The STARPAHC collection: part of an archive of the history of telemedicine

An early telemedicine project involving NASA, the Papago Tribe (now the Tohono O'odham Indian Nation), the Lockheed Missile and Space Company, the Indian Health Service and the Department of Health, Education and Welfare explored the possibilities of using technology to provide improved health care to a remote population in southern Arizona. The project, called STARPAHC (Space Technology Applied to Rural Papago Advanced Health Care), took place in the 1970s and demonstrated the feasibility of a consortium of public and private partners working together to provide medical care to remote populations via telecommunication. In 2001 the Arizona Health Sciences Library acquired important archival materials documenting the STARPAHC project and in collaboration with the Arizona Telemedicine Program established the Arizona Archive of Telemedicine. The material is likely to interest those studying early attempts to use technology to deliver health care at a distance, as well as those studying the sociological ramifications of technical and scientific projects among indigenous populations.     

Clinical characteristics of non-insulin-dependent diabetes mellitus among southwestern American Indian youths

The clinical characteristics and presentation of non-insulin-dependent diabetes mellitus (NIDDM) among 22 youths, aged less than 20 years, of an American Indian tribe Tohono O'odham Nation in the southwestern United States were studied. Ten males and 12 females (7-20 years old) were identified with a 13.7-year mean age of onset of diabetes. Over 80% (18/22) of the patients were obese at diagnosis having a body mass index greater than the 95th percentile for their age and sex, and there was a strong family history of NIDDM; eight patients were born to mothers who had gestational diabetes, and 19 patients had at least one parent with NIDDM. At the time of diagnosis, plasma glucose levels ranged from 10.3 mmol/L to 33 mmol/L, with nearly 60% (13/22) of the patients having a glucose reading greater than 16.8 mmol/L. C-peptide levels were done on 10 patients, and these were in the normal to elevated range. Clinical management of the 22 patients varied. To control hyperglycaemia and symptoms, such as nocturia and polyuria, 14 patients were on oral hypoglycaemic medication, and five were on insulin therapy. Compliance with dietary management was very difficult for these patients as evidenced by the fact that only three patients were on dietary control for their diabetes. The cases described in this series demonstrate NIDDM in childhood and illustrate the importance of accurate classification of diabetes during childhood, particularly in children from populations at high risk for NIDDM.     

Gardening for Health: Patterns of Gardening and Fruit and Vegetable Consumption Among the Navajo

American Indians, including Navajo, are disproportionately affected by obesity and diabetes, in part due to diet-related health behaviors. The purpose of this study was to assess the patterns of gardening and fruit and vegetable (FV) consumption among residents in two communities on the Navajo Nation in order to inform a community gardening intervention. We analyzed survey data collected from participants in the Yéego Gardening study conducted in two communities in the Navajo Nation (N?=?169). We found that 51% of the sample gardened, and on average participants gardened 8.9 times per month. Lack of time (53%) and financial barriers, such as gas for transportation or irrigation (51 and 49%, respectively), were reported as barriers to gardening. Most participants reported low levels of self-efficacy (80%) and behavioral capability (82%) related to gardening. Those with higher levels of gardening self-efficacy and behavioral capability reported more frequent gardening. Average daily FV consumption was 2.5 servings. Most participants reported high levels of self-efficacy to eat FV daily (64%) and high behavioral capability to prepare FV (66%). There was a positive association between FV consumption and gardening, with those gardening more than 4 times per month eating about 1 more serving of FV per day than those gardening 4 or fewer times per month. Further research is needed to better understand how gardening can increase fruit and vegetable availability and consumption among residents of the Navajo Nation.     

Solid‐waste management: Sampling,analysis and assessment of household waste in the city of Amman

The prominent problem in current solid‐waste management is the rapid increase in amounts of solid waste and the extensive environmental pollution. This trend is observable in Jordan where the natural conditions are deteriorating and serious environmental problems may occur. This study focuses on several topics: First, a detailed monthly examination of constituents of refuse is presented and compared with other industrialized and developing countries. Second, total refuse quantities and per capita production for two different communities are analysed. The per capita production of solid waste in Amman is less than any industrialized countries, and two to three times higher than middle‐income countries. Third, the volume and weight of solid waste generated varies seasonally. These variations exhibit strong diurnal and seasonal dependence on population growth, density and interrelated socioeconomic characteristics of people. Fourth, an assessment of solid waste to the year 2000, is made using a solid‐waste sub‐model. The estimated quantity for the year 2000 is 3668.5 tons per day, which would imply an increase of 5.38% per year. Fifth, the paper concludes with a brief discussion of future policy directions to solve the solid‐waste problem and prevent future problems from occurring.     

Micro-plastics in the Vicinity of an Urban Solid Waste Management Facility in India: Assessment and Policy Implications

The study focuses on analyzing the presence and quantity of microplastics near an unscientific solid waste dumping site located at Kochi city in India and thereby assessing the contribution of massive open dumping towards microplastic pollution in the river. Two sets of sampling with three sediment samples from nearby Kadambrayar river and five topsoil samples from various parts of the Brahmapuram waste dumping yard were carried out during January – February 2019. The samples were analyzed as per the US National Oceanic and Atmospheric Administration (US NOAA) protocol. ATR-FTIR and DSC analysis based characterization indicated that polyethylene dominated the micro plastics followed by polypropylene and polystyrene. The size distribution of particles showed that comparatively larger particles of size range between 2.36 ??4.75 mm were present in the topsoil than that in river sediments which had more number of particles in size range below 2.36 mm. The study confirmed the presence of an average of 100 microplastic pieces per 100 gram of sediments of Kadambrayar river bordering the waste dumping yard at Brahmapuram. The topsoil of Brahmapuram waste dumping yard was found to contain 178 pieces of microplastics per 100 gm of soil. Microplastics are found to be high in the river stretch near the open dumping site which has a significant role in the pollution, causing a major threat to the entire ecosystem.

     

Impact on Plate Waste of Switching from a Tray to a Trayless Delivery System in a University Dining Hall and Employee Response to the Switch

A potential strategy for decreasing food waste in foodservice operations is trayless dining. The objective of this 2010 study was to compare the impact of using a tray vs a trayless system on plate waste and on employees' attitudes. To test the hypothesis that going trayless would reduce waste, liquid and solid plate waste were measured for 1 week with the then-existing tray system and again after a new trayless system was implemented in a buffet-style university dining hall serving roughly1,000 meals a day. Foodservice staff were invited to participate in a focus group about the impact on their jobs. The investigators calculated plate waste per patron under the two systems and used an independent samples t test to examine the significance of the difference. Comments from the focus group were analyzed for themes. A significant decrease in solid waste per patron (0.81 oz; P=0.001) was observed in switching from the tray to the trayless system (4.39±0.24 oz vs 3.58±0.08 oz per patron). A nonsignificant reduction was observed with liquid waste (49.77±2.62 mL vs 46.36±4.51 mL; P=0.18). Most of the employees preferred the trayless system as long as it did reduce waste, but felt that increased breakage of dishware and increased need to wipe down tables were possible concerns resulting from the switch. This study demonstrates that trayless dining can reduce plate waste, and that employees can be supportive of the change.     

Economic Evaluation of the Juvenile Drug Court/Reclaiming Futures (JDC/RF) Model

Juvenile drug court (JDC) programs are an increasingly popular option for rehabilitating juvenile offenders with substance problems, but research has found inconsistent evidence regarding their effectiveness and economic impact. While assessing client outcomes such as reduced substance use and delinquency is necessary to gauge program effectiveness, a more comprehensive understanding of program success and sustainability can be attained by examining program costs and economic benefits. As part of the National Cross-Site Evaluation of JDC and Reclaiming Futures (RF), an economic analysis of five JDC/RF programs was conducted from a multisystem and multiagency perspective. The study highlights the direct and indirect costs of JDC/RF and the savings generated from reduced health problems, illegal activity, and missed school days. Results include the average (per participant) cost of JDC/RF, the total economic benefits per JDC/RF participant, and the net savings of JDC/RF relative to standard JDC.     

Disposal of waste glass in sanitary departments: a sample survey in the Lazio region

As a result of Italian law, DPR 15/7/2003 n. 254, about hospital waste, and given that little has been written about recycling waste glass in hospitals, a survey of 28 health departments in Lazio was performed. The objectives were: to estimate the mean quantity of clear vitreous waste in one year, to estimate how vitreous waste is administered, to estimate the extent of the use of plastic instead of glass, to analyse the costs and benefits of glass use and/or plastic use and to evaluate staff training about hospital waste disposal. The average production of clear vitreous waste was 0.28 kilogram per day per hospital bed occupied. (This would be the theoretical maximum quantity of glass to be recycled). Among the 28 departments studied, 82% separated waste products but only 36% disposed of glass in accordance with the law. The estimated possible savings on glass phleboclysis in 2002 year were 35,000 euro. Staff training could avoid this conspicuous waste of money. Fifteen departments also used plastic phleboclysis; of these, in 2 departments plastic waste is separated in the wards, but unfortunately this material is later disposed of in the bins for general solid urban waste. The other thirteen hospitals dispose of waste plastic as infectious material. Using glass phleboclysis instead of plastic phleboclysis would save about 680,000 euros per year. The disposal of glass waste material in practice was not found to follow the principles taught in the training courses. Theoretic data about glass production, estimated in this survey, refers only to clear glass and it is an underestimate of that of all glass used in departments. The quantity of glass actually recycled has been about 0.14 kilogram per day per hospital bed occupied and thus only 50% of the theoretical quantity (0.28 kilogram per day per hospital bed occupied). This percentage could be improved by effective training. Ideally, the disposal of waste glass would follow the legal requirements and be monitored locally.     

Ecoefficiency: a tool to reduce solid waste production and waste of materials in health care units

The main goal of health care units is patient care. During this process, water, energy, and different materials are used, generating liquid effluents and solid waste that require adequate treatment. Although medical waste management demands increasing attention by health care units, reduction in the generation of medical solid waste has still not been set as a priority. Using ecoefficiency techniques, it is possible to demonstrate whether a company is meeting it standards for quality, procedures, environmental control, and economic efficiency. Therefore, ecoefficient companies realize both economic and environmental benefits through progressive reduction in solid waste, liquid effluents, and air emissions. This new concept requires further dissemination among health care units, since many are making efforts to improve quality of services, but still overlook the issue of waste and generate an increasing amount of solid waste. This leads not only to waste of raw materials but also additional costs for proper waste management.     

Determination of natural radionuclides content in some building materials in Nigeria by gamma-ray spectrometry

This paper presents the findings of a study undertaken to determine the natural radioactivity present in some building materials in Nigeria using a gamma-ray spectrometer with a hyper pure germanium detector. A total of 118 samples of commonly used building materials were collected from manufacturers and suppliers of these materials. The mean radioactivity concentrations measured in the different building materials varied from 9.4 to 62.9, 1.3 to 88.4, and 21.5 to 762.4 Bq kg(-1), respectively, for 226Ra, 232Th, and 40K. The average contents of 226Ra, 232Th, and 40K for all the samples were 36.3, 46.5, and 320.9 Bq kg(-1), respectively, lower than the world average for building materials (50, 50, and 500 Bq kg(-1)). The calculated mean radium equivalent activity and external and internal hazard indices for the entire sample were lower than United Nation Scientific Committee on the Effects of Atomic Radiation recommended limits and comparable with results of similar studies undertaken in other countries. The mean annual gonadal equivalent doses of some of the samples were higher than the world average value for soil.     

Municipal solid waste management on the south coastline of the Caspian Sea (Golestan, Mazandaran, and Guilan Provinces of Iran)

The Caspian region (including the Golestan, Mazandaran, and Guilan provinces of Iran) occupies 58,678 square kilometers (22,651 square miles) and has a population of 6,270,192, according to the census of 1996. This part of Iran is attractive to tourists because of its proximity to the Caspian Sea. In addition, the region boasts invaluable forests and grasslands, and is the exclusive producer in the country of key agricultural crops like rice and tea. The lack of systematic solid waste management has put this region on the edge of irreparable environmental damage. The large number and dispersion of open-dumping landfills, as well as the faded role of functional elements like waste minimization and processing, have sped up the environmental deterioration. This article evaluates the current status of solid waste management in the Caspian region and suggests practical alternatives. As a result of a field and desk study, the authors offer some instructions for separation of putrescibles, paper and cardboard, plastics, and so forth. Finally, after considering all aspects of the environmental impact assessments for different alternatives, the authors recommend the construction of two compost-producing facilities in Golestan province with a combined capacity of 500 metric tons per day and a total cost of $60,000, and four incineration sites in southern and southwestern parts of the region (Mazandaran and Guilan provinces) with a total capacity of 2,000 metric tons per day and total cost of $75 million.     

Exploring possibilities of achieving sustainability in solid waste management

The solid waste management scenario in the recent years has shifted towards a more sustainable approach. This paper brings in to focus the waste management methods that can be adopted using Bangalore as case study, in order to achieve economic viability and explores the sustainable options that conserves both natural and man-made resources and averts ecological risks. Bangalore, the Garden City of India with a population of 6 million is facing the daunting task of handling 3613 tonnes of municipal solid waste per day. Added to this are the constraints that are faced by the authorities such as poor political back up, inadequate infrastructure, insufficient funds and lack of public support. Attempts have been made to clear wastes by door to door collection method, introduction of push carts, which separate biodegradable wastes from non biodegradable wastes, deployment of auto tippers to clear slum wastes etc. under the guidance of Bangalore Agenda Task Force (government appointed body) and Bangalore Mahanagara Palike (city municipal corporation). Integrated waste management system is proposed as an option, which include collection, transport and processing of wastes in an environmentally sound way. The methods to overcome constraints in waste management and the future plans and actions that will bring about a significant change in the current waste management practices are also discussed in the paper.     

An overview of nursing home facilities: data from the 1997 National Nursing Home Survey

OBJECTIVE: This report presents estimates on the number and distribution of nursing home facilities, their services, current residents, and discharges in the United States during 1997. METHODS: Data presented in this report are estimates based on a sample of nursing home facilities, residents, and discharges from the 1997 National Nursing Home Survey (NHHS). The survey collects information about providers and recipients of care from nursing home facilities. NHHS has been periodically conducted by the National Center for Health Statistics since 1973. RESULTS: In 1997 there were an estimated 1.6 million current residents and 2.4 million discharges from 17,000 nursing homes nationwide. These facilities were predominantly proprietary and certified by both Medicare and Medicaid. There was an average of 107 beds per nursing home with an occupancy rate of 88 percent and a discharge rate of 130 patients per 100 beds. The majority of nursing home residents and discharges were elderly, white, and female.     

A review and framework for understanding the potential impact of poor solid waste management on health in developing countries

Background

The increase in solid waste generated per capita in Africa has not been accompanied by a commensurate growth in the capacity and funding to manage it. It is reported that less than 30% of urban waste in developing countries is collected and disposed appropriately. The implications of poorly managed waste on health are numerous and depend on the nature of the waste, individuals exposed, duration of exposure and availability of interventions for those exposed.

Objective

To present a framework for understanding the linkages between poor solid waste management, exposure and associated adverse health outcomes. The framework will aid understanding of the relationships, interlinkages and identification of the potential points for intervention.

Methods

Development of the framework was informed by a review of literature on solid waste management policies, practices and its impact on health in developing countries. A configurative synthesis of literature was applied to develop the framework. Several iterations of the framework were reviewed by experts in the field. Each linkage and outcomes are described in detail as outputs of this study.

Result

The resulting framework identifies groups of people at a heightened risk of exposure and the potential health consequences. Using the iceberg metaphor, the framework illustrates the pathways and potential burden of ill-health related to solid waste that is hidden but rapidly unfolding with our inaction. The existing evidence on the linkage between poor solid waste management and adverse health outcomes calls to action by all stakeholders in understanding, prioritizing, and addressing the issue of solid waste in our midst to ensure that our environment and health are preserved.

Conclusion

A resulting framework developed in this study presents a clearer picture of the linkages between poor solid waste management and could guide research, policy and action.

     

餐厨垃圾与市政污泥连续式混合中温厌氧消化

研究了在连续进出料条件下,餐厨垃圾与市政污泥的不同混合比例对混合中温厌氧日产气量、pH、VFA/碱度、TS去除率、VS去除率以及沼气产率和甲烷产率的影响.结果表明：当物料单独厌氧消化时,投加含固率为8％餐厨垃圾的系统比投加合固率为10％餐厨垃圾的系统更加稳定;当餐厨垃圾与市政污泥TS之比为80：20时,去除单位VS的沼气和甲烷平均产量最高,分别达到712 mL/g和388 mL/g,物料TS和VS平均去除率分别为60％和75％;而当混合比例为60∶40时,获得最高的TS和VS平均去除率,分别是71％和77％,去除单位VS的沼气和甲烷平均产量分别是668 mL/g和374 mL/g;餐厨垃圾与市政污泥混合厌氧消化与餐厨垃圾单独厌氧消化相比,沼气甲烷含量、去除单位VS的沼气和甲烷平均产率都有所提高,并且具有更好的系统稳定性.     

Dioxin emissions and soft-tissue sarcoma: results of a population-based case-control study

BACKGROUND: In 1998, the French Ministry of Environment revealed that of 71 French municipal solid waste incinerators processing more than 6 metric tons of material per hour, dioxin emission from 15 of them was above the 10 ng international toxic equivalency factor/m3 (including Besan?on, emitting 16.3 ng international toxic equivalency factor/m3) which is substantially higher than the 0.1 international toxic equivalency factor/m3 prescribed by a European directive of 1994. In 2000, a macrospatial epidemiological study undertaken in the administrative district of Doubs, identified two significant clusters of soft-tissue sarcoma and non Hodgkin lymphoma in the vicinity of the municipal solid waste incinerator of Besan?on. This microspatial study (at the Besan?on city scale), was designed to test the association between the exposure to dioxins emitted by the municipal solid waste incinerator of Besan?on and the risk of soft-tissue sarcoma. METHODS: Ground-level concentrations of dioxin were modeled with a dispersion model (Air Pollution Control 3 software). Four increasing zones of exposure were defined. For each case of soft tissue sarcoma, ten controls were randomly selected from the 1990 census database and matched for gender and age. A geographic information system allowed the attribution of a dioxin concentration category to cases and controls, according to their place of residence. RESULTS: Thirty-seven cases of soft tissue sarcoma were identified by the Doubs cancer registry between 1980 and 1995, corresponding to a standardized incidence (French population) of 2.44 per 100,000 inhabitants. Compared with the least exposed zone, the risk of developing a soft tissue sarcoma was not significantly increased for people living in the more exposed zones. CONCLUSION: Before definitely concluding that there is no relationship between the exposure to dioxin released by a solid waste incinerator and soft tissue sarcoma, a nationwide investigation based on other registries should be conducted.     

Environmental and health impacts of household solid waste handling and disposal practices in third world cities: the case of the Accra Metropolitan Area, Ghana

Inadequate provision of solid waste management facilities in Third World cities results in indiscriminate disposal and unsanitary environments, which threatens the health of urban residents. The study reported here examined household-level waste management and disposal practices in the Accra Metropolitan Area, Ghana. The residents of Accra currently generate large amounts of solid waste, beyond the management capabilities of the existing waste management system. Because the solid waste infrastructure is inadequate, over 80 percent of the population do not have home collection services. Only 13.5 percent of respondents are served with door-to-door collection of solid waste, while the rest dispose of their waste at communal collection points, in open spaces, and in waterways. The majority of households store their waste in open containers and plastic bags in the home. Waste storage in the home is associated with the presence of houseflies in the kitchen (r = .17, p < .0001). The presence of houseflies in the kitchen during cooking is correlated with the incidence of childhood diarrhea (r = .36, p < .0001). Inadequate solid waste facilities result in indiscriminate burning and burying of solid waste. There is an association between waste burning and the incidence of respiratory health symptoms among adults (r = .25, p < .0001) and children (r = .22, p < .05). Poor handling and disposal of waste are major causes of environmental pollution, which creates breeding grounds for pathogenic organisms, and the spread of infectious diseases. Improving access to solid waste collection facilities and services will help achieve sound environmental health in Accra.     

An industry perspective on commercial radioactive waste disposal conditions and trends

The United States is presently served by Class-A, -B and -C low-level radioactive waste and naturally-occurring and accelerator-produced radioactive material disposal sites in Washington and South Carolina; a Class-A and mixed waste disposal site in Utah that also accepts naturally-occurring radioactive material; and hazardous and solid waste facilities and uranium mill tailings sites that accept certain radioactive materials on a site-specific basis. The Washington site only accepts low-level radioactive waste from 11 western states due to interstate Compact restrictions on waste importation. The South Carolina site will be subject to geographic service area restrictions beginning 1 July 2008, after which only three states will have continued access. The Utah site dominates the commercial Class-A and mixed waste disposal market due to generally lower state fees than apply in South Carolina. To expand existing commercial services, an existing hazardous waste site in western Texas is seeking a Class-A, -B and -C and mixed waste disposal license. With that exception, no new Compact facilities are proposed. This fluid, uncertain situation has inspired national level rulemaking initiatives and policy studies, as well as alternative disposal practices for certain low-activity materials.     

International standards related to the classification and deregulation of radioactive waste

Although solid radioactive waste management is mainly a national concern, there are some aspects that have international implications. One important example is the decommissioning of nuclear facilities, which results in the release of materials that could be reused and recycled. It is possible that these materials could enter international trade, especially if the material is a metal. It is clearly desirable, therefore, to have appropriate international standards to help regulate trade. This paper describes recent international developments relating to the establishment of radiological criteria for the release of materials from regulatory control (clearance). There have already been some experiences of clearance and the transfer of recycled materials within Europe, and this paper reviews that experience. It also discusses recent developments in relation to the international classification of radioactive waste.