A Financial, Environmental and Social Evaluation of Domestic Water Management Options in the West Bank, Palestine

Water is one of the most valuable natural resources in the West Bank, Palestine. Due to its limited availability, it is a resource that needs particular protection. Although agriculture consumes most of the water (70%) in the West Bank, the domestic water supply is strategically not less important. It is the aim of this study to evaluate domestic water management options suitable for Palestinian conditions that contribute to achieving water sufficiency in the domestic water use in the house of tomorrow. A number of options were evaluated economically, environmentally and socially using the concept of life cycle impact assessment (LCIA). Results of the study showed that by introducing a combination of domestic water management options, a substantial decrease in the water consumption of more than 50% can be achieved, thereby reducing the pressure on the scarce water resources. The annual environmental impact of the in-house water use can be reduced in the range of 8%, when using low-flow shower head to 38% when using rainwater harvesting systems. Some of the options (faucet aerators, low-flow shower heads and dual flush toilets) were found to be financially attractive with a pay back period of less than their expected lives, others (rainwater harvesting, graywater reuse and dry toilets) were found to be financially unattractive because of the high investment. In the social context, it was found that introducing such options can improve the quality of life of those not having enough water. There is already a popular willingness to take part in water conservation in the domestic sector in the West Bank. The strongest driving force for using water conservation measures is the awareness that water is a scarce resource. It was concluded that, theoretically, the house of tomorrow can be largely independent in terms of water and sanitation. Education and awareness campaigns in the context of water management with a focus on non-traditional options are key to achieve such a house.Water ManagementCivil Engineering and Geoscience

Congenital malformations in Rio de Janeiro, Brazil: prevalence and associated factors Malformações congênitas no Município do Rio de Janeiro, Brasil: prevalência e fatores associados a sua ocorrência

This study aims to estimate the prevalence of congenital malformations and their correlation with socioeconomic and maternal variables. The design was cross-sectional, based on a sample of 9,386 postpartum women after admission for childbirth in maternity hospitals in the city of Rio de Janeiro, Brazil. Data were collected through interviews with mothers in the immediate postpartum, as well as by consulting the patient records of both the mothers and newborn infants. Prevalence of congenital malformations at birth was 1.7%, and minor malformations were the most frequent. Neural tube defects were the most frequent major malformations. According to multivariate analysis, congenital malformations were statistically associated with: maternity hospitals belonging to or outsourced by the Unified National Health System (SUS) and inadequate prenatal care (&frac34; 3 visits). This study highlights the importance of measures for health promotion and disease prevention in childbearing-age women, with special attention to prenatal care and childbirth, which can directly influence neonatal indicators and prevention of birth defects.<br>Este trabalho tem como objetivo estimar a prevalência ao nascimento das malformações congênitas e sua associação com escolaridade e outras características maternas. Trata-se de um estudo seccional, a partir de uma amostra de 9.386 puérperas hospitalizadas em maternidades do Município do Rio de Janeiro, Brasil, no momento do parto, no período de 1999 a 2001. Os dados foram coletados através de entrevistas com as mães, no pós-parto imediato, assim como consulta aos prontuários das puérperas e dos recém-nascidos. A prevalência ao nascimento de malformação congênita foi de 1,7% e as malformações menores foram as mais freqüentes (polidactilia e pé torto congênito). Os defeitos de fechamento do tubo neural foram as principais anomalias maiores detectadas. Na análise multivariada, a anomalia congênita esteve associada à maternidade ser pública ou conveniada com o SUS e receber inadequada assistência pré-natal (até três consultas). Ressalta-se neste estudo a importância de ações de promoção da saúde e prevenção de agravos a mulheres em idade fértil, com atenção especial para o atendimento ao pré-natal e ao parto, que podem repercutir diretamente nos indicadores infantis e na prevenção das anomalias congênitas

Speciation of Cr, Cu, Ni and Zn in soils irrigated with contaminated waters: A case study of agricultural soils from the plain of Saiss (Fez, Morocco)

The excessive input of heavy metals into agricultural soils has become one of the most important concerns in the third world cities all over the world. The contamination of agricultural soils can affect the health of people living in agricultural areas and the surrounding ecosystems. The current study was conducted to assess the quality of urban and suburban soils of the City of Fez (Morocco), which are irrigated by waters enriched by heavy metals. The main objective was to define the distribution and the mobility of heavy metals in different soil compartments using the method of sequential extractions. The samples were also investigated for mineralogy using X-ray diffraction. The identified minerals were mainly composed of quartz, carbonate and clay minerals. Smectite and mixed-layer (chlorite-vermiculite and mica-smectite) are by far the most abundant clay minerals in all soils. The study of the availability and distribution of heavy metals (Cr, Cu, Ni, Pb and Zn) in urban soils, allowed us to observe a total content of Cr in the Oued Fez soils which is lower than the contents in the Oued Sebou soils. The Cu and Zn contents are low in Oued Sebou. Despite the Oued Fez input; the contents of these elements in the confluence do not increase. Sequential extractions completed the study of the potential mobility of heavy metals in different fractions of the soil. Indeed, this has allowed us to show that Cr, Cu, Ni and Pb are mostly related to the residual fraction; they are therefore theoretically little mobile; while Zn is practically related to the metals oxides fraction and exchangeable phase, respectively, in soils (FEZ1, FEZ2, SEBup) and (SEBdown, SEBconf), therefore the Zn is potentially mobile

Clinical predictors of abnormal esophageal pH monitoring in preterm infants Preditores clínicos para pHmetria esofágica anormal em prematuros

BACKGROUND: Risk factors for gastroesophageal reflux disease in preterm neonates have not been yet clearly defined. AIM: To identify factors associated with increased esophageal acid exposition in preterm infants during the stay in the neonatal unit. METHODS: A case-control study in preterm infants who had undergone prolonged monitoring of distal esophageal pH, following clinical indication. Eighty-seven preterms with reflux index (percentage of total time of esophageal pHmetry) >10% (cases) and 87 unpaired preterms were selected with reflux index <10% (controls). Demographic variables, signs and symptoms, main diagnoses and some aspects of treatment were studied. Simple and multiple logistic regression analysis adjusted for birthweight and postconceptional age at the pH study were used. RESULTS: The factors associated with a greater chance of reflux index >10% in preterms were: vomiting, regurgitation, Apnea, female gender. The variables that were associated with a lower frequency of increased reflux index were: volume of enteral intake at the onset of symptoms >147 mL/kg/day, and postnatal corticoid use. CONCLUSIONS: Vomiting, regurgitation, apnea, female gender and acute respiratory distress during the first week of life were variables predictive of increased esophageal acid exposition in preterm infants with birthweight <2000 g. Bronchopulmonary dysplasia and use of caffeine were not associated with reflux index >10%.<br>RACIONAL: Os fatores de risco para a doença pelo refluxo gastroesofágico em recém-nascidos prematuros não foram, até momento, claramente estabelecidos. OBJETIVO: Identificar fatores associados ao aumento da exposição ácida intra-esofágica em prematuros durante o período de internação em unidade neonatal. MÉTODOS: Realizou-se estudo de caso controle com prematuros que realizaram monitorização prolongada do pH esofágico por suspeita clínica de doença do refluxo. Foram selecionados 87 recém-nascidos com valor do índice de refluxo (percentual do tempo total do exame com pH abaixo de 4) >10% (casos) e 87 recém-nascidos com índice de refluxo <10% (controles). Casos e controles não foram emparelhados. As variáveis estudadas foram as demográficas, os sinais e sintomas clínicos, os principais diagnósticos e alguns aspectos da terapêutica. Foram utilizadas as análises de regressão logística uni e multivariada, ambas ajustadas pelo peso ao nascimento e pela idade pós-conceptual no momento do estudo de pH. RESULTADOS: Os fatores que se associaram a maior chance de índice de refluxo >10% foram: vômitos, regurgitações, apnéia, sexo feminino e insuficiência respiratória na 1ª semana de vida. As variáveis que se associaram a menor freqüência de índice de refluxo <10% foram: volume de mamada ao início dos sintomas >147mL/kg/d e uso de corticóide pós-natal. CONCLUSÕES: Vômitos, regurgitações, apnéia, sexo feminino e a insuficiência respiratória na primeira semana de vida foram variáveis preditoras para elevada exposição ácida do esôfago em prematuros com peso ao nascer <2000 g. A displasia broncopulmonar e o uso de cafeína não se associaram ao índice de refluxo >10%