sectional, Descriptive Study of Medication Use Among Persons With a Gastrointestinal Stoma.

PubMed

Pereira de Paula, Bianca Augusta; da Silva Alves, Geisa Cristina; PercÍnio, Álvaro; Pereira, Mariana Linhares; Moraes, Juliano Teixeira; Sanches, Cristina

2017-09-01

Research on the use of medications in people with intestinal stomas is lacking, creating gaps in knowledge of pharmacoepidemiology in these patients. A cross-sectional, descriptive study was conducted over a period of 4 months in Divinópolis, Brazil to describe the profile of medication use among people enrolled in the Health Support Service for People with Stoma - Level II (SSPS II) of a municipality in the state of Minas Gerais, Brazil. All patients from SSPS II with a colostomy or ileostomy were invited by phone to participate; those with incomplete registration data and/or who were <18 years old, hospitalized for any reason, or had their stoma reversed were excluded from participation. During home interviews, researchers obtained sociodemographic profiles (age, gender, education, occupation, and family income) and information on comorbidities, medication use, adherence to medication protocols (per the Morisky Green Levine test), polypharmacy, and adult/pharmaceutical care (medication description and indication, expiration date, self-medication). Drug storage was assessed by visual evaluation. The information was entered onto individual data sheets, numbered to ensure patient anonymity. The data then were entered into and analyzed using SSPS II statistical software using frequency measurements, measures of central tendency, and dispersion of demographic variables, health conditions, and medicine use. The study population included 59 persons (average age 66.9 ± 13.27 years), 36 (61.0%) women, 38 (64.4%) with an incomplete/primary level education, and 44 (74.5%) retired. Forty-nine (49) patients had a colostomy and 10 had an ileostomy; cancer was the main reason for stoma creation (61.1%). Half of the survey participants reported having 1 or 2 comorbidities (average 2.3); the most prevalent (52) was circulatory system disease among which hypertension (38, 64.4%) was most common. Analysis of the pharmacotherapeutic profile (prescribed and used) showed 89.8% of the study population used medication, and 52.8% were prescribed >5 medications (polypharmacy). Low and medium level adherence with prescriptions was noted (37.7%); 39.6% reported receiving no guidance on the use of the medication associated with their condition. Improper storage was observed in 33.9% of participants. In this population, persons with a stoma had complex pharmacotherapy, a high rate of polypharmacy, and deficiency in guidance on the use of medication. Further research into determining whether investments in both inclusion of a pharmacist on the team and more pharmacoepidemiological studies would improve patient care and medication safety in patients with a stoma is warranted.

Projected climate change threatens pollinators and crop production in Brazil

PubMed Central

Costa, Wilian França; Cordeiro, Guaraci Duran; Imperatriz-Fonseca, Vera Lucia; Saraiva, Antonio Mauro; Biesmeijer, Jacobus; Garibaldi, Lucas Alejandro

2017-01-01

Animal pollination can impact food security since many crops depend on pollinators to produce fruits and seeds. However, the effects of projected climate change on crop pollinators and therefore on crop production are still unclear, especially for wild pollinators and aggregate community responses. Using species distributional modeling, we assessed the effects of climate change on the geographic distribution of 95 pollinator species of 13 Brazilian crops, and we estimated their relative impacts on crop production. We described these effects at the municipality level, and we assessed the crops that were grown, the gross production volume of these crops, the total crop production value, and the number of inhabitants. Overall, considering all crop species, we found that the projected climate change will reduce the probability of pollinator occurrence by almost 0.13 by 2050. Our models predict that almost 90% of the municipalities analyzed will face species loss. Decreases in the pollinator occurrence probability varied from 0.08 (persimmon) to 0.25 (tomato) and will potentially affect 9% (mandarin) to 100% (sunflower) of the municipalities that produce each crop. Municipalities in central and southern Brazil will potentially face relatively large impacts on crop production due to pollinator loss. In contrast, some municipalities in northern Brazil, particularly in the northwestern Amazon, could potentially benefit from climate change because pollinators of some crops may increase. The decline in the probability of pollinator occurrence is found in a large number of municipalities with the lowest GDP and will also likely affect some places where crop production is high (20% to 90% of the GDP) and where the number of inhabitants is also high (more than 6 million people). Our study highlights key municipalities where crops are economically important and where pollinators will potentially face the worst conditions due to climate change. However, pollinators may be able to find new suitable areas that have the potential to improve crop production. The results shown here could guide policy decisions for adapting to climate change and for preventing the loss of pollinator species and crop production. PMID:28792956

A spatio-temporal analysis of suicide in El Salvador.

PubMed

Carcach, Carlos

2017-04-20

In 2012, international statistics showed El Salvador's suicide rate as 40th in the world and the highest in Latin America. Over the last 15 years, national statistics show the suicide death rate declining as opposed to an increasing rate of homicide. Though completed suicide is an important social and health issue, little is known about its prevalence, incidence, etiology and spatio-temporal behavior. The primary objective of this study was to examine completed suicide and homicide using the stream analogy to lethal violence within a spatio-temporal framework. A Bayesian model was applied to examine the spatio-temporal evolution of the tendency of completed suicide over homicide in El Salvador. Data on numbers of suicides and homicides at the municipal level were obtained from the Instituto de Medicina Legal (IML) and population counts, from the Dirección General de Estadística y Censos (DIGESTYC), for the period of 2002 to 2012. Data on migration were derived from the 2007 Population Census, and inequality data were obtained from a study by Damianović, Valenzuela and Vera. The data reveal a stable standardized rate of total lethal violence (completed suicide plus homicide) across municipalities over time; a decline in suicide; and a standardized suicide rate decreasing with income inequality but increasing with social isolation. Municipalities clustered in terms of both total lethal violence and suicide standardized rates. Spatial effects for suicide were stronger among municipalities located in the north-east and center-south sides of the country. New clusters of municipalities with large suicide standardized rates were detected in the north-west, south-west and center-south regions, all of which are part of time-stable clusters of homicide. Prevention efforts to reduce income inequality and mitigate the negative effects of weak relational systems should focus upon municipalities forming time-persistent clusters with a large rate of death by suicide. In municipalities that are part of newly-formed suicide clusters and also are located in areas with a large rate of homicide, interrupting the expansion of spatial concentrations of suicide over time may require the implementation of both public health and public safety interventions.

Projected climate change threatens pollinators and crop production in Brazil.

PubMed

Giannini, Tereza Cristina; Costa, Wilian França; Cordeiro, Guaraci Duran; Imperatriz-Fonseca, Vera Lucia; Saraiva, Antonio Mauro; Biesmeijer, Jacobus; Garibaldi, Lucas Alejandro

2017-01-01

Animal pollination can impact food security since many crops depend on pollinators to produce fruits and seeds. However, the effects of projected climate change on crop pollinators and therefore on crop production are still unclear, especially for wild pollinators and aggregate community responses. Using species distributional modeling, we assessed the effects of climate change on the geographic distribution of 95 pollinator species of 13 Brazilian crops, and we estimated their relative impacts on crop production. We described these effects at the municipality level, and we assessed the crops that were grown, the gross production volume of these crops, the total crop production value, and the number of inhabitants. Overall, considering all crop species, we found that the projected climate change will reduce the probability of pollinator occurrence by almost 0.13 by 2050. Our models predict that almost 90% of the municipalities analyzed will face species loss. Decreases in the pollinator occurrence probability varied from 0.08 (persimmon) to 0.25 (tomato) and will potentially affect 9% (mandarin) to 100% (sunflower) of the municipalities that produce each crop. Municipalities in central and southern Brazil will potentially face relatively large impacts on crop production due to pollinator loss. In contrast, some municipalities in northern Brazil, particularly in the northwestern Amazon, could potentially benefit from climate change because pollinators of some crops may increase. The decline in the probability of pollinator occurrence is found in a large number of municipalities with the lowest GDP and will also likely affect some places where crop production is high (20% to 90% of the GDP) and where the number of inhabitants is also high (more than 6 million people). Our study highlights key municipalities where crops are economically important and where pollinators will potentially face the worst conditions due to climate change. However, pollinators may be able to find new suitable areas that have the potential to improve crop production. The results shown here could guide policy decisions for adapting to climate change and for preventing the loss of pollinator species and crop production.

The role of urban municipal governments in reducing health inequities: A meta-narrative mapping analysis

PubMed Central

2010-01-01

Background The 1986 Ottawa Charter for Health Promotion coincided with a preponderance of research, worldwide, on the social determinants of health and health inequities. Despite the establishment of a 'health inequities knowledge base', the precise roles for municipal governments in reducing health inequities at the local level remain poorly defined. The objective of this study was to monitor thematic trends in this knowledge base over time, and to track scholarly prescriptions for municipal government intervention on local health inequities. Methods Using meta-narrative mapping, four bodies of scholarly literature - 'health promotion', 'Healthy Cities', 'population health' and 'urban health' - that have made substantial contributions to the health inequities knowledge base were analyzed over the 1986-2006 timeframe. Article abstracts were retrieved from the four literature bodies using three electronic databases (PubMed, Sociological Abstracts, Web of Science), and coded for bibliographic characteristics, article themes and determinants of health profiles, and prescriptions for municipal government interventions on health inequities. Results 1004 journal abstracts pertaining to health inequities were analyzed. The overall quantity of abstracts increased considerably over the 20 year timeframe, and emerged primarily from the 'health promotion' and 'population health' literatures. 'Healthy lifestyles' and 'healthcare' were the most commonly emphasized themes in the abstracts. Only 17% of the abstracts articulated prescriptions for municipal government interventions on local health inequities. Such interventions included public health campaigns, partnering with other governments and non-governmental organizations for health interventions, and delivering effectively on existing responsibilities to improve health outcomes and reduce inequities. Abstracts originating from Europe, and from the 'Healthy Cities' and 'urban health' literatures, were most vocal regarding potential avenues for municipal government involvement on health inequities. Conclusions This study has demonstrated a pervasiveness of 'behavioural' and 'biomedical' perspectives, and a lack of consideration afforded to the roles and responsibilities of municipal governments, among the health inequities scholarly community. Thus, despite considerable research activity over the past two decades, the 'health inequities knowledge base' inadequately reflects the complex aetiology of, and solutions to, population health inequities. PMID:20500850

Spatial and temporal contrasts in the distribution of crops and pastures across Amazonia: A new agricultural land use data set from census data since 1950

PubMed Central

Imbach, P; Manrow, M; Barona, E; Barretto, A; Hyman, G; Ciais, P

2015-01-01

Amazonia holds the largest continuous area of tropical forests with intense land use change dynamics inducing water, carbon, and energy feedbacks with regional and global impacts. Much of our knowledge of land use change in Amazonia comes from studies of the Brazilian Amazon, which accounts for two thirds of the region. Amazonia outside of Brazil has received less attention because of the difficulty of acquiring consistent data across countries. We present here an agricultural statistics database of the entire Amazonia region, with a harmonized description of crops and pastures in geospatial format, based on administrative boundary data at the municipality level. The spatial coverage includes countries within Amazonia and spans censuses and surveys from 1950 to 2012. Harmonized crop and pasture types are explored by grouping annual and perennial cropping systems, C3 and C4 photosynthetic pathways, planted and natural pastures, and main crops. Our analysis examined the spatial pattern of ratios between classes of the groups and their correlation with the agricultural extent of crops and pastures within administrative units of the Amazon, by country, and census/survey dates. Significant correlations were found between all ratios and the fraction of agricultural lands of each administrative unit, with the exception of planted to natural pastures ratio and pasture lands extent. Brazil and Peru in most cases have significant correlations for all ratios analyzed even for specific census and survey dates. Results suggested improvements, and potential applications of the database for carbon, water, climate, and land use change studies are discussed. The database presented here provides an Amazon-wide improved data set on agricultural dynamics with expanded temporal and spatial coverage. Key Points Agricultural census database covers Amazon basin municipalities from 1950 to 2012Harmonized database groups crops and pastures by cropping system, C3/C4, and main cropsWe explored correlations between groups and the extent of agricultural lands PMID:26709335

Model-based analyses reveal insular population diversification and cryptic frog species in the Ischnocnema parva complex in the Atlantic forest of Brazil.

PubMed

Gehara, Marcelo; Barth, Adriane; Oliveira, Eliana Faria de; Costa, Marco Antonio; Haddad, Célio Fernando Baptista; Vences, Miguel

2017-07-01

The Atlantic Forest (AF) of Brazil has long been recognized as a biodiversity conservation hotspot. Despite decades of studies the species inventory of this biome continues to increase with the discovery of cryptic diversity and the description of new species. Different diversification mechanisms have been proposed to explain the diversity in the region, including models of forest dynamics, barriers to gene flow and dispersal. Also, sea level change is thought to have influenced coastal diversification and isolated populations on continental islands. However, the timing and mode of diversification of insular populations in the AF region were rarely investigated. Here, we analyze the phylogeography and species diversity of the small-sized direct-developing frog Ischnocnema parva. These frogs are independent from water bodies but dependent on forest cover and high humidity, and provide good models to understand forest dynamics and insular diversification. Our analysis was based on DNA sequences for one mitochondrial and four nuclear genes of 71 samples from 18 localities including two islands, São Sebastião, municipality of Ilhabela, and Mar Virado, municipality of Ubatuba, both in the state of São Paulo. We use molecular taxonomic methods to show that I. parva is composed of six independently evolving lineages, with the nominal I. parva likely endemic to the type locality. The time-calibrated species tree shows that these lineages have diverged in the Pliocene and Pleistocene, suggesting the persistence of micro-refuges of forest in the AF. For the two insular populations we used approximate Bayesian computation to test different diversification hypotheses. Our findings support isolation with migration for São Sebastião population, with ∼1Mya divergence time, and isolation without migration for Mar Virado population, with ∼13Kya divergence time, suggesting a combination of different processes for diversification on AF islands. Copyright © 2017. Published by Elsevier Inc.

Leaching, geochemical modelling and field verification of a municipal solid waste and a predominantly non-degradable waste landfill.

PubMed

van der Sloot, H A; Kosson, D S; van Zomeren, A

2017-05-01

In spite of the known heterogeneity, wastes destined for landfilling can be characterised for their leaching behaviour by the same protocols as soil, contaminated soil, sediments, sludge, compost, wood, waste and construction products. Characterisation leaching tests used in conjunction with chemical speciation modelling results in much more detailed insights into release controlling processes and factors than single step batch leaching tests like TCLP (USEPA) and EN12457 (EU Landfill Directive). Characterisation testing also can provide the potential for mechanistic impact assessments by making use of a chemical speciation fingerprint (CSF) derived from pH dependence leaching test results. This CSF then forms the basis for subsequent chemical equilibrium and reactive transport modelling to assess environmental impact in a landfill scenario under relevant exposure conditions, including conditions not readily evaluated through direct laboratory testing. This approach has been applied to municipal solid waste (MSW) and predominantly non-degradable waste (PNW) that is representative of a significant part of waste currently being landfilled. This work has shown that a multi-element modelling approach provides a useful description of the release from each of these matrices because relevant release controlling properties and parameters (mineral dissolution/precipitation, sorption on Fe and Al oxides, clay interaction, interaction with dissolved and particulate organic carbon and incorporation in solid solutions) are taken into consideration. Inclusion of dissolved and particulate organic matter in the model is important to properly describe release of the low concentration trace constituents observed in the leachate. The CSF allows the prediction of release under different redox and degradation conditions in the landfill by modifying the redox status and level of dissolved and particulate organic matter in the model runs. The CSF for MSW provides a useful starting point for comparing leachate data from other MSW landfills. Copyright © 2016 Elsevier Ltd. All rights reserved.

Acute myocardial infarction mortality in Cuba, 1999-2008.

PubMed

Armas, Nurys B; Ortega, Yanela Y; de la Noval, Reinaldo; Suárez, Ramón; Llerena, Lorenzo; Dueñas, Alfredo F

2012-10-01

Acute myocardial infarction is one of the leading causes of death in the world. This is also true in Cuba, where no national-level epidemiologic studies of related mortality have been published in recent years. Describe acute myocardial infarction mortality in Cuba from 1999 through 2008. A descriptive study was conducted of persons aged ≥25 years with a diagnosis of acute myocardial infarction from 1999 through 2008. Data were obtained from the Ministry of Public Health's National Statistics Division database for variables: age; sex; site (out of hospital, in hospital or in hospital emergency room) and location (jurisdiction) of death. Proportions, age- and sex-specific rates and age-standardized overall rates per 100,000 population were calculated and compared over time, using the two five-year time frames within the study period. A total of 145,808 persons who had suffered acute myocardial infarction were recorded, 75,512 of whom died, for a case-fatality rate of 51.8% (55.1% in 1999-2003 and 49.7% in 2004-2008). In the first five-year period, mortality was 98.9 per 100,000 population, falling to 81.8 per 100,000 in the second; most affected were people aged ≥75 years and men. Of Cuba's 14 provinces and special municipality, Havana, Havana City and Camagüey provinces, and the Isle of Youth Special Municipality showed the highest mortality; Holguín, Ciego de Ávila and Granma provinces the lowest. Out-of-hospital deaths accounted for the greatest proportion of deaths in both five-year periods (54.8% and 59.2% in 1999-2003 and 2004-2008, respectively). Although risk of death from acute myocardial infarction decreased through the study period, it remains a major health problem in Cuba. A national acute myocardial infarction case registry is needed. Also required is further research to help elucidate possible causes of Cuba's high acute myocardial infarction mortality: cardiovascular risk studies, studies of out-of-hospital mortality and quality of care assessments for these patients.

Spatial and temporal contrasts in the distribution of crops and pastures across Amazonia: A new agricultural land use data set from census data since 1950.

PubMed

Imbach, P; Manrow, M; Barona, E; Barretto, A; Hyman, G; Ciais, P

2015-06-01

Amazonia holds the largest continuous area of tropical forests with intense land use change dynamics inducing water, carbon, and energy feedbacks with regional and global impacts. Much of our knowledge of land use change in Amazonia comes from studies of the Brazilian Amazon, which accounts for two thirds of the region. Amazonia outside of Brazil has received less attention because of the difficulty of acquiring consistent data across countries. We present here an agricultural statistics database of the entire Amazonia region, with a harmonized description of crops and pastures in geospatial format, based on administrative boundary data at the municipality level. The spatial coverage includes countries within Amazonia and spans censuses and surveys from 1950 to 2012. Harmonized crop and pasture types are explored by grouping annual and perennial cropping systems, C3 and C4 photosynthetic pathways, planted and natural pastures, and main crops. Our analysis examined the spatial pattern of ratios between classes of the groups and their correlation with the agricultural extent of crops and pastures within administrative units of the Amazon, by country, and census/survey dates. Significant correlations were found between all ratios and the fraction of agricultural lands of each administrative unit, with the exception of planted to natural pastures ratio and pasture lands extent. Brazil and Peru in most cases have significant correlations for all ratios analyzed even for specific census and survey dates. Results suggested improvements, and potential applications of the database for carbon, water, climate, and land use change studies are discussed. The database presented here provides an Amazon-wide improved data set on agricultural dynamics with expanded temporal and spatial coverage. Agricultural census database covers Amazon basin municipalities from 1950 to 2012Harmonized database groups crops and pastures by cropping system, C3/C4, and main cropsWe explored correlations between groups and the extent of agricultural lands.

Mercury in municipal solid wastes and New Jersey mercury prevention and reduction program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Erdogan, H.; Stevenson, E.

1994-12-31

Mercury is a very toxic heavy metal which accumulates in the brain causing neurological damages involving psychasthenic and vegetative syndrome. At high exposure levels it causes behavioral and personality changes, loss of memory and insomnia. Long-term exposure or exposure during pregnancy to mercury or mercury compounds can permanently damage the kidney and fetus. In addition to potential effects on human health, mercury poisoning can also affect other living organisms. Mercury is different than other heavy metals. It consistently biomagnifies and bioaccumulates within the aquatic food chain. Global sources of mercury release are both natural and anthropogenic. Natural sources include volatilizationmore » of gaseous-mercury iron soils ana rocks, volcanic releases, evaporation from the ocean and other water bodies. Anthropogenic sources are fuel and coal combustion, mining, smelting, manufacturing activities, disposal of sludge, pesticides, animal and food waste, and incineration of municipal solid waste. Worldwide combustion of municipal solid waste is the second largest source of atmospheric emission of mercury. In New Jersey, incineration of solid waste is the largest source of atmospheric emission of mercury. The New Jersey Department of Environmental Protection and Energy (NJDEPE) has developed a comprehensive program to control and prevent emission of mercury resulting from combustion municipal solid waste.« less

A Tale of Two ObesCities: The Role of Municipal Governance in Reducing Childhood Obesity in New York City and London

PubMed Central

Libman, Kimberly; O’Keefe, Eileen

2010-01-01

As rates of childhood obesity and overweight rise around the world, researchers and policy makers seek new ways to reverse these trends. Given the concentration of the world’s population, income inequalities, unhealthy diets, and patterns of physical activity in cities, urban areas bear a disproportionate burden of obesity. To address these issues, in 2008, researchers from the City University of New York and London Metropolitan University created the Municipal Responses to Childhood Obesity Collaborative. The Collaborative examined three questions: What role has city government played in responding to childhood obesity in each jurisdiction? How have municipal governance structures in each city influenced its capacity to respond effectively? How can policy and programmatic interventions to reduce childhood obesity also reduce the growing socioeconomic and racial/ethnic inequities in its prevalence? Based on a review of existing initiatives in London and New York City, the Collaborative recommended 11 broad strategies by which each city could reduce childhood obesity. These recommendations were selected because they can be enacted at the municipal level; will reduce socioeconomic and racial/ethnic inequalities in obesity; are either well supported by research or are already being implemented in one city, demonstrating their feasibility; build on existing city assets; and are both green and healthy. PMID:20811951

A new methodology for royalties distribution of the Itaipu hydroelectric plant: The hydrographic basin as the unit of analysis.

PubMed

Lorenzon, Alexandre Simões; Ribeiro, Carlos Antonio Alvares Soares; Dos Santos, Alexandre Rosa; de Castro, Nero Lemos Martins; Marcatti, Gustavo Eduardo; Domingues, Getulio Fonseca; Teixeira, Thaisa Ribeiro; Silva, Elias; Soares, Vicente Paulo; Menezes, Sady Júnior Martins da Costa de; de Almeida Telles, Lucas Arthur; Mota, Pedro Henrique Santos

2018-07-01

Over the past few years, many sectors such as energy generation, industry, domestic supply, and agriculture have encountered serious environmental problems due to the lack of rainfall. Thus, the purpose of this paper is to review the current methodology of royalties distribution from Itaipu hydroelectric plant. In the proposed approach, two criteria were considered to establish the division of Itaipu royalties: (1) the relative percentage of the water flow in the generation of electricity and, (2) the relative percentage of the drop in the height of water. 62 hydroelectric plants were evaluated in this study. In 52 plants the water flow was the factor that most contributed to the generation of electricity. In 2013, 346 municipalities benefited the Itaipu royalties. With the proposed methodology, 1,327 municipalities will receive the resource, what would increase the revenue of each of these municipalities by, on average, US$ 87,436.91 per year. The methodology presented herein proposes a reduction in the environmental disparity that now exists in Brazil, through improvement to Government instruments and environmental policies. The distribution of royalties throughout the watershed can provide additional resources to support payment programs for environmental services at the state and municipality levels. Copyright © 2018 Elsevier Ltd. All rights reserved.

Aspects of Equality in Mandatory Partnerships – From the Perspective of Municipal Care in Norway

PubMed Central

Ljunggren, Birgitte

2016-01-01

Introduction: This paper raises questions about equality in partnerships, since imbalance in partnerships may effect collaboration outcomes in integrated care. We address aspects of equality in mandatory, public-public partnerships, from the perspective of municipal care. We have developed a questionnaire wherein the Norwegian Coordination Reform is an illustrative example. The following research question is addressed: What equality dimensions are important for municipals related to mandatory partnerships with hospitals? Theory/methods: Since we did not find any instrument to measure equality in partnerships, an explorative design was chosen. The development of the instrument was based on the theory on partnership and knowledge about the field and context. A national online survey was emitted to all 429 Norwegian municipalities in 2013. The response rate was in total 58 percent (n = 248). The data were mainly analysed using Principal component analysis. Results: It seems that the two dimensions “learning and expertise equality” and “contractual equality” collects reliable and valid data to measure aspects of equality in partnerships. Discussion: Partnerships are usually based on voluntarism. The results indicate that mandatory partnerships, within a public health care system, can be appropriate to equalize partnerships between health care providers at different care levels. PMID:27616962

The effect of moisture on the release and enrichment of heavy metals during pyrolysis of municipal solid waste.

PubMed

Raclavská, Helena; Corsaro, Agnieszka; Hlavsová, Adéla; Juchelková, Dagmar; Zajonc, Ondřej

2015-03-01

The investigation of the effect of moisture on the release and enrichment of heavy metals during pyrolysis of municipal solid waste is essential. This is important owing to: (i) the increasing amount of metals in the solid product of pyrolysis beyond the normalised level; (ii) the effect of moisture on the overall cost of pyrolysis process; and (iii) the utilisation of pyrolysis products. Seven metals were selected for evaluation: arsenic, cadmium, chromium, mercury, nickel, lead, and vanadium. Pyrolysis experiments were conducted in a steel retort at 650 °C. The municipal solid waste samples with moisture contents of 0, 30, and 65 wt% were investigated. The relative enrichment index and release of heavy metals were evaluated individually for liquid and solid fractions. A consistent trend was observed for the majority of metals investigated. Reductions of relative enrichment index and release, i.e. an increase of volatility, were observed for arsenic, chromium, cadmium, nickel, and vanadium, with an increase of municipal solid waste moisture. Whereas divergent results were obtained for lead and mercury. The effect of moisture on the relative enrichment index and release was greater at 65 wt% moisture than at 30 wt% for lead, and more remarkable at 30 wt% than at 65 wt% for mercury. © The Author(s) 2015.

Policy implications of transportation network companies.

DOT National Transportation Integrated Search

2016-01-01

This policy brief presents a brief introduction to transportation network companies (TNCs) and their services, a review of state-level legislation across the United States, and the municipal regulations that have been implemented in Texas in response...

40 CFR 81.354 - Northern Mariana Islands.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Municipality Unclassifiable/Attainment. Saipan Municipality Unclassifiable/Attainment. Tinian Municipality... Unclassifiable/Attainment. Rota Municipality Unclassifiable/Attainment Unclassifiable/Attainment. Saipan...

40 CFR 81.354 - Northern Mariana Islands.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Unclassifiable/Attainment. Saipan Municipality Unclassifiable/Attainment. Tinian Municipality Unclassifiable.../Attainment. Rota Municipality Unclassifiable/Attainment Unclassifiable/Attainment. Saipan Municipality...

Scaling-up primary health care-based prevention and management of heavy drinking at the municipal level in middle-income countries in Latin America: Background and protocol for a three-country quasi-experimental study

PubMed Central

Anderson, Peter; O'Donnell, Amy; Kaner, Eileen; Gual, Antoni; Schulte, Bernd; Pérez Gómez, Augusto; de Vries, Hein; Natera Rey, Guillermina; Rehm, Jürgen

2017-01-01

Background: While primary health care (PHC)-based prevention and management of heavy drinking is clinically effective and cost-effective, it remains poorly implemented in routine practice. Systematic reviews and multi-country studies have demonstrated the ability of training and support programmes to increase PHC-based screening and brief advice activity to reduce heavy drinking. However, gains have been only modest and short term at best. WHO studies have concluded that a more effective uptake could be achieved by embedding PHC activity within broader community and municipal support. Protocol: A quasi-experimental study will compare PHC-based prevention and management of heavy drinking in three intervention cities from Colombia, Mexico and Peru with three comparator cities from the same countries. In the implementation cities, primary health care units (PHCUs) will receive training embedded within ongoing supportive municipal action over an 18-month implementation period. In the comparator cities, practice as usual will continue at both municipal and PHCU levels. The primary outcome will be the proportion of consulting adult patients intervened with (screened and advice given to screen positives). The study is powered to detect a doubling of the outcome measure from an estimated 2.5/1,000 patients at baseline. Formal evaluation points will be at baseline, mid-point and end-point of the 18-month implementation period. We will present the ratio (plus 95% confidence interval) of the proportion of patients receiving intervention in the implementation cities with the proportions in the comparator cities. Full process evaluation will be undertaken, coupled with an analysis of potential contextual, financial and political-economy influencing factors. Discussion: This multi-country study will test the extent to which embedding PHC-based prevention and management of alcohol use disorder with supportive municipal action leads to improved scale-up of more patients with heavy drinking receiving appropriate advice and treatment. Study status: The four-year study will start on 1 st December 2017. PMID:29188013

SEA effectiveness for landscape and master planning: An investigation in Sardinia

DOE Office of Scientific and Technical Information (OSTI.GOV)

De Montis, Andrea, E-mail: andreadm@uniss.it; Ledda, Antonio, E-mail: antonioledda@gmail.com; Caschili, Simone, E-mail: s.caschili@ucl.ac.uk

The Italian administrative bodies and planning agencies have embraced with mixed feedbacks the introduction of Strategic Environmental Assessment (SEA) through the European Directive 2001/42/EC. Concurrently, regional and local spatial planning practice have been characterized by a new approach inspired by landscape planning. The Italian region of Sardinia has been one of the pioneering administrative bodies in the Italian and European arena that has adopted landscape principles for the construction of its regional master plan (PPR, Piano Paesaggistico Regionale). Municipalities are now carrying out the review of their master plans to the PPR's prescriptions and indications. Against this background, the aimmore » of this paper is to assess the level of SEA implementation in the municipal master plans of Sardinia, six years after the approval of the PPR. Rooted in the SEA international literature we construct a modular and adaptable on-line survey for officers involved in the review of municipal master plans. The results show that many Sardinian municipalities have not reviewed their master plans to the PPR's regulations yet and only a few municipalities have started this review process according to the SEA procedure. - Highlights: • We study strategic environmental assessment (SEA) effectiveness on land use plans • Four SEA implementation key issues are drawn from international literature • Data collection has included an on-line survey with close and open questions • Results indicate that SEA has been poorly implemented in landscape and master plans • Weak aspects include planning alternatives, financial resources, and monitoring.« less

Municipality Level Simulations of Dengue Fever Incidence in Puerto Rico Using Ground Based and Remotely Sensed Climate Data

NASA Technical Reports Server (NTRS)

Quattrochi, Dale A.; Morin, Cory

2015-01-01

Dengue fever (DF) is caused by a virus transmitted between humans and Aedes genus mosquitoes through blood feeding. In recent decades incidence of the disease has drastically increased in the tropical Americas, culminating with the Pan American outbreak in 2010 which resulted in 1.7 million reported cases. In Puerto Rico dengue is endemic, however, there is significant inter-annual, intraannual, and spatial variability in case loads. Variability in climate and the environment, herd immunity and virus genetics, and demographic characteristics may all contribute to differing patterns of transmission both spatially and temporally. Knowledge of climate influences on dengue incidence could facilitate development of early warning systems allowing public health workers to implement appropriate transmission intervention strategies. In this study, we simulate dengue incidence in several municipalities in Puerto Rico using population and meteorological data derived from ground based stations and remote sensing instruments. This data was used to drive a process based model of vector population development and virus transmission. Model parameter values for container composition, vector characteristics, and incubation period were chosen by employing a Monte Carlo approach. Multiple simulations were performed for each municipality and the results were compared with reported dengue cases. The best performing simulations were retained and their parameter values and meteorological input were compared between years and municipalities. Parameter values varied by municipality and year illustrating the complexity and sensitivity of the disease system. Local characteristics including the natural and built environment impact transmission dynamics and produce varying responses to meteorological conditions.

The operational context of care sport connectors in the Netherlands.

PubMed

Leenaars, K E F; van der Velden-Bollemaat, E C; Smit, E; Wagemakers, A; Molleman, G R M; Koelen, M A

2017-02-22

To stimulate physical activity (PA) and guide primary care patients towards local sport facilities, Care Sport Connectors (CSCs), to whom a broker role has been ascribed, were introduced in 2012 in the Netherlands. The aim of this study is to describe CSCs' operational context. A theoretical framework was developed and used as the starting point for this study. Group interviews were held with policymakers in nine participating municipalities, and, when applicable, the CSC's manager was also present. Prior to the interviews, a first outline of the operational context was mapped, based on the analysis of policy documents and a questionnaire completed by the policymakers. A deductive content analysis, based on the theoretical framework, was used to analyse the interviews. Differences were found in CSCs' operational context in the different municipalities, especially the extent to which municipalities adopted an integral approach. An integral approach consists of an integral policy in combination with an imbedding of this policy in partnerships at management level. This integral approach is reflected in the activities of other municipal operations, for example the implementation of health and PA programs by different organisations. Given the CSC mandate, we think that this integral approach may be supportive of the CSCs' work, because it is reflected in other operations of the municipalities and thus creates conditions for the CSCs' work. Further study is required to ascertain whether this integral approach is actually supporting CSCs in their work to connect the primary care and the PA sector. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Regionalization of municipal solid waste management in Japan: balancing the proximity principle with economic efficiency.

PubMed

Okuda, Itaru; Thomson, Vivian E

2007-07-01

The proximity principle - disposing of waste close to its origin - has been a central value in municipal solid waste (MSW) management in Japan for the last 30 years and its widespread adoption has helped resolve numerous "Not in My Backyard" issues related to MSW management. However, MSW management costs have soared, in large part because of aggressive recycling efforts and because most MSW is incinerated in a country that has scarce landfill capacity. In addition, smaller, less sophisticated incinerators have been closed because of high dioxin emissions. Rising costs combined with the closure of smaller incinerators have shifted MSW management policy toward regionalization, which is the sharing of waste management facilities across municipalities. Despite the increased use of regionalized MSW facilities, the proximity principle remains the central value in Japanese MSW management. Municipal solid waste management has become increasingly regionalized in the United States, too, but different driving forces are at work in these two countries. The transition to regionalized MSW management in Japan results from strong governmental control at all levels, with the central government providing funds and policy direction and prefectures and municipalities being the primary implementing authorities. By contrast, market forces are a much stronger force with US MSW management, where local governments - with state government oversight - have primary responsibility for MSW management. We describe recent changes in Japan's MSW programs. We examine the connections between MSW facility regionalization, on the one hand, and, on the other hand, the proximity principle, coordination among local governments, central government control, and financing mechanisms.

40 CFR 81.354 - Northern Mariana Islands.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Saipan Municipality Unclassifiable/Attainment. Tinian Municipality Unclassifiable/Attainment. a Includes... Municipality Unclassifiable/Attainment Unclassifiable/Attainment. Saipan Municipality Unclassifiable/Attainment...

40 CFR 81.354 - Northern Mariana Islands.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... Saipan Municipality Unclassifiable/Attainment. Tinian Municipality Unclassifiable/Attainment. a Includes... Municipality Unclassifiable/Attainment Unclassifiable/Attainment. Saipan Municipality Unclassifiable/Attainment...