TANK SIZING AND OPTIMIZING LOOP PLACEMENT IN A BRANCHED WATER DISTRIBUTION SYSTEM

More than eighteen percent of the world’s population lives without reliable access to clean water, forced to walk long distances to get small amounts of contaminated surface water. Carrying heavy loads of water long distances and ingesting contaminated water can lead to long-term health problems and even death. These problems affect the most vulnerable populations, women, children, and the elderly, more than anyone else. Water access is one of the most pressing issues in development today. Boajibu, a small village in Sierra Leone, where the author served in Peace Corps for two years, lacks access to clean water. Construction of a water distribution system was halted when a civil war broke out in 1992 and has not been continued since. The community currently relies on hand-dug and borehole wells that can become dirty during the dry season, which forces people to drink contaminated water or to travel a far distance to collect clean water. This report is intended to provide a design the system as it was meant to be built. The water system design was completed based on the taps present, interviews with local community leaders, local surveying, and points taken with a GPS. The design is a gravity-fed branched water system, supplied by a natural spring on a hill adjacent to Boajibu. The system’s source is a natural spring on a hill above Boajibu, but the flow rate of the spring is unknown. There has to be enough flow from the spring over a 24-hour period to meet the demands of the users on a daily basis, or what is called providing continuous flow. If the spring has less than this amount of flow, the system must provide intermittent flow, flow that is restricted to a few hours a day. A minimum flow rate of 2.1 liters per second was found to be necessary to provide continuous flow to the users of Boajibu. If this flow is not met, intermittent flow can be provided to the users. In order to aid the construction of a distribution system in the absence of someone with formal engineering training, a table was created detailing water storage tank sizing based on possible source flow rates. A builder can interpolate using the source flow rate found to get the tank size from the table. However, any flow rate below 2.1 liters per second cannot be used in the table. In this case, the builder should size the tank such that it can take in the water that will be supplied overnight, as all the water will be drained during the day because the users will demand more than the spring can supply through the night. In the developing world, there is often a problem collecting enough money to fund large infrastructure projects, such as a water distribution system. Often there is only enough money to add only one or two loops to a water distribution system. It is helpful to know where these one or two loops can be most effectively placed in the system. Various possible loops were designated for the Boajibu water distribution system and the Adaptive Greedy Heuristic Loop Addition Selection Algorithm (AGHLASA) was used to rank the effectiveness of the possible loops to construct. Loop 1 which was furthest upstream was selected because it benefitted the most people for the least cost. While loops which were further downstream were found to be less effective because they would benefit fewer people. Further studies should be conducted on the water use habits of the people of Boajibu to more accurately predict the demands that will be placed on the system. Further population surveying should also be conducted to predict population change over time so that the appropriate capacity can be built into the system to accommodate future growth. The flow at the spring should be measured using a V-notch weir and the system adjusted accordingly. Future studies can be completed adjusting the loop ranking method so that two users who may be using the water system for different lengths of time are not counted the same and vulnerable users are weighted more heavily than more robust users.

Discussion: Food security and sustainable food systems: The role of soil

There is a general consensus that healthy soils are pivotal for food security. Food production is one of the main ecosystem services provided by and thus dependent on well-functioning soils. There are also intrinsic connections between the four pillars of food security: food availability, access, utilization, and stability; with how soils are managed, accessed and secured, in particular by food insecure and vulnerable populations. On the other hand, socio-political and economic processes that precipitate inequalities and heighten vulnerabilities among poor populations often increase pressure on soils due to unsustainable forms of land use and poor agricultural practises. This has often led to scenarios that can be described as: ‘poor soils, empty stomachs (hungry people) and poor livelihoods.' In 2015, in particular, as we head towards approval of the ‘Sustainable Development Goals' (SDGs), the role of Financing for Development is debated and agreed upon and a new climate pact is signed – these three political dimensions define how a new post-2015 agenda needs to be people-smart as well as resource-smart. For proposed SDG 2 (Food Security and Hunger), there can be so resolution without addressing people, policies and institutions.

Lessons for emerging state Children's Health Insurance Premium Assistance programs: Case study of the Massachusetts Masshealth Family Assistance Program (MHFAP)

Providing health insurance coverage for vulnerable populations such as low-income high-risk children with limited access to health care is a challenge for many states. Over the past decade, higher private insurance premiums and unpredictable labor markets have increased the number of uninsured and underinsured children nationwide. Due to recent economic downfalls, many states such as Texas, have expressed interest in using premium assistance programs to increase enrollment of low income children and families in private coverage through employer sponsored health insurance. Massachusetts has been especially successful in reducing the number of uninsured children through the implementation of MassHealth Family Assistance Program (MHFAP), an employer based premium assistance program. The purpose of this study is to identify key implementation factors of a fully established premium assistance program which may provide lessons and facilitate implementation of emerging premium assistance programs. ^ The case study of the fully established MassHealth Family Assistance Program (MHFAP) has illustrated the ability of states to expand their Medicaid and SCHIP programs in order to provide affordable health coverage to uninsured and underinsured low income children and their families. As demonstrated by MHFAP, the success of a premium assistance program depends on four key factors: (1) determination of participant and employer eligibility; (2) determination of employer benefits meeting benchmark equivalency (Medicaid or State Children's Health Insurance Program); (3) the use of appropriate marketing and outreach strategies; and (4) establishment of adequate monitoring and reporting techniques. Successful implementation strategies, revealed by the case study of the Massachusetts MassHealth Family Assistance Program, may be used by emerging premium assistance programs, such as Texas Children's Health Insurance Premium Assistance Program (CHIP-PA) toward establishment of an effective, efficient, and equitable employer sponsored health program.^

Contraceptive attitudes and knowledge of female adolescents

Despite the recent decline in adolescent pregnancy rates, adolescent pregnancy continues to be a significant public health issue in the United States. The United States consistently reports the highest rate of adolescent pregnancy among developed countries. Adolescent mothers are more likely to have multiple pregnancies, to access welfare and other social services, and to be unmarried. Teen mothers are less likely to complete high school, enter college, and typically command much less earning power throughout their lifetime as compared to women who delay childbirth until later. Moreover, the United States spends approximately $9.1 billion annually on teen pregnancies. ^ Additionally disconcerting is recent data which demonstrates that the decline in teen pregnancy rates is leveling off and that the rate of adolescent pregnancy has increased for the first time since 1993. Contraceptive use is a key component to the prevention of adolescent pregnancy. Contraceptive nonuse and failure result in unintended pregnancies among adolescents. This review sought to assess the levels of knowledge and attitudes toward contraception among adolescent females.^ Levels of knowledge of contraception among adolescents are tolerable; however, there is substantial room for improvement. Misperceptions about the side effects and mechanisms of action of contraception are pervasive among this population. Adolescents who have low levels of knowledge regarding contraception tend to discontinue usage or use inconsistently. Attitudes toward contraception are greatly influenced by levels of knowledge. As a result, adolescents tend to develop more positive attitudes as misperceptions are abated. Moreover, clear disparities persist among adolescents with minority and young adolescents being at increased risk of pregnancy, poor contraceptive use, and insufficient knowledge about contraception.^ Understanding the level of knowledge of and attitudes toward contraceptives among adolescents is essential to the development of effective pregnancy prevention programs. In order to effectively reduce adolescent pregnancy, prevention initiatives must target the vulnerable populations and incorporate the necessary cultural components.^

A health disparities perspective on developing emerging infectious disease preparedness

A systematic review of the literature yielded 10 articles that explored the interaction between race/ethnicity, citizenship, socioeconomic status, and health literacy domains with respect to preparedness agenda development. Current emerging infectious disease (EID) preparedness plans do not adequately address the needs of vulnerable populations for the events before, during, and after an epidemic. Central to the disadvantage of most vulnerable populations are various health disparity domains that persist as barriers for individuals and communities alike to engage in preparedness efforts. Seven out of the ten articles discussed the importance of including health disparity domains in preparedness policy. Two proposed frameworks for an emerging infectious disease framework that considers health disparities are presented in this study. ^ Framework 1 is beneficial for the evaluation phase after a disaster has struck and preparedness efforts have been initiated. It considers several existing disparities and remediation strategies at the individual, community, and system levels to reach adequate restructuring of preparedness aims. Framework 2 serves as a "how to" carry out preparedness during a disaster event. It is a revision of a framework proposed by Blumenshine et al. (2008) and explores those characteristics central to pandemic preparedness plan development/deployment. Although two frameworks were devised, no one framework will adequately address the needs of vulnerable populations during an epidemic. However, the two frameworks propose to demonstrate the inclusion of important health disparity domains in preparedness plan development. ^ The National Consensus Panel for Emergency Preparedness and Cultural Diversity has released guidelines that are considered the leading strategies necessary to reorient preparedness infrastructure. In order for vulnerable populations to benefit from ample protection during a disaster, inclusion of health disparity domains in the development phases of preparedness must occur prior to full deployment in communities. Although "promising practices" and other methods at the frontier of exploring these multidimensional constraints has entered the research arena, new studies on adequate preparedness merit further investigation and support.^

Systematic review of mobile dental vans

Objectives. To assess the reach and effectiveness of mobile dental vans as a delivery method by providing access to underserved populations. ^ Methods. A literature review was conducted to identify mobile delivery methods whose aims are to address the increasing oral health disparity concern. Forty articles met the inclusion criteria. Of the 40 articles, only 7 analyzed the reach and coverage of the mobile dental clinics. Data was compiled from the literature to compare and assess the different mobile dental care delivery methods. ^ Results. There is a correlation between transportation barriers and lack of access to healthcare. Mobile dentistry helps to delivery dental care to vulnerable populations. ^ Conclusion. Mobile dental clinics are an effective method in improving access to care in underserved populations, as well as increasing overall oral health in these individuals.^

An investigation of pertussis cases in a Texas county from 2008 through 2012

Background: Once thought to be eradicated, pertussis is now making a steady comeback throughout Texas and the United States. Pertussis can have an effect on all demographics, but infants have the greatest health concern as they suffer the highest case-fatality rate. The objective of this study was to create and report a comprehensive summary of confirmed or probable pertussis cases in a Texas County during the 2008 through 2012 time period.^ Methods: A cross-sectional study design was used to show at risk populations in a Texas county using descriptive statistics of data from probable and confirmed pertussis cases in this Texas County from 2008-2012. Data was collected during routine pertussis investigations conducted by the local health department of this Texas County.^ Results: There was a sharp increase in pertussis cases seen in this county in 2012. Hispanics made up the majority of cases (74.9%) as compared to 12.8% of cases among Whites, 3.1% of cases among Blacks and 9.2% of cases among unknown/other. The population of Hispanics within this county was 58.9%. Almost a quarter of cases (24.2%) in this study were hospitalized. There was no difference identified in the proportion of male sources of exposure (48.9%) as compared to female (51.1%). Household contacts were the main sources of exposure: siblings (29.2%), fathers (14.5%), children (14.6%), and mothers (12.5%).^ Conclusion: Prevention intervention needs to be designed to target vulnerable populations and reduce the effect of this sometimes fatal disease. These results show pertussis proportionally has a greater effect on Hispanics. Additional research needs to be conducted on risk factors such as household crowding and immunization status among Hispanics to identify if ethnicity plays a role in risk of transmission of pertussis. The results were limited due to the large amount of missing data in vaccination history and identification of source of exposure.^

Indigent care and infant mortality in Texas

Infant Mortality has been made a point of emphasis by the Department of Health and Human Services in the Healthy People 2000, 2010, and 2020 priorities. This study used the Behavioral Model for Vulnerable Populations to consider a number of factors which impact infant mortality in the indigent populations in the State of Texas. The primary focus of this study was the enabling factor of community resources, specifically the program used by each county to provide care to their indigent population. The Legislature of the State of Texas requires that each state have a program set up within a Hospital District, Public Hospital or develop a County Indigent Health Care Program (CIHCP) in order to provide the basic health care needs of their most vulnerable residents. We sought to determine whether the development of a CICHP without an appointed hospital to provide the care would have an adverse effect on residents seeking care and increase infant mortality. A Poisson Regression Analysis was used to analyze incidence rate ratios adjusting for race/ethnicity and wealth/poverty variables. Our study showed that counties using a CIHCP had significantly lower infant mortality rates when compared to counties using a hospital district and were statistically equivalent to counties using a public hospital program or a combination of service programs. This relationship was maintained when adjusted incidence rate ratios were calculated. This may give evidence that counties struggling to fund a public hospital or hospital district may be able to find a more cost-effective alternative in the CIHCP without adversely affecting the health status of their residents. More cost-benefit analysis and controlling analysis must be done to further characterize this relationship. ^

Alfabetismo en salud bucal : una experiencia en poblaciones vulnerables de la provincia de Mendoza

El acceso al alfabetismo en salud es considerado un elemento esencial para la eliminación de las desigualdades y la búsqueda de la equidad, resultando en un verdadero empoderamiento en salud, individual y colectivo. Mediante la estrategia de promoción para la salud, nuestro objetivo fue contribuir con el Alfabetismo en aalud bucal de comunidades vulnerables de la provincia de Mendoza. Sólo cuando la gente se siente escuchada y comprendida puede ser motivada y acepta el cambio; por ello, la educación para la salud se ha transformado en una herramienta esencial para la adquisición de hábitos salutogénicos (generadores de salud).

Reflexiones en torno al proceso de implementación de un programa social en el campo de la actividad física en poblaciones vulnerables : Aportes para la formación del profesorado de Educación Física y la mejora de las políticas públicas

En este artículo se propone describir y analizar el proceso de implementación de un Programa social de intervención en poblaciones vulnerables a través del deporte, la actividad física y el juego recreativo que se desarrolla desde 2011 en tres espacios socio-residenciales de villa o asentamiento urbano informal del Partido de la Matanza. El programa social es analizado en diferentes aspectos claves de su proceso de implementación. Estos aspectos fueron abordados a través de una investigación cualitativa con objetivos amplios y un enfoque integral, en esta oportunidad se reflexiona sobre un avance de investigación que privilegia las percepciones y representaciones de los docentes técnicos que ejercieron el rol docente en el marco del Programa y se realizan algunos aportes para pensar la mejora en las futuras acciones y en la formación del profesorado.Se realizaron 6 grupos focales y se estima que los insumos generados serán útiles para la mejor planificación de las prácticas docentes y formación específica de los futuros profesores. Asimismo, se espera poder aportar elementos de análisis y de juicio para la gestión de políticas públicas en el campo del deporte y la actividad física como estrategia de integración social

Reflexiones en torno al proceso de implementación de un programa social en el campo de la actividad física en poblaciones vulnerables : Aportes para la formación del profesorado de Educación Física y la mejora de las políticas públicas

En este artículo se propone describir y analizar el proceso de implementación de un Programa social de intervención en poblaciones vulnerables a través del deporte, la actividad física y el juego recreativo que se desarrolla desde 2011 en tres espacios socio-residenciales de villa o asentamiento urbano informal del Partido de la Matanza. El programa social es analizado en diferentes aspectos claves de su proceso de implementación. Estos aspectos fueron abordados a través de una investigación cualitativa con objetivos amplios y un enfoque integral, en esta oportunidad se reflexiona sobre un avance de investigación que privilegia las percepciones y representaciones de los docentes técnicos que ejercieron el rol docente en el marco del Programa y se realizan algunos aportes para pensar la mejora en las futuras acciones y en la formación del profesorado.Se realizaron 6 grupos focales y se estima que los insumos generados serán útiles para la mejor planificación de las prácticas docentes y formación específica de los futuros profesores. Asimismo, se espera poder aportar elementos de análisis y de juicio para la gestión de políticas públicas en el campo del deporte y la actividad física como estrategia de integración social

Reflexiones en torno al proceso de implementación de un programa social en el campo de la actividad física en poblaciones vulnerables : Aportes para la formación del profesorado de Educación Física y la mejora de las políticas públicas

En este artículo se propone describir y analizar el proceso de implementación de un Programa social de intervención en poblaciones vulnerables a través del deporte, la actividad física y el juego recreativo que se desarrolla desde 2011 en tres espacios socio-residenciales de villa o asentamiento urbano informal del Partido de la Matanza. El programa social es analizado en diferentes aspectos claves de su proceso de implementación. Estos aspectos fueron abordados a través de una investigación cualitativa con objetivos amplios y un enfoque integral, en esta oportunidad se reflexiona sobre un avance de investigación que privilegia las percepciones y representaciones de los docentes técnicos que ejercieron el rol docente en el marco del Programa y se realizan algunos aportes para pensar la mejora en las futuras acciones y en la formación del profesorado.Se realizaron 6 grupos focales y se estima que los insumos generados serán útiles para la mejor planificación de las prácticas docentes y formación específica de los futuros profesores. Asimismo, se espera poder aportar elementos de análisis y de juicio para la gestión de políticas públicas en el campo del deporte y la actividad física como estrategia de integración social

Avaliação sistemática do uso do Dried Blood Spot para determinação de elementos químicos em sangue capilar visando estudos de biomonitoramento no Brasil

A biomonitorização humana ou biomonitoramento (BH) é definido como a medida periódica de determinada substância química ou seu metabólito em fluidos biológicos, principalmente sangue e urina, de uma população com o objetivo de avaliar a exposição e os riscos à saúde. Tal método tem se tornado comum em países desenvolvidos, porém ainda é uma prática pouco utilizada no Brasil. Isso ocorre pela dificuldade de coleta, armazenamento e transporte das amostras, principalmente em regiões sem infraestrutura e de difícil acesso. Diante disso, alguns procedimentos alternativos de coleta de amostra vêm sendo propostos. Um destes procedimentos é o Dried Blood Spot (DBS) ou coleta e armazenamento de amostra em papel-cartão. Este método oferece uma série de vantagens sobre os procedimentos de coleta convencionais, principalmente por reduzir consideravelmente o volume de amostra coletada. Entretanto, pouco se sabe sobre a estabilidade dos analitos após a deposição da amostra no cartão e do risco de contaminação da amostra pelo substrato sólido. Além disso, procedimentos de extração dos analitos do papel, para posterior quantificação, ainda não estão totalmente estabelecidos. Neste sentido, o presente trabalho avaliou de forma sistemática o procedimento de coleta de sangue por DBS visando sua futura aplicação em programas de biomonitoramento no Brasil para determinação dos elementos químicos As, Cd, Cu, Hg, Mn, Pb, Se e Zn por espectrometria de massas com plasma indutivamente acoplado (ICP-MS). Para isso, no estudo foram utilizadas três diferentes marcas comerciais de cartão coletor: Whatman 903(TM), Munktell(TM), e DMPK-C(TM). Todas as marcas de cartão apresentaram baixas concentrações dos elementos químicos. Após a deposição da amostra no papel cartão verificou-se que a concentração dos elementos químicos manteve-se estável por um período de pelo menos 60 dias (temperatura ambiente e ao abrigo da luz). Foi otimizado o método de extração dos analitos do substrato, com melhor condição obtida após a imersão do papel (corte circular de diâmetro de 1/2´´) por 60 minutos em solução extratora (0,5% v/v HNO3 e 0,01% v/v Triton(TM) X-100) na proporção de 1:50 v/v, seguida de 10 segundos de agitação por vortex. Após a extração, a solução resultante contendo os analitos foi diretamente injetada no ICP-MS. Cabe também destacar que não foram observadas diferenças estatísticas nas concentrações dos elementos químicos com coleta de sangue da veia do antebraço (sangue venoso) ou do dedo (sangue capilar). Os resultados obtidos no presente estudo, devem contribuir para a implementação deste procedimento em análises de elementos químicos (biomonitoramento da população brasileira), principalmente considerando as dificuldades de coleta, armazenamento e transporte de amostras clínicas em nosso país por sua extensão territorial. Além disso, este procedimento pode facilitar estudos com populações vulneráveis e que vivem em áreas remotas e de difícil acesso.

O cérebro sócio-musical: estudo de uma experiência de educação musical

A prática musical tem efeitos positivos no desenvolvimento humano, envolvendo aspectos cognitivos, emocionais, motivacionais e sociais, que implicam em alterações no processamento cerebral. O número de Programas de Educação Musical (PEMs) com enfoque em populações jovens em vulnerabilidade social tem crescido no Brasil e no mundo. Dessa maneira, torna-se importante a realização de estudos que verifiquem os efeitos de PEMs no desenvolvimento destas populações. O objetivo do presente estudo é investigar os impactos de uma experiência de um PEM sobre os aspectos psicológicos de seus estudantes, mais especificamente a autoestima, as habilidades sociais e o funcionamento executivo. A coleta de dados foi realizada em um PEM da cidade de Ribeirão Preto SP e em duas escolas regulares de ensino, uma particular e outra da rede pública. Participaram do estudo 69 crianças e adolescentes com idades entre 10 e 17 anos, divididos em três grupos, a saber: Grupo Iniciante (GI), composto por alunos com até 12 meses de matrícula no PEM; Grupo Experiente (GE), composto por alunos com mais de 24 meses de matrícula no PEM; e Grupo Controle (GC), constituído por participantes sem qualquer envolvimento com aprendizado musical. Cada grupo foi composto por 23 estudantes. Os três grupos de participantes responderam aos seguintes testes psicológicos: Escala de Autoestima de Rosenberg (EAR), Matson Evaluation of Social Skills with Youngsters (MESSY) e Teste de Stroop. Também foram realizadas entrevistas semi-estruturadas com todos os estudantes dos grupos GI e GE, dez estudantes do PEM que não compuseram nenhum grupo por não possuírem o pré-requisito de tempo de matrícula exigido, seis responsáveis legais dos estudantes e doze profissionais do PEM. As entrevistas tiveram a função de fornecerem relatos verbais a respeito dos impactos percebidos nos estudantes pelo envolvimento com o PEM. Os dados dos testes psicológicos foram analisados através dos testes estatísticos ANOVA, Mann-Whitney e t de Student e as entrevistas foram analisadas através da investigação qualitativa em educação. As análises dos testes psicológicos mostraram que os GI e GE não possuem diferenças entre si para nenhuma das variáveis de estudo. O GC apresentou escores inferiores aos GI e GE para a Autoestima e escores superiores para Solidão e Ansiedade Social, indicando que o envolvimento com o PEM pode acarretar em ganhos nessas habilidades. A partir da análise das entrevistas foram construídas três categorias de codificação relacionadas a impactos comportamentais do envolvimento com o PEM, a saber: relacionamento interpessoal, desenvolvimento de habilidades intrapessoais e envolvimento com música e desenvolvimento humano na perspectiva de profissionais e responsáveis legais. A análise das entrevistas indicou que a participação no PEM está relacionada a impactos positivos na autoestima, habilidades sociais e funcionamento executivo dos participantes. Os resultados foram discutidos buscando interrelaciona-los de maneira a integrar os dados colhidos por meio dos testes psicológicos e através das entrevistas. Conclui-se que a participação em PEMs com enfoque no resgate social de populações vulneráveis possui influência no desenvolvimento de crianças e adolescentes, indicando que o uso da educação musical caracteriza uma importante estratégia de intervenção social.