Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 408
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-39136396

RESUMO

We assessed the oxidative potential (OP) of PM2.5 (n = 230) using dithiothreitol (DTT) assay to identify the major emission sources in Bhubaneswar (20.20°N, 85.80°E), one of the non-attainment cities under the National Clean Air Program, situated on the eastern coast of India. Continuous day and night PM2.5 samples were collected during periods influenced by marine airmass (MAM; April-May 2019) as well as continental airmass (CAM; October 2019-December 2019). Volume normalized DTT (DDTv) activities were approximately two times higher during CAM compared to MAM periods. In contrast, mass normalized DTT activity (DDTm) showed insignificant variations between CAM and MAM periods. This might be due to particulate organic matter, which accounted for more than one-fifth of the PM2.5 mass loading and remained surprisingly invariant during the study periods. Positive matrix factorization (PMF) identified secondary aerosols (MAM: 26% and CAM: 33%) as dominant contributors to PM2.5 mass in both periods. OP, is, however, dominated by vehicular emissions (21%) as identified through multiple linear regression. Conditional Bivariate Probability Function (CBPF) analysis indicated that local sources were the primary drivers for the catalytic activity of PM2.5 in the study region. Additionally, stagnant meteorological conditions, combined with the chemical aging of species during regional transport of pollutants, likely enhanced redox activity of PM2.5 during the CAM period. The study highlights that increasing traffic congestion is primarily responsible for adverse health outcomes in the region. Therefore, it is important to regulate mobility and vehicular movement to mitigate the hazardous impact of PM2.5 in Bhubaneswar.

2.
Sci Total Environ ; 949: 175072, 2024 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-39084378

RESUMO

Atmospheric aerosols have a serious impact on altering the radiation balance of the vulnerable Himalayan atmosphere. Organic aerosol (OA), one of the least resolved aerosol fractions in the Himalayas, constrain our competence to assess their climate impacts on the region. Here we investigate water-soluble OA molecules in PM10 samples collected from March to May 2019 at Lachung (27.4°N and 88.4°E), a high-altitude location (2700 m a.s.l.) in the eastern Himalaya, to elucidate their origin and formation process. The dominance of oxalic acid (C2) reveals that water-soluble OA in the eastern Himalaya are atmospherically processed. Backward air mass trajectories and mass concentration ratios of organic tracers as well as relationships with inorganic species (K+, SO42-, NH4+) suggest an anthropogenic origin of water-soluble OA with significant atmospheric processing during long-range transport to the eastern Himalayan region. We used the thermodynamic prediction of aerosol liquid water (ALW) to examine the formation mechanism of secondary OA (SOA) such as oxalic acid. Correlations of ALW with SO42- and water-soluble organic matter show that ALW is sensitive to both anthropogenic sulfate and water-soluble organic compounds in Himalayan aerosols. A strong positive relationship of C2 acid with predicted ALW provides evidence of extensive SOA formation from precursors via aqueous phase photochemical processes. This inference is supported by positive correlations of C2 acid relative abundance with diagnostic mass concentration ratios of C2 acid to precursor molecules. Our findings underscore the importance of anthropogenic sources and ALW in SOA formation through aqueous phase processes in the eastern Himalaya.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38966514

RESUMO

Patients with cirrhosis that are hospitalized with COVID-19 infection have been found to have worse outcomes. No comparative study has been conducted between gastrointestinal (GI) bleeding in patients with cirrhosis who are diagnosed with COVID-19. We utilized the National Inpatient Sample (NIS) database to perform a retrospective analysis of 24, 050 patients diagnosed with cirrhosis and COVID-19. The identified patients were separated into variceal bleeding, nonvariceal bleeding, and no (or neither) GI bleeding groups. After performing propensity sample matching and multivariate analysis of mortality, we found no significant differences in mortality among the three groups. However, the variceal bleed group had a shorter length of stay (5.67 days lower than the no-bleed group). Esophagogastroduodenoscopy (EGD) with intervention was associated with reduced mortality in the variceal and nonvariceal bleeding groups. Acute kidney injury was a strong predictor of mortality in both bleeding groups. A native American race was found to be associated with higher mortality in the nonvariceal bleeding group. Our study suggests that there are various pathophysiological processes among the three groups, with no significant mortality differences with cirrhosis complications of GI bleeding.

4.
Sci Rep ; 14(1): 14528, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38914618

RESUMO

Spatial and temporal shifts in rainfall patterns over South Asia and the adjoining Seas during the pre-monsoon season have been observed over the past 2 decades from 2000 to 2019. Aerosol particles suspended above the boundary layer are a contributing factor to these changes. These particles not only alter cloud characteristics, but also diminish the lapse rate, thereby suppressing convective activity, leading to precipitation anomalies. Over the past 2 decades, high-rainfall regions have experienced declining rainfall, while low-rainfall regions have received increased rainfall. Coinciding with notable anomalies in precipitation, contrasting trends in aerosol optical depth, particularly due to absorbing aerosols in the elevated regions of the atmosphere, are seen. Apart from aerosols, several factors are considered that are critical in modifying precipitation patterns over the study region, such as water vapor content, convective processes, and lower-level relative humidity. We observed a potential transport of excess water vapor by ambient circulation from the oceanic regions having reduced rain, such as Bay of Bengal and the Arabian Sea, to higher latitudes enabling precipitation anomaly at distant locations.

5.
Sci Total Environ ; 942: 173780, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-38844230

RESUMO

Arctic regions are extremely sensitive to global warming. Aerosols are one of the most important short-lived climate-forcing agents affecting the Arctic climate. The present study examines the summertime chemical characteristics and potential sources of various organic and inorganic aerosols at a Norwegian Arctic site, Ny-Ålesund (79°N). The results show that organic matter (OM) accounts for 60 % of the total PM10 mass, followed by sulfate (SO42-). Water-soluble organic carbon (WSOC) contributes 62 % of OC. Photochemical processes involving diverse anthropogenic and biogenic precursor compounds are identified as the major sources of WSOC, while water-insoluble organic carbon (WIOC) aerosols are predominantly linked to primary marine emissions. Despite being a remote pristine site, the aerosols show a sign of chemical aging, evidenced by a significant chloride depletion, which was about 82 % on average during the study period. Nitrogen-containing aerosols are likely stemming from migratory seabird colonies and local dust sources around the sampling site. While biogenic, crustal, and sea salt-derived SO42- account for 37%, 8%, and 5% respectively, the remaining 50% is attributed to anthropogenic SO42-. Through chemical tracers, Pearson correlation coefficient matrix, and Hierarchical Cluster Analysis (HCA), the present study identifies soil biota (terrestrial biogenic) and marine emissions, along with their photochemical oxidation processes, as potential sources of Arctic aerosols during summer, while biomass burning and combustion-related sources have a minor contribution. The chemical closure of hygroscopicity highlights that while organics predominantly control aerosol hygroscopicity in the Arctic summer, specific inorganic components like (NH4)2SO4 can significantly increase it on certain days, affecting aerosol-cloud interactions and climate processes over the Arctic during summer. The present study highlights the high abundance of organics and their vital role in the Arctic climate during summer when natural aerosols are conquered.

6.
Mater Horiz ; 11(14): 3213-3266, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-38717455

RESUMO

Cerium oxide nanoparticles (CeNPs) are versatile materials with unique and unusual properties that vary depending on their surface chemistry, size, shape, coating, oxidation states, crystallinity, dopant, and structural and surface defects. This review encompasses advances made over the past twenty years in the development of CeNPs and ceria-based nanostructures, the structural determinants affecting their activity, and translation of these distinct features into applications. The two oxidation states of nanosized CeNPs (Ce3+/Ce4+) coexisting at the nanoscale level facilitate the formation of oxygen vacancies and defect states, which confer extremely high reactivity and oxygen buffering capacity and the ability to act as catalysts for oxidation and reduction reactions. However, the method of synthesis, surface functionalization, surface coating and defects are important factors in determining their properties. This review highlights key properties of CeNPs, their synthesis, interactions, and reaction pathways and provides examples of emerging applications. Due to their unique properties, CeNPs have become quintessential candidates for catalysis, chemical mechanical planarization (CMP), sensing, biomedical applications, and environmental remediation, with tremendous potential to create novel products and translational innovations in a wide range of industries. This review highlights the timely relevance and the transformative potential of these materials in addressing societal challenges and driving technological advancements across these fields.

8.
Sci Rep ; 14(1): 7453, 2024 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-38548774

RESUMO

The recent developments in quantum technology have opened up new opportunities for machine learning algorithms to assist the healthcare industry in diagnosing complex health disorders, such as heart disease. In this work, we summarize the effectiveness of QuEML in heart disease prediction. To evaluate the performance of QuEML against traditional machine learning algorithms, the Kaggle heart disease dataset was used which contains 1190 samples out of which 53% of samples are labeled as positive samples and rest 47% samples are labeled as negative samples. The performance of QuEML was evaluated in terms of accuracy, precision, recall, specificity, F1 score, and training time against traditional machine learning algorithms. From the experimental results, it has been observed that proposed quantum approaches predicted around 50.03% of positive samples as positive and an average of 44.65% of negative samples are predicted as negative whereas traditional machine learning approaches could predict around 49.78% of positive samples as positive and 44.31% of negative samples as negative. Furthermore, the computational complexity of QuEML was measured which consumed average of 670 µs for its training whereas traditional machine learning algorithms could consume an average 862.5 µs for training. Hence, QuEL was found to be a promising approach in heart disease prediction with an accuracy rate of 0.6% higher and training time of 192.5 µs faster than that of traditional machine learning approaches.


Assuntos
Algoritmos , Cardiopatias , Humanos , Aprendizado de Máquina
9.
Arthrosc Tech ; 13(1): 102809, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38312870

RESUMO

Soft-tissue grafts are an option for anterior cruciate ligament reconstruction. One of the major drawbacks of soft-tissue grafts is the delay in the osteointegration and ligamentization of the implanted graft. Enveloping the ends of the graft with periosteum sleeves can hasten the osteointegration process and help in quicker rehabilitation of the patient. This article describes a simple and unique way to augment the soft-tissue graft with periosteum for anterior cruciate ligament reconstruction.

10.
Sci Total Environ ; 901: 166461, 2023 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-37607630

RESUMO

Aerosol-bound water, a ubiquitous and abundant component of atmospheric aerosols, has an impact on regional climate, visibility, human health, the hydrological cycle, and atmospheric chemistry. Yet, the intricate relationship between aerosol liquid water (ALWC) and chemical composition and relative humidity (RH) was not well understood. The present study explores ALWC derived from the ISORROPIA II model using real-time, high-resolution data of non-refractory submicron chemical species and meteorological parameters (temperature and RH) collected over the Indian Ocean as part of the ICARB (Integrated Campaign for Aerosols, Gases, and Radiation Budget)-2018 experiment. Results show that ALWC values over the South Eastern Arabian Sea (SEAS) were found to be higher by 4-6 times than those observed over the Equatorial Indian Ocean (EIO) due to a large decrease in aerosol loading from SEAS to EIO. ALWC peaked in the early morning hours (4:00-7:00), with greater values during the nighttime and lower values during the daytime across SEAS, which is comparable with RH variation. While the ratio of organics-to-SO42- mass fraction linearly decreased with increasing mass-based growth factors (MGFs) over EIO, such a scenario was not observed over SEAS. The latitudinal gradient of mass fraction of ALWC had shown a decrease towards EIO, consistent with organic fraction. The extinction coefficient of the dry mass of submicron particles is noticeably increased by 40 % by ALWC over SEAS and EIO. Moreover, ALWC could enhance the aerosol negative forcing by an average of 66 % (64 %) over SEAS (EIO) at the top of the atmosphere during the cruise period. These inferences imply that ALWC is the key factor in assessing the role of aerosols on atmospheric radiative forcing. Overall, the present study highlights the serious need to consider the ALWC in climate forcing simulations, particularly in moist tropical environments where their effect can be significant.

11.
Nat Commun ; 14(1): 4950, 2023 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-37587109

RESUMO

Residual stresses affect the performance and reliability of most manufactured goods and are prevalent in casting, welding, and additive manufacturing (AM, 3D printing). Residual stresses are associated with plastic strain gradients accrued due to transient thermal stress. Complex thermal conditions in AM produce similarly complex residual stress patterns. However, measuring real-time effects of processing on stress evolution is not possible with conventional techniques. Here we use operando neutron diffraction to characterize transient phase transformations and lattice strain evolution during AM of a low-temperature transformation steel. Combining diffraction, infrared and simulation data reveals that elastic and plastic strain distributions are controlled by motion of the face-centered cubic and body-centered cubic phase boundary. Our results provide a new pathway to design residual stress states and property distributions within additively manufactured components. These findings will enable control of residual stress distributions for advantages such as improved fatigue life or resistance to stress-corrosion cracking.

12.
Sci Total Environ ; 900: 165644, 2023 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-37495130

RESUMO

Water-soluble organic carbon (WSOC) has been identified as a key component in atmospheric aerosols due to its ability to act as cloud condensation nuclei (CCN) owing to their highly hygroscopic nature. This paper discusses about the spatio-temporal variability in WSOC mass concentration, sources (primary and secondary contributions), the role of long-range air-mass transport in modulating their abundance, at distinct sectors over South Asia. We found from our observations that, photochemical ageing of primary organic aerosols that are derived from biomass emissions, significantly contribute to the total WSOC budget over South Asia. The wide range of water-soluble compounds released by biomass burning can contribute directly to the WSOC fraction or undergo further atmospheric processing, such as oxidation or ageing, leading to the formation of additional WSOC. WSOC/OC (organic carbon) ratio and the correlation between the WSOC and secondary organic carbon (SOC) are used for assessing the contribution from secondary sources. The three different ratios are used to delineate different source processes; OC/EC (elemental carbon) for source identification, WSOC/OC for long-range atmospheric transport (ageing) and WSOC/SOC to understand the primary and secondary contribution of WSOC. The present investigation revealed that, the primary OC that have undergone significant chemical processing as a result of long-range transport have a substantial influence on WSOC formation over South Asia, especially in Indo Gangetic Plain outflow regions such as southern peninsular and adjacent marine regions. Overall, oxidation and ageing of primary organic aerosols emitted from biomass burning was found to serve as an important source of WSOC over South Asia.

13.
Biomed Chromatogr ; 37(9): e5695, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37406633

RESUMO

Fipronil is a broad-spectrum phenyl pyrazole insecticide that has a high degree of environmental toxicity. Commonly available chilies in the market are treated with fipronil insecticides. Demand for insecticide-free chili has thus been increasing globally. This needs various sustainable and economical methods to remove insecticides from chilies. The present study examined the effectiveness of several cleaning methods to remove pesticide residues in chili fruits. A supervised field trial was conducted in randomized block design at Rajasthan Agricultural Research Institute, Durgapura, Jaipur, India. Chili samples were subjected to seven different household methods. The samples were extracted using the quick, easy, cheap, effective, rugged, and safe (QuEChERS) method. The residues were analyzed using a gas chromatograph-electron capture detector and confirmed by GC-MS. Of the seven methods, the acetic acid treatment removes the maximum residue effect of fipronil and its metabolites (desulfinyl [MB046513]), sulfide (MB045950), and sulfone (MB046136) on chili fruits. By contrast, the tap water treatment was the least effective. The Food Safety and Standards Authority of India (FSSAI) have set the maximum residue limit value of 0.001 mg kg-1 for fipronil on green chili.


Assuntos
Capsicum , Inseticidas , Resíduos de Praguicidas , Capsicum/química , Frutas/química , Descontaminação , Índia , Inseticidas/análise , Pirazóis/química , Resíduos de Praguicidas/análise
14.
J Dent Anesth Pain Med ; 23(3): 163-171, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37313268

RESUMO

Background: Surgical extraction of impacted mandibular third molars is the most common procedure performed by oral surgeons. The procedure cannot be performed effectively without achieving profound anesthesia. During this procedure, patients may feel pain during surgical bone removal (at the cancellous level) or during splitting and luxation of the tooth, despite administration of routine nerve blocks. Administration of intraosseous (IO) lignocaine injections during third molar surgeries to provide effective anesthesia for pain alleviation has been documented. However, whether the anesthetic effect of lignocaine is the only reason for pain alleviation when administered intraosseously remains unclear. This conundrum motivated us to assess the efficacy of IO normal saline versus lignocaine injections during surgical removal of impacted mandibular third molars. The aim of this study was to assess the efficacy of IO normal saline as a viable alternative or adjunct to lignocaine for alleviation of intraoperative pain during surgical removal of impacted mandibular third molars. Methods: This randomized, double-blind, interventional study included 160 patients who underwent surgical extraction of impacted mandibular third molars and experienced pain during surgical removal of the buccal bone or sectioning and luxation of the tooth. The participants were divided into two groups: the study group, which included patients who would receive IO saline injections, and the control group, which included patients who would receive IO lignocaine injections. Patients were asked to complete a visual analog pain scale (VAPS) at baseline and after receiving the IO injections. Results: Of the 160 patients included in this study, 80 received IO lignocaine (control group), whereas 80 received IO saline (study group) following randomization. The baseline VAPS score of the patients and controls was 5.71 ± 1.33 and 5.68 ± 1.21, respectively. The difference between the baseline VAPS scores of the two groups was not statistically significant (P > 0.05). The difference between the numbers of patients who experienced pain relief following administration of IO lignocaine (n=74) versus saline (n=69) was not statistically significant (P > 0.05). The difference between VAPS scores measured after IO injection in both groups was not statistically significant (P >0.05) (1.05 ± 1.20 for the control group vs. 1.72 ± 1.56 for the study group). Conclusion: The study demonstrates that IO injection of normal saline is as effective as lignocaine in alleviating pain during surgical removal of impacted mandibular third molars and can be used as an effective adjunct to conventional lignocaine injection.

15.
Public Health Action ; 13(2): 34-36, 2023 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-37359061

RESUMO

Undernutrition is the leading risk factor for TB infection and death in India. We undertook a micro-costing analysis of a nutritional intervention for household contacts of people living with TB in Puducherry, India. We found that the total 6-month food cost for a family of four was USD4/day. We also identified several alternative regimens and cost-lowering strategies to encourage wider adoption of nutritional supplementation as a public health tool.


La sous-nutrition est le principal facteur de risque d'infection et de décès dus à la TB en Inde. Nous avons entrepris une analyse de micro-coût d'une intervention nutritionnelle destinée aux contacts familiaux des personnes atteintes de la TB à Puducherry, en Inde. Nous avons constaté que le coût total de la nourriture pendant 6 mois pour une famille de quatre personnes était de 4 USD par jour. Nous avons également identifié plusieurs régimes alternatifs et stratégies de réduction des coûts pour encourager une adoption plus large de la supplémentation nutritionnelle en tant qu'outil de santé publique.

16.
Sci Total Environ ; 887: 164105, 2023 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-37172851

RESUMO

Oxidative potential (OP) of fine marine aerosols (PM2.5) over the northern Indian Ocean (N_IO) and equatorial Indian Ocean (E_IO) were studied using shipborne measurements conducted as part of the Integrated Campaign for Aerosols, gases and Radiation Budget (ICARB-2018). During the study, an enhanced concentration of PM2.5 was found over N_IO (27.22 ± 14.29 µg.m-3) compared with E_IO (15.91 ± 2.58 µg.m-3), as N_IO experiences continental outflow from anthropogenically dominated South Asian region. However, E_IO received pristine air masses from the middle of the Arabian Sea, implying a reduced concentration. The OP of PM2.5 was evaluated using a dithiothreitol (DTT) assay. The mass (DTTm or intrinsic OP) and volume (DTTv or extrinsic OP) normalized DTT exhibited a significant spatial variation over the Indian Ocean (IO). Intrinsic OP showed ∼2 times higher values over N_IO than E_IO, indicating aging of aerosols during long-range transport impacts OP of marine aerosol. Similarly, increased concentrations of anthropogenic species such as non-sea sulfate (nssSO42-), nitrate (NO3-), ammonium (NH4+), non-sea potassium ion (nssK+), water-soluble transition metals (Fe, Ti, Zn, Cu, Mn, Cr), elemental carbon (EC), organic carbon (OC), water-soluble organic carbon (WSOC), were also observed over N_IO compared with E_IO. Pearson correlation and multiple linear regression (MLR) analysis revealed that combustion sources, chemical processing and co-transportation of anthropogenic species during long-range transport are the main drivers of intrinsic OP in the outflow region.

17.
Sci Rep ; 13(1): 5321, 2023 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-37002285

RESUMO

This paper presents a novel method that uses the cold metal transfer based wire arc additive manufacturing process to fabricate functionally graded Inconel 825-SS316L walls. The optical micrograph of Inconel 825 exhibits continuous and discontinuous dendritic structures. The SS316L region comprises 5% of δ-ferrite in primary austenitic (γ) dendrites which was confirmed by the Creq/Nieq ratio of 1.305. The functionally graded interface reveals a partially mixed zone with a transition from the elongated dendrites to fine equiaxed dendrites. The tensile properties of the fabricated wall were determined at room temperature using specimens extracted from Inconel 825, SS316L, and the interface regions. The morphology of the tensile tested specimens revealed significant plastic deformation, indicating ductile failure. The fracture toughness of the wall was experimentally investigated by employing the crack tip opening displacement (CTOD) test. The fracture morphology exhibited a ductile mode of fracture with striations perpendicular to the direction of crack development. Elemental mapping revealed that there was no evidence of elemental segregation on the fractured surfaces, and the elements were uniformly dispersed. The CTOD measures 0.853 mm, 0.873 mm on the Inconel 825 side and the SS316L side respectively. The test results confirm that both the Inconel 825 and SS316L sides have good fracture toughness.

19.
Public Health Action ; 13(Suppl 1): 6-11, 2023 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-36949745

RESUMO

SETTING: The Kerala health system in India has more than 25 years of decentralised implementation experience. Decentralization could assist in addressing health disparities such as gender, disability, and migration. OBJECTIVE: To explore how inequity issues comprising gender, disability and internal migrations were being addressed at present by the decentralised Kerala health system. DESIGN: Our approach was qualitative, using document review, key informant interviews and in-depth interviews with policy makers, health staff and other stakeholders. RESULTS: Gender aspects were incorporated into planning and budgeting, with 10% funds earmarked for women. Projects were gender-specific to women, and within conventional social roles of livelihood, welfare or reproductive health. Recently, transgender focused projects were also initiated. Schemes for people with disabilities remained welfare-centric and driven by top-down policies. The local governments performed beneficiary identification and benefit disbursal. Migrant health aspects were focused on infectious diseases surveillance and later living conditions of migrant workers. CONCLUSION: The importance that health systems place on socioeconomic determinants of health and fundamental human rights is reflected in the health interventions for marginalised communities. In Kerala, there is now a passive application of central rules and a reluctance to utilise local platforms. Changing this is a necessary condition for achieving equal development.


CONTEXTE: Le système de santé du Kérala en Inde possède plus de 25 ans d'expérience de mise en œuvre décentralisée. La décentralisation pourrait aider à lutter contre les disparités en matière de santé, telles que le genre, le handicap et la migration. OBJECTIF: Examiner comment les questions d'inégalité, notamment le genre, le handicap et les migrations internes, sont actuellement abordées par le système de santé décentralisé du Kérala. MÉTHODES: Notre approche qualitative s'est appuyée sur une analyse documentaire, des entretiens avec des informateurs clés et des entretiens approfondis avec des décideurs politiques, du personnel de santé et d'autres parties prenantes. RÉSULTATS: Les aspects liés au genre ont été intégrés dans la planification et les prévisions budgétaires, en réservant 10 % des fonds aux femmes. Les projets s'adressaient uniquement aux femmes et s'inscrivaient dans le cadre des rôles sociaux conventionnels de subsistance, de bien-être ou de santé génésique. Récemment, des projets axés sur les transsexuels ont également été lancés. Les programmes destinés aux personnes porteuses de handicaps restaient axés sur l'aide sociale et dictés par des politiques descendantes. Les gouvernements locaux se chargeaient de l'identification des bénéficiaires et du versement des prestations. Les aspects de la santé des migrants étaient axés sur la surveillance des maladies infectieuses, puis sur les conditions de vie des travailleurs migrants. CONCLUSION: L'importance accordée par les systèmes de santé aux déterminants socio-économiques de la santé et aux droits fondamentaux de l'homme se reflète dans les interventions sanitaires destinées aux communautés marginalisées. Au Kérala, on constate aujourd'hui une application passive des règles centrales et une réticence à utiliser les plateformes locales. Changer cet état de fait est une condition nécessaire pour parvenir à un développement égalitaire.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...