A qualitative analysis of environmental policy and children's health in Mexico

<p>Abstract</p> <p>Background</p> <p>Since Mexico's joining the North American Free Trade Agreement (NAFTA) and the Organization for Economic Cooperation and Development (OECD) in 1994, it has witnessed rapid industrialization. A byproduct of this industrialization is increasing population exposure to environmental pollutants, of which some have been associated with childhood disease. We therefore identified and assessed the adequacy of existing international and Mexican governance instruments and policy tools to protect children from environmental hazards.</p> <p>Methods</p> <p>We first systematically reviewed PubMed, the Mexican legal code and the websites of the United Nations, World Health Organization, NAFTA and OECD as of July 2007 to identify the relevant governance instruments, and analyzed the approach these instruments took to preventing childhood diseases of environmental origin. Secondly, we interviewed a purposive sample of high-level government officials, researchers and non-governmental organization representatives, to identify their opinions and attitudes towards children's environmental health and potential barriers to child-specific protective legislation and implementation.</p> <p>Results</p> <p>We identified only one policy tool describing specific measures to reduce developmental neurotoxicity and other children's health effects from lead. Other governance instruments mention children's unique vulnerability to ozone, particulate matter and carbon monoxide, but do not provide further details. Most interviewees were aware of Mexican environmental policy tools addressing children's health needs, but agreed that, with few exceptions, environmental policies do not address the specific health needs of children and pregnant women. Interviewees also cited state centralization of power, communication barriers and political resistance as reasons for the absence of a strong regulatory platform.</p> <p>Conclusions</p> <p>The Mexican government has not sufficiently accounted for children's unique vulnerability to environmental contaminants. If regulation and legislation are not updated and implemented to protect children, increases in preventable exposures to toxic chemicals in the environment may ensue.</p

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

N2O and CH4 emissions from a fallow-wheat rotation with low N input in conservation and conventional tillage under a Mediterranean agroecosystem

Conservation agriculture that includes no tillage (NT) or minimum tillage (MT) and crop rotation is an effective practice to increase soil organic matter in Mediterranean semiarid agrosystems. But the impact of these agricultural practices on greenhouse gases (GHGs), such as nitrous oxide (N2O) and methane (CH4), is variable depending mainly on soil structure and short/long-term tillage. The main objective of this study was to assess the long-term effect of three tillage systems (NT, MT and conventional tillage (CT)) and land-covers (fallow/wheat) on the emissions of N2O and CH4 in a low N input agricultural system during one year. This was achieved by measuring crop yields, soil mineral N and dissolved organic C contents, and fluxes of N2O and CH4. Total cumulative N2O emissions were not significantly different (P&gt;0.05) among the tillage systems or between fallow and wheat. The only difference was produced in spring, when N2O emissions were significantly higher (P&lt;0.05) in fallow than in wheat subplots, and NT reduced N2O emissions (P&lt;0.05) compared with MT and CT. Taking into account the water filled pore space (WFPS), both nitrification and denitrification could have occurred during the experimental period. Denitrification capacity in March was similar in all tillage systems, in spite of the higher DOC content maintained in the topsoil of NT. This could be due to the similar denitrifier densities, targeted by nirK copy numbers at that time. Cumulative CH4 fluxes resulted in small net uptake for all treatments, and no significant differences were found among tillage systems or between fallow and wheat land-covers. These results suggest that under a coarse-textured soil in low N agricultural systems, the impact of tillage on GHG is very low and that the fallow cycle within a crop rotation is not a useful strategy to reduce GHG emissions. © 2014 Elsevier B.V

Nitrous oxide and methane emissions from a vetch cropping season are changed by long-term tillage practices in a Mediterranean agroecosystem

Lower greenhouse gas (GHG) emissions from legume-based cropping systems have encouraged their use to deliver mitigation in agricultural systems. Considerable uncertainties remain about the interaction of legumes with long-term tillage systems on GHG emissions under rainfed agroecosystems. In this context, a field experiment was undertaken under a rainfed vetch crop to evaluate the effect of three long-term tillage systems (i.e. no tillage (NT), minimum tillage (MT) and conventional tillage (CT)) on nitrous oxide (N2O) and methane (CH4) emissions for 1 year. Different N2O flux patterns were observed among tillage systems during the growth period of vetch, which depended on the soil conditions favouring nitrification and denitrification. The NT system maintained a higher sink for N2O than MT and CT from January to mid-April, which significantly reduced N2O emissions at this stage. In this period, denitrification capacity and nirK gene numbers were higher for MT than NT and CT. Additionally, an increase in soil NO− 3 content and more favourable denitrification conditions in MT and NT than in CT for the last crop period increased N2O emissions in conservation tillage systems. Total annual N2O losses were significantly higher in MT (124.2 g N2O–N ha−1) than NT (51.1 g N2O–N ha−1) and CT (54 g N2O–N ha−1) in a vetch crop. Low net uptake of CH4 was observed for all tillage systems. These results suggested that long-term NT may be a better option thanMT to mitigate GHG emissions in rainfed legume-cereal rotation. © Springer-Verlag Berlin Heidelberg 2014

Effect of tillage and crop (cereal versus legume) on greenhouse gas emissions and Global Warming Potential in a non-irrigated Mediterranean field

Crop rotation with legumes and conservation tillage systems are advisable practices in rainfed Mediterranean agro-ecosystems, since, in these areas, soils are broadly characterized by low organic matter contents and low fertility. These management practices can substantially modify the dynamics of soil greenhouse gas (GHG) emissions, carbon sequestration and carbon dioxide (CO2) emissions derived from system inputs and farm operations. In this context, a field experiment was conducted under Mediterranean conditions to evaluate the effect of three long-term tillage systems (no tillage (NT), minimum tillage (MT) and conventional tillage (CT)) and two crops (vetch (V, Vicia sativa L.) versus barley (B, Hordeum vulgare L.)) on nitrous oxide (N2O), methane (CH4) and CO2 emissions during one year. Crop yields, soil mineral nitrogen concentrations, dissolved organic carbon and GHG fluxes were measured during the growing season. Soil organic carbon was measured in spring 2012 (18 years after the beginning of a long-term tillage experiment) and together with input and fuel consumption by farm machinery was used to compare the Global Warming Potential (GWP) of the different crop and tillage treatments. Cumulative fluxes of N2O ranged between 0.16 (B-MT) and 0.29 (V-MT) kg N2O-N ha-1 yr-1, resulting in a lower impact on Net GWP than in previous studies. A significant 'tillage × crop' interaction was observed in cumulative N2O emissions (V resulted in higher N2O losses than barley in CT and MT, whereas similar fluxes were observed under NT), which was influenced by soil water-filled pore space, dissolved organic carbon content and denitrification losses, in spite of the presumable predominance of nitrification. Neither tillage nor crop influenced CH4 or CO2 emissions. Yield-scaled N2O emissions (YSNE) were low (&lt;4 g N2O-N kg aboveground N uptake-1) and significantly higher in B than in V. The most sustainable crop and tillage treatments in terms of GWP were non-fertilized-V and NT, due to higher carbon sequestration and lower fuel consumption under NT and the absence of mineral N fertilizers in V. These crop and tillage treatments could be considered good management strategies in rainfed Mediterranean agro-ecosystems since they provide the best balance between soil emissions, YSNE and Net GWP. © 2016 Elsevier B.V.