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1.
Lancet Glob Health ; 6(6): e691-e702, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29773123

RESUMEN

BACKGROUND: Interventions to reduce child deaths in Africa have often underachieved, causing the Millennium Development Goal targets to be missed. We assessed whether a community enquiry into the circumstances of death could improve intervention effectiveness by identifying local avoidable factors and explaining implementation failures. METHODS: Deaths of children younger than 5 years were ascertained by community informants in two districts in Mali (762 deaths) and three districts in Uganda (442 deaths) in 2011-15. Deaths were investigated by interviewing parents and health workers. Investigation findings were reviewed by a panel of local health-care workers and community representatives, who formulated recommendations to address avoidable factors and, subsequently, oversaw their implementation. FINDINGS: At least one avoidable factor was identified in 97% (95% CI 96-98, 737 of 756) of deaths in children younger than 5 years in Mali and 95% (93-97, 389 of 409) in Uganda. Suboptimal newborn care was a factor in 76% (146 of 194) of neonatal deaths in Mali and 64% (134 of 194) in Uganda. The most frequent avoidable factor in postneonatal deaths was inadequate child protection (mainly child neglect) in Uganda (29%, 63 of 215) and malnutrition in Mali (22%, 124 of 562). 84% (618 of 736 in Mali, 328 of 391 in Uganda) of families had consulted a health-care provider for the fatal illness, but the quality of care was often inadequate. Even in official primary care clinics, danger signs were often missed (43% of cases in Mali [135 of 396], 39% in Uganda [30 of 78]), essential treatment was not given (39% in Mali [154 of 396], 35% in Uganda [27 of 78]), and patients who were seriously ill were not referred to a hospital in time (51% in Mali [202 of 396], 45% in Uganda [35 of 78]). Local recommendations focused on quality of care in health-care facilities and on community issues influencing treatment-seeking behaviour. INTERPRETATION: Local investigation and review of circumstances of death of children in sub-Saharan Africa is likely to lead to more effective interventions than simple consideration of the biomedical causes of death. This approach discerned local public health priorities and implementable solutions to address the avoidable factors identified. FUNDING: European Union's 7th Framework Programme for research and technological development.


Asunto(s)
Causas de Muerte , Mortalidad del Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Malí/epidemiología , Embarazo , Factores de Riesgo , Uganda/epidemiología
2.
Sci Total Environ ; 580: 1489-1504, 2017 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-28041693

RESUMEN

Sustainable water management remains a global concern to meet the food needs of industrial and agricultural activities. Therefore, pollution abatement techniques, cheap and environmentally, are highly desired and recommended. The present review is devoted to the origin and the toxicity of nitrogen-containing organic compounds in water. The progress made in removing these pollutants, in recent years, is addressed. However, a prominent place is given to the photocatalytic degradation process using the TiO2 as a semiconductor, the conditions for good mineralization and especially the factors influencing it. The parameters that impact the performance of this method are the pH, the temperature, the reactor used, the light, the concentration of the pollutant, the amount of catalyst, etc. Up to now, the importance of one parameter relative to another has not been established because in the context of the photocatalytic degradation, certain parameters are often tightly coupled. Consequently, the mineralization is dependent on the initial degree of oxidation of nitrogen atom contained in the pollutant to be degraded. The hydroxyl nitrogen is primarily converted into nitrate ions (NO3-), while the amides and the primary amines are converted into ammonium ions (NH4+).


Asunto(s)
Nitrógeno/química , Titanio/química , Contaminantes Químicos del Agua/química , Catálisis
3.
Water Sci Technol ; 60(8): 2187-93, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19844066

RESUMEN

In order to remove pesticides from water, a basic photoreactor has been built. We evaluated the performance of this photoreactor using two commercial photocatalytic materials from Ahlstrom group and from Saint-Gobain, with solar and artificial UV-lamps. We compared the kinetics of photocatalytic degradation and mineralization of Diuron in the same reactor with of both photocatalyst supports. We showed that Diuron is easily degraded under solar or artificial irradiation, while the kinetics of mineralization in the same condition are very slow. The behaviour of these commercial materials has been studied after several uses in the same conditions. We showed the effectiveness of this basic and cheap photoreactor for the elimination of pesticide in water.


Asunto(s)
Diurona/aislamiento & purificación , Plaguicidas/aislamiento & purificación , Fotoquímica/economía , Fotoquímica/instrumentación , Luz Solar , Contaminantes Químicos del Agua/aislamiento & purificación , Agua/química , Carbono/análisis , Catálisis/efectos de la radiación , Celulosa/ultraestructura , Conservación de los Recursos Naturales , Análisis Costo-Beneficio , Diseño de Equipo , Cinética , Cuarzo/química , Soluciones , Factores de Tiempo
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