Pollution of water in Africa: a review of contaminants and fish as biomonitors and analytical methodologies-the case of Senegal.

Environmental pollution is one of the major problems facing human health, ecosystems, and biodiversity. This is particularly the case for water quality in Senegal. Fish can be used as a biomonitor of pollution by accumulating pollutants from the environment through their tissues. Fish is an indispensable element in the assessment of the quality of the environment due to the diversity of biological cycles and their position in the food chain. Fish, which is very sensitive to chemical and bacterial pollution, concentrates pollutants and is a good indicator of water quality. This review presents water pollution in Senegal and the possibility of using fish as an ideal monitoring matrix for marine environments, to detect the concentration of heavy metals and organic pollutants. The different extraction and analytical techniques used for fish biomonitoring will be also described.

Application of the QuEChERS method for the determination of pesticides, PAHs and PCBs in fish in Senegal.

Pollution of water by persistent organic pollutants is well described; however, little is known about the accumulation of these pollutants by aquatic organisms. For this reason, a method based on QuEChERS extraction and gas chromatography coupled to tandem mass spectrometry (GC-MS/MS) was developed for the determination of pesticides, polychlorinated biphenyls (PCBs) and polycyclic aromatic hydrocarbons (PAHs) in the muscles of five fish species from the bay of Soumbedioune (Dakar, Senegal). This method shows good recoveries of extraction (68.2-98.1% for pesticides, 83.87-98.10% for PAHs and 81.30-98.15% for PCBs), precision (% RSD ≤ 1%), sensitivity (LODs between 0.001 and 0.079 ng g-1), linearity (R2 ≥ 0.99) and repeatability and reproducibility, evaluated for three concentration levels (10 ng g-1, 200 ng g-1 and 500 ng g-1), ≤ 15% for the majority of pollutants under study except for alachlor, atrazine, acetochlor, dicofol, deltamethrin and dichlorvos where a RSD ≥ 20% was determined for the 10 ng g-1 concentration. Organic pollutants have been detected in fish from the Soumbedioune coast demonstrating the necessity of a regular survey of water and fish in order to protect the populations.

Cost control, a myth or reality: do hospital costs really go down when quality goes up?

Quality improvement is needed to meet the demands for quality while simultaneously reducing the cost of delivered health care. In a competitive market of corporate hospitals, quality improvement would lower the proportion of unit cost relative to potential revenue thereby increasing profit. For public hospitals, the mandate for 'minimum quality', which is the basis for accreditation, could also be attained by efficient use of hospital resources.

Developing hospital efficiency-cost control measures.

The purpose of this paper is to provide hospital managers with important knowledge and skills in developing efficiency measures that hospital can use as guidelines in monitoring and controlling operational costs. Efficiency measures are judgmental and comparative. Cost and quantity are the variables in the computation of efficiency measures but it is very important to integrate these variables with quality. A hospital is efficient if it can render quality service at the most cost effective manner.