Présence de métaux lourds et de résidus médicamenteux dans les effluents des établissements de santé de Dakar (Sénégal)

L’objectif de cette étude est de quantifier les concentrations en métaux lourds et de rechercher la présence de résidus de molécules médicamenteuses des effluents de trois hôpitaux de Dakar (Sénégal). C’est ainsi que la collecte des effluents a été réalisée chaque jour sur une période de trois semaines à l’entrée du déversoir des services de radiologie, de médecine interne et d’odontologie. Ensuite, des échantillons composites par semaine ont été constitués pour rechercher leur composition en métaux lourds et en résidus médicamenteux. Le transport a été effectué à +4 °C et à l'obscurité pour assurer une conservation satisfaisante. Les métaux lourds ont été dosés par ICP-MS et les résidus de médicaments ont été recherchés par UPLCMS/ MS. Les médicaments identifiés dans les effluents sont essentiellement des analgésiques et des psychotropes. La concentration en métaux lourds des effluents des trois hôpitaux est inférieure aux normes sénégalaises et de celles de L’OMS fixant les conditions de rejet de métaux dans les eaux usées. Cependant, bien que les taux retrouvés soient tolérables, leur introduction continuelle en milieu aquatique pourrait être à l’origine d’effets néfastes sur les organismes marins par des phénomènes de bioaccumulation et de biomagnification. D’où l’importance et la nécessité des stations d’épuration pour une bonne gestion et une réduction des risques écotoxicologiques liés aux effluents liquides hospitaliers.Mots clés : Effluents hospitaliers, métaux lourds, résidus médicamenteux, toxicité

Community health insurance amidst abolition of user fees in Uganda: the view from policy makers and health service managers

BACKGROUND: This paper investigates knowledge of Community Health Insurance (CHI) and the perception of its relevance by key policy makers and health service managers in Uganda. Community Health Insurance schemes currently operate in the private-not-for-profit sector, in settings where church-based facilities function. They operate in a wider policy environment where user fees in the public sector have been abolished. METHODS: Semi-structured interviews were conducted during the second half of 2007 with District Health Officers (DHOs) and senior staff of the Ministry of Health (MOH). The qualitative data collected were analyzed using the framework method, facilitated by EZ-Text software. RESULTS: There is poor knowledge and understanding of CHI activities by staff of the MOH headquarters and DHOs. However, a comparison of responses reveals a relatively high level of awareness of CHI principles among DHOs compared to that of MOH staff. All the DHOs in the districts with schemes had a good understanding of CHI principles compared to DHOs in districts without schemes. Out-of-pocket expenditure remains an important feature of health care financing in Uganda despite blanket abolition of user fees in government facilities. CONCLUSION: CHI is perceived as a relevant policy option and potential source of funds for health care. It is also considered a means of raising the quality of health care in both public and private health units. To assess whether it is also feasible to introduce CHI in the public sector, there is an urgent need to investigate the willingness and readiness of stakeholders, in particular high level political authorities, to follow this new path. The current ambiguity and contradictions in the health financing policy of the Uganda MOH need to be addressed and clarified

Photon Shielding Features of Quarry Tuff

Abstract. Cantera is a quarry tuff widely used in the building industry; in this work the shielding features of cantera were determined. The shielding characteristics were calculated using XCOM and MCNP5 codes for 0.03, 0.07, 0.1, 0.3, 0.662, 1, 2, and 3 MeV photons. With XCOM the mass interaction coefficients, and the total mass attenuation coefficients, were calculated. With the MCNP5 code a transmission experiment was modelled using a point-like source located 42 cm apart from a point-like detector. Between the source and the detector, cantera pieces with different thickness, ranging from 0 to 40 cm were included. The collided and uncollided photon fluence, the Kerma in air and the Ambient dose equivalent were estimated. With the uncollided fluence the linear attenuation coefficients were determined and compared with those calculated with XCOM. The linear attenuation coefficient for 0.662 MeV photons was compared with the coefficient measured with a NaI(Tl)-based �-ray spectrometer and a 137Cs source

Ethnobotanical study of cowpea (Vigna unguiculata (L.) Walp.) in Senegal

Open Access Article; Published online: 05 Feb 2022Cowpea (Vigna unguiculata) plays a key role in family farming systems in Senegal. It makes an essential contribution to economic, nutritional and food security. Although it is crucial, little is known about how farmers classify the diversity of local varieties or about the social practices associated with them. The aim of this study is to characterize the farming practices associated with growing cowpea in Senegal. Surveys were conducted involving 335 rural farmers living in 37 villages, spread across seven regions that produce cowpea. An average of ten farmers were randomly selected in each village. The results reveal that cowpea is a key feature of cropping systems in the studied area. Our findings highlight the high diversity of local cowpea varieties with 59 local names inventoried. In 75% of cases, the name refers to the seed’s morphology or color. Cowpea production is more diverse in Diourbel and Louga and less diverse in the south. More than half the farmers (57%) acquired their cowpea seeds (early, semi-early and late maturity varieties) outside their village, either from markets, seed suppliers or NGOs. This new understanding of farmers’ expertize in the management of cowpea and its local variability will help to valorize local diversity in breeding programs

Water

Meta-analysis can be a powerful tool for demonstrating the applicability of a concept beyond the context of individual clinical trials and observational studies, including exploration of effects across different subgroups. Meta-analysis avoids Simpson's paradox, in which a consistent effect in constituent trials is reversed when results are simply pooled. Meta-analysis in critical care medicine is made more complicated, however, by the heterogeneous nature of critically ill patients and the contexts within which they are treated. Failure to properly adjust for this heterogeneity risks missing important subgroup effects in, for example, the interaction of treatment with varying levels of baseline risk. When subgroups are defined by characteristics that vary within constituent trials (such as age) rather than features constant within each trial (such as drug dose), there is the additional risk of incorrect conclusions due to the ecological fallacy. The present review explains these problems and the strategies by which they are overcome

Ontogenic changes in hematopoietic hierarchy determine pediatric specificity and disease phenotype in fusion oncogene-driven myeloid leukemia

Fusion oncogenes are prevalent in several pediatric cancers, yet little is known about the specific associations between age and phenotype. We observed that fusion oncogenes, such as ETO2–GLIS2, are associated with acute megakaryoblastic or other myeloid leukemia subtypes in an age-dependent manner. Analysis of a novel inducible transgenic mouse model showed that ETO2–GLIS2 expression in fetal hematopoietic stem cells induced rapid megakaryoblastic leukemia whereas expression in adult bone marrow hematopoietic stem cells resulted in a shift toward myeloid transformation with a strikingly delayed in vivo leukemogenic potential. Chromatin accessibility and single-cell transcriptome analyses indicate ontogeny-dependent intrinsic and ETO2–GLIS2-induced differences in the activities of key transcription factors, including ERG, SPI1, GATA1, and CEBPA. Importantly, switching off the fusion oncogene restored terminal differentiation of the leukemic blasts. Together, these data show that aggressiveness and phenotypes in pediatric acute myeloid leukemia result from an ontogeny-related differential susceptibility to transformation by fusion oncogenes. SIGNIFICANCE: This work demonstrates that the clinical phenotype of pediatric acute myeloid leukemia is determined by ontogeny-dependent susceptibility for transformation by oncogenic fusion genes. The phenotype is maintained by potentially reversible alteration of key transcription factors, indicating that targeting of the fusions may overcome the differentiation blockage and revert the leukemic state

Thomas Decomposition and Nonlinear Control Systems

This paper applies the Thomas decomposition technique to nonlinear control systems, in particular to the study of the dependence of the system behavior on parameters. Thomas' algorithm is a symbolic method which splits a given system of nonlinear partial differential equations into a finite family of so-called simple systems which are formally integrable and define a partition of the solution set of the original differential system. Different simple systems of a Thomas decomposition describe different structural behavior of the control system in general. The paper gives an introduction to the Thomas decomposition method and shows how notions such as invertibility, observability and flat outputs can be studied. A Maple implementation of Thomas' algorithm is used to illustrate the techniques on explicit examples

Negotiating power relations, gender equality, and collective agency: are village health committees transformative social spaces in northern India?

BACKGROUND: Participatory health initiatives ideally support progressive social change and stronger collective agency for marginalized groups. However, this empowering potential is often limited by inequalities within communities and between communities and outside actors (i.e. government officials, policymakers). We examined how the participatory initiative of Village Health, Sanitation, and Nutrition Committees (VHSNCs) can enable and hinder the renegotiation of power in rural north India. METHODS: Over 18 months, we conducted 74 interviews and 18 focus groups with VHSNC members (including female community health workers and local government officials), non-VHSNC community members, NGO staff, and higherlevel functionaries. We observed 54 VHSNC-related events (such as trainings and meetings). Initial thematic network analysis supported further examination of power relations, gendered “social spaces,” and the “discourses of responsibility” that affected collective agency. RESULTS: VHSNCs supported some re-negotiation of intra-community inequalities, for example by enabling some women to speak in front of men and perform assertive public roles. However, the extent to which these new gender dynamics transformed relations beyond the VHSNC was limited. Furthermore, inequalities between the community and outside stakeholders were re-entrenched through a “discourse of responsibility”: The comparatively powerful outside stakeholders emphasized community responsibility for improving health without acknowledging or correcting barriers to effective VHSNC action. In response, some community members blamed peers for not taking up this responsibility, reinforcing a negative collective identity where participation was futile because no one would work for the greater good. Others resisted this discourse, arguing that the VHSNC alone was not responsible for taking action: Government must also intervene. This counter-narrative also positioned VHSNC participation as futile. CONCLUSIONS: Interventions to strengthen participation in health systems can engender social transformation. However they must consider how changing power relations can be sustained outside participatory spaces, and how discourse frames the rationale for community participation.ISIScopu