AN INVESTIGATION OF SUSTAINABLE FLUORIDE WATER TREATMENT TECHNOLOGIES WITH A FOCUS ON ETHIOPIA

Human consumption of unsafe drinking water from an unimproved source is a global issue affecting approximately 748 million people worldwide. While this number has been decreasing in recent years, an additional 1.2 billion people are estimated to lack access to water that is consistently free from health risks. This dissertation begins with a literature review investigating drinking water improvement initiatives around the world and a discussion of reasons why these initiatives often fail. Resources are provided for researchers and practitioners working on drinking water treatment implementations and examples of implementations that have failed or succeeded are discussed. The conclusion from this review is that global drinking water solutions will be more effective when designed and implemented by personnel from multiple disciplines. For example, people in several fields, including: social sciences, engineering and business, should collaborate and share ideas and expertise. Ideally this collaboration should start at the genesis of a project and continue through implementation and follow up. There is hope that the synergistic efforts of multidisciplinary teams will help to increase the number of successful water initiatives. Next the dissertation focuses on the problem of elevated fluoride concentrations in drinking water. Naturally occurring fluoride is the second largest issue contributing to the global water crisis. It is estimated that globally over 200 million people are affected by elevated concentrations of fluoride in drinking water. The goal of the technical portion of this dissertation is to investigate locally available and sustainable materials that can be used to remove fluoride from drinking water, with a focus on Ethiopia and eastern Sub-Saharan Africa. Bone char is very effective as an adsorptive material, but is not always accepted by communities due to religious or cultural beliefs. Therefore, this research evaluated methods to improve the fluoride removal capacity of bone char as well as investigated materials that might serve as a replacement for bone char in appropriate communities. Eucalyptus trees are prevalent in Ethiopia where a large fluoride problem exists, and thus, eucalyptus wood char was investigated as a potential substitute for bone char. This dissertation studied wood char produced from Eucalyptus robusta as an adsorption material to remove fluoride from water, thereby making it safe for consumption. Although the use of eucalyptus wood char alone removed minimal fluoride, when it was amended with aluminum and iron oxides it evidenced much higher fluoride removal capacities. Metal oxides, produced from starting materials such as aluminum sulfate and iron (III) nitrate, were used to amend the wood char. Metal amendments resulted in fluoride removal capacities ranging from 3 to 50 times higher than wood char without amendment. The combination of wood char and metal oxide amendment is synergistic because the wood char provides a matrix with a high specific surface area for the metal oxides to adhere to while the metal oxide amendment increases the electrostatic attraction of the char surface for fluoride. Additionally, wood char was pretreated with oxidizing agents such as hydrogen peroxide and potassium permanganate prior to metal amendment. These pretreated and metal amended chars were found, in most cases, to have increased metal loading rates and, in some cases, higher fluoride removal capacities. This dissertation also looked at ways to improve the adsorption effectiveness of bone char for communities where bone char is an acceptable material for drinking water treatment. Amending bone char with aluminum nitrate showed an increase in fluoride removal at high equilibrium concentrations but not at low equilibrium concentrations close to the WHO recommended value for fluoride (1.5 mg/L). Select fluoride removal materials, including aluminum impregnated wood char, activated alumina, bone char and aluminum amended bone char, were studied in the field using groundwater from a well in a rural Ethiopian community. Field results suggested that the combination of elevated groundwater pH along with competing ions such as sulfate (both common in ground waters of the Ethiopian Rift Valley) affected the fluoride removal capacities of the materials studied, particularly the aluminum impregnated wood char. Finally, this research tested the validity of the Rapid Small Scale Column Tests (RSSCT) principles for bone char adsorbing fluoride from water. These experiments indicated that RSSCT principles are applicable for bone char; use of this approach can result in large time and cost savings to researchers and implementers. Overall, this dissertation provides several conclusions that are practically helpful to researchers in the field and also foundational research on which future studies can build to continue efforts to find sustainable and appropriate fluoride removal technologies

Sustainable use and implementation of bone char as a technology for arsenic and fluoride removal

Arsenic and fluoride are key issues in the global water challenge as they exist above the World Health Organization (WHO) recommended limits of 0.010 mg/L and 1.5 mg/L, respectively, in the natural drinking water sources of many regions of the world. The suitability of using several types of bone char as a sustainable removal technology for arsenic and fluoride in remote areas of developing countries is evaluated. The results suggest that 500˚C is the ideal charring temperature for fish bone char based on removal capacity and aesthetic concerns, such as water discoloration and smell, and that there is no significant competition found when removing fluoride and arsenic simultaneously. Current water projects often fail after one to three years for a variety of reasons. Therefore, implementation strategies will also be discussed

Linking the Medical and Educational Home to Support Children With Autism Spectrum Disorder: Practice Recommendations

Children with autism spectrum disorder (ASD) present with complex medical problems that are often exacerbated by a range of other intellectual and psychiatric comorbidities. These children receive care for their physical and mental health from a range of providers within numerous child-serving systems, including their primary care clinic, school, and the home and community. Given the longitudinal nature in which care is provided for this chronic disorder, it is particularly necessary for services and providers to coordinate their care to ensure optimal efficiency and effectiveness. There are 2 primary venues that serve as a “home” for coordination of service provision for children with ASD and their families—the “medical home” and the “educational home.” Unfortunately, these venues often function independently from the other. Furthermore, there are limited guidelines demonstrating methods through which pediatricians and other primary care providers (PCPs) can coordinate care with schools and school-based providers. The purpose of this article is 2-fold: (1) we highlight the provision of evidence-based care within the medical home and educational home and (2) we offer practice recommendations for PCPs in integrating these systems to optimally address the complex medical, intellectual, and psychiatric symptomology affected by autism

Small Water Enterprise in Rural Rwanda: Business Development and Year-One Performance Evaluation of Nine Water Kiosks at Health Care Facilities

Small water enterprises (SWEs) have lower capital expenditures than centralized systems, offering decentralized solutions for rural markets. This study evaluated SWEs in rural Rwanda, where nine health care facilities (HCF) owned and operated water kiosks supplying water from onsite water treatment systems (WTS). SWEs were monitored for 12 months. Spearman’s Rank Correlation Coefficient (rs) was used to evaluate correlations between demand for kiosk water and community characteristics, and between kiosk profit and factors influencing the cost model. On average, SWEs distributed 15,300 L/month. One SWE ran at a loss, four had profit margins of ≤10% and four had profit margins of 45–75%. Factors influencing SWE performance were intermittent water supply (87% of SWE closures were due to water shortage), consumer demand (demand was high where populations already used improved water sources (rs = 0.81, p = 0.02)), price sensitivity (demand was lower where SWEs had high prices (rs = −0.65, p = 0.08)), and production cost (water utility tariffs negatively impacted SWE profits (rs = −0.52, p < 0.01)). Sustainability was more favorable in circumstances where recovery of capital expenditures was not expected, and the demand for treated water was sufficient to fund operational expenditures. Future research is needed to assess the extent to which kiosk revenue can support ongoing operational costs of WTS and kiosks both at HCF and in other contexts

Mechanisms of late-onset cognitive decline after early-life stress.

Progressive cognitive deficits that emerge with aging are a result of complex interactions of genetic and environmental factors. Whereas much has been learned about the genetic underpinnings of these disorders, the nature of "acquired" contributing factors, and the mechanisms by which they promote progressive learning and memory dysfunction, remain largely unknown. Here, we demonstrate that a period of early-life "psychological" stress causes late-onset, selective deterioration of both complex behavior and synaptic plasticity: two forms of memory involving the hippocampus, were severely but selectively impaired in middle-aged, but not young adult, rats exposed to fragmented maternal care during the early postnatal period. At the cellular level, disturbances to hippocampal long-term potentiation paralleled the behavioral changes and were accompanied by dendritic atrophy and mossy fiber expansion. These findings constitute the first evidence that a short period of stress early in life can lead to delayed, progressive impairments of synaptic and behavioral measures of hippocampal function, with potential implications to the basis of age-related cognitive disorders in humans