A comparative review of water disinfection methods appropriate for developing countries and their efficacy, cost-efficiency, and usability

Developing countries are heavily burdened by limited access to safe drinking water and subsequent water-related diseases. Numerous water treatment interventions combat this public health crisis, encompassing both traditional and less-common methods. Of these, water disinfection serves as an important means to provide safe drinking water. Existing literature discusses a wide range of traditional treatment options and encourages the use of multi-barrier approaches including coagulation-flocculation, filtration, and disinfection. Most sources do not delve into approaches specifically appropriate for developing countries, nor do they exclusively examine water disinfection methods.^ The objective of this review is to focus on an extensive range of chemical, physio-chemical, and physical water disinfection techniques to provide a compilation, description and evaluation of options available. Such an objective provides further understanding and knowledge to better inform water treatment interventions and explores alternate means of water disinfection appropriate for developing countries. Appropriateness for developing countries corresponds to the effectiveness of an available, easy to use disinfection technique at providing safe drinking water at a low cost.^ Among chemical disinfectants, SWS sodium hypochlorite solution is preferred over sodium hypochlorite bleach due to consistent concentrations. Tablet forms are highly recommended chemical disinfectants because they are effective and very easy to use, but also because they are stable. Examples include sodium dichloroisocyanurate, calcium hypochlorite, and chlorine dioxide, which vary in cost depending on location and availability. Among physio-chemical disinfection options, electrolysis which produces mixed oxidants (MIOX) provides a highly effective disinfection option with a higher upfront cost but very low cost over the long term. Among physical disinfection options, solar disinfection (SODIS) applications are effective, but they treat only a fixed volume of water at a time. They come with higher initial costs but very low on-going costs. Additional effective disinfection techniques may be suitable depending on the location, availability and cost.^

Community diagnosis: A working tool for developing culturally appropriate diarrhea intervention programs

Most studies related to diarrhea have been focused narrowly on the etiological and pathophysiological factors involved in inducing the disease. Such studies have often failed to consider other facets contributing to and possibly prolonging the problem, namely: socio-economic conditions, educational opportunities and attainments, cultural characteristics and beliefs, and the political administration and its commitment towards fulfilling its moral and ethical obligations in responding to and fostering human development.^ This study utilized the diagnostic approach of the PRECEDE model. The acronym stands for the predisposing reinforcing, and enabling constructs in educational diagnosis and evaluation. The constituents of this model were identified by utilizing participant observation field methods, traditionally applied by ethnographers to collect data describing the multiple facets of a culture, and linguistic anthropology used to capture and define characteristic semantics and viewpoints. The household study sample was randomly selected from a defined list of households known to have at least one child less than five years of age. An open-ended questionnaire format was used to interview the 115 mothers in the selected households sample.^ Kalama, the study community, is characteristically an agricultural village, situated in the Governorate of Kaliobia and located approximately 25 Km (about 15.5 miles) from the capital, Cairo, Egypt. The 1986 census indicates a population size of 13,328 people in 4,818 households. There were 65 deaths occurring among children less than five years in 1986. The causes of death were primarily related to diarrhea, followed by upper respiratory infections, congenital anomalies and birth injuries.^ This study outlines (a) practices related to the management of diarrhea, including the administration of foods and drinks during such episodes; (b) influences of governmental policies; and (c) recommended strategies for overcoming barriers and promoting effective diarrhea intervention programs. ^

Perceptions of chief executives of Texas Catholic health care institutions regarding the poor and the provision of Catholic health care

Perceptions of chief executive officers (CEOs) of Texas Catholic health care institutions regarding the poor and the provision of Catholic health care were the focus for this study. A total of 40 health care administrators were asked to participate in a survey. Thirty-seven CEOs responded, including seven religious superiors, six health system CEOs and 24 hospital CEOs. Survey items concerning Catholic health for the poor centered on obligations and responsibilities of Catholic hospitals, means of achieving those obligations, and assessment of whether hospitals' objectives were being met. In addition, respondents' attitudes and beliefs about poor people in general were examined. Independent variables were CEO type, gender, religious preference, member of a religious order, and educational preparation. For purposes of analysis, most survey items were classified by level of consensus exhibited by respondents. The respondents to this survey agreed on most issues concerning poor people and the provision of Catholic health care. However, there were areas of disagreement particularly in Part I of the survey which dealt with responsibility/obligation, means/methods, and assessment of health care delivery for the poor. ^

Cross-culture perspectives on fear of HIV disease and AIDS in health care workers

Health care workers have been known to carry into the workplace a variety of judgmental and negative attitudes towards their patients. In no other area of patient care has this issue been more pronounced as in the management of patients with AIDS. Health care workers have refused to treat or manage patients with AIDS and have often treated them more harshly than identically described leukemia patients. Some health care institutions have simply refused to admit patients with AIDS and even recent applicants to medical colleges and schools of nursing have indicated a preference for schools in areas with low prevalence of HIV disease. Since the attitudes of health care workers do have significant consequences on patient management, this study was carried out to determine the differences in clinical practice in Nigeria and the United States of America as it relates to knowledge of a patient's HIV status, determine HIV prevalence and culture in each of the study sites and how they impact on infection control practices, determine the relationship between infection control practices and fear of AIDS, and also determine the predictors of safe infection control practices in each of the study sites.^ The study utilized the 38-item fear of AIDS scale and the measure of infection control questionnaire for its data. Questionnaires were administered to health care workers at the university teaching hospital sites of Houston, Texas and Calabar in Nigeria. Data was analyzed using a chi-square test, and where appropriate, a student t-tests to establish the demographic variables for each country. Factor analysis was done using principal components analysis followed by varimax rotation to simple structure. The subscale scores for each study site were compared using t-tests (separate variance estimates) and utilizing Bonferroni adjustments for number of tests. Finally, correlations were carried out between infection control procedures and fear of AIDS in each study site using Pearson-product moment correlation coefficients.^ The study revealed that there were five dimensions of the fear of AIDS in health care workers, namely fear of loss of control, fear of sex, fear of HIV infection through blood and illness, fear of death and medical interventions and fear of contact with out-groups. Fear of loss of control was the primary area of concern in the Nigerian health care workers whereas fear of HIV infection through blood and illness was the most important area of AIDS related feats in United States health care workers. The study also revealed that infection control precautions and practices in Nigeria were based more on normative and social pressures whereas it was based on knowledge of disease transmission, supervision and employee discipline in the United States, and thus stresses the need for focused educational programs in health care settings that emphasize universal precautions at all times and that are sensitive to the cultural nuances of that particular environment. ^

STRATEGIES FOR THE TRANSFER OF APPROPRIATE TECHNOLOGY TO DEVELOPING COUNTRIES: THE IMPLEMENTATION AND DEVELOPMENT OF ENVIRONMENTAL HEALTH PROGRAMS IN TUNISIA

This dissertation focuses on Project HOPE, an American medical aid agency, and its work in Tunisia. More specifically this is a study of the implementation strategies of those HOPE sponsored projects and programs designed to solve the problems of high morbidity and infant mortality rates due to environmentally related diarrheal and enteric diseases. Several environmental health programs and projects developed in cooperation with Tunisian counterparts are described and analyzed. These include (1) a paramedical manpower training program; (2) a national hospital sanitation and infection control program; (3) a community sewage disposal project; (4) a well reconstruction project; and (5) a solid-waste disposal project for a hospital.^ After independence, Tunisia, like many developing countries, encountered several difficulties which hindered progress toward solving basic environmental health problems and prompted a request for aid. This study discusses the need for all who work in development programs to recognize and assess those difficulties or constraints which affect the program planning process, including those latent cultural and political constraints which not only exist within the host country but within the aid agency as well. For example, failure to recognize cultural differences may adversely affect the attitudes of the host staff towards their work and towards the aid agency and its task. These factors, therefore, play a significant role in influencing program development decisions and must be taken into account in order to maximize the probability of successful outcomes.^ In 1969 Project HOPE was asked by the Tunisian government to assist the Ministry of Health in solving its health manpower problems. HOPE responded with several programs, one of which concerned the training of public health nurses, sanitary technicians, and aids at Tunisia's school of public health in Nabeul. The outcome of that program as well as the strategies used in its development are analyzed. Also, certain questions are addressed such as, what should the indicators of success be, and when is the time right to phase out?^ Another HOPE program analyzed involved hospital sanitation and infection control. Certain generic aspects of basic hospital sanitation procedures were documented and presented in the form of a process model which was later used as a "microplan" in setting up similar programs in other Tunisian hospitals. In this study the details of the "microplan" are discussed. The development of a nation-wide program without any further need of external assistance illustrated the success of HOPE's implementation strategies.^ Finally, although it is known that the high incidence of enteric disease in developing countries is due to poor environmental sanitation and poor hygiene practices, efforts by aid agencies to correct these conditions have often resulted in failure. Project HOPE's strategy was to maximize limited resources by using a systems approach to program development and by becoming actively involved in the design and implementation of environmental health projects utilizing "appropriate" technology. Three innovative projects and their implementation strategies (including technical specifications) are described.^ It is advocated that if aid agencies are to make any progress in helping developing countries basic sanitation problems, they must take an interdisciplinary approach to progrm development and play an active role in helping counterparts seek and identify appropriate technologies which are socially and economically acceptable. ^

Gamma irradiation on Alstroemeria aurea G. in vitro rhizomes: : an approach to the appropriate dosage for breeding purposes

Gamma irradiation has been widely used as a breeding technique to obtain new cultivars in ornamental species such as Alstroemeria, where several cultivars have been obtained through rhizome radiation. The optimum dosage for an appropriate induction of mutation must be considered for breeding purposes and it depends mainly on plant susceptibility. Thus in this study in vitro cultured rhizomes of Alstroemeria aurea were irradiated with a gamma source using different dosages to evaluate the direct effect produced. Damage and number of rhizome sprouting were observed and recorded during 61 days after irradiation. At the end of this period, rhizomes were weighted and mortality was evaluated. Both mortality and weight increased depending on dosage. All irradiated rhizomes showed early sprouting in comparison with control (0 Gy) and no significant difference in final number of shoots after 61 days among irradiated treatments was observed. Bleaching and necrosis was observed in all irradiated rhizomes and was more evident at higher doses. LD50 was established at about 40 Gy and the optimum dosage to induce mutation was suggested between 2.5 and 5 Gy, when the growth was reduced in 50%, and probably this dosage could be used for breeding purposes.

Instituciones, población y mercados de tierra locales en perspectiva comparada. Los ejidos y colonias agrícolas de Chascomús y Junín [Buenos Aires, Argentina], 1860-1914

El objetivo de esta ponencia es analizar el funcionamiento del mercado de tierras privadas ejidales y de colonias cuando la provincia de Buenos Aires estaba impulsando la mayor expansión territorial del siglo y recibía un importante flujo de inmigrantes, entre 1860 y la primera guerra mundial. Enfocaremos nuestra indagación en los partidos de Chascomús y Junín. Ya hemos estudiado el mercado de tierras de campos y estancias en los partidos elegidos y también hemos comparado esos datos con el único trabajo que se ocupa de un ejido en la provincia (Mercedes), cuyos resultados nos indican un comportamiento diferente en los actores y en la conformación del mercado, nos parece pertinente estudiar el impacto que tuvieron en las transacciones y en la formación del precio el crecimiento demográfico, los cambios institucionales, las políticas públicas sobre tierras (especialmente las relacionadas con las colonias y la expansión de los ejidos). De esta manera podremos estimar las interrelaciones entre los mercados en campos de grandes dimensiones y los más reducidos de los ejidos y colonias

Las empresas regionales : ¿Nuevo actor innovador?

En este trabajo se intenta reflexionar, a partir de un estudio de caso, sobre los desafíos que enfrentan los empresarios regionales para la introducción de una respuesta original aplicada tanto a sus procesos y productos como a la estructura total de la empresa. Pensar en el estudio de las diferentes tecnologías que posee una región en particular requiere, al menos, la consideración y el análisis de distintas dimensiones, siendo una de ellas la economía regional y, en especial, las actividades productivas, su dinámica empresarial y el desarrollo de las instituciones presentes dentro de la región. En este sentido, parece apropiado preguntarnos si, en las actuales condiciones sociales y económicas de la región, los actores organizacionales asumen un papel activo o pasivo frente a la necesidad de incorporación de innovación en las organizaciones empresariales. En función de lo planteado, el punto nodal debe ubicarse en la relación que se establece entre las políticas internas de las empresas regionales, la incorporación de innovación y su impacto en las instituciones locales

Hacer las reglas del hacer : Concepciones y rutinas bibliotecarias en los reglamentos de las bibliotecas populares en la Argentina (1870-1875)

El artículo aborda los vínculos sostenidos por la Comisión Protectora de las Bibliotecas Populares y las bibliotecas populares con relación a la elaboración de reglas adecuadas para ordenar el funcionamiento de estas instituciones. A partir de un análisis del Boletín de las Bibliotecas Populares, se estudia la manera en que la Comisión insistió en la difusión de dos servicios: la lectura gratuita en la sala y el préstamo domiciliario de libros a cambio de una cuota accesible. Se observa cómo las bibliotecas incorporaron progresivamente esas pautas y, al hacerlo, colaboraron con sus propios reglamentos con la estrategia pedagógica del Boletín. Se examinan, asimismo, las indicaciones técnicas presentes en la revista para contribuir con el desarrollo de los procesos bibliotecarios necesarios para sustentar dichos servicios. Se concluye que entre 1870 y 1875 estas acciones renovaron la tradición bibliotecaria en la Argentina, aun cuando es posible detectar diversas deficiencias y contrasentidos en la transmisión de esta nueva concepción bibliotecológica. Finalmente, se evalúa la pertinencia de los reglamentos y otros documentos institucionales para desenvolver los estudios históricos sobre los contextos de la lectura

Igualitarismo, estructura básica y contextualismo rawlsiano

En este trabajo se analiza si es apropiado evaluar acciones individuales con los principios de justicia aplicables a las instituciones. Para lograr este objetivo, el artículo examina la teoría de la justicia rawlsiana y algunas de las principales objeciones en su contra. Los críticos niegan que los principios de justicia de esta teoría estén configurados para evaluar exclusivamente las instituciones sociales básicas. Es más: afirman que la justicia no sólo exige instituciones justas sino que además exige acciones individuales justas. La hipótesis de este trabajo afirma que principios aptos para ciertos contextos sociales no son adecuados para evaluar otro tipo de interacciones sociales. El argumento apela a una interpretación normativa de la noción de estructura básica, elemento clave para defender el carácter institucional de la justicia rawlsiana

Las empresas regionales : ¿Nuevo actor innovador?

En este trabajo se intenta reflexionar, a partir de un estudio de caso, sobre los desafíos que enfrentan los empresarios regionales para la introducción de una respuesta original aplicada tanto a sus procesos y productos como a la estructura total de la empresa. Pensar en el estudio de las diferentes tecnologías que posee una región en particular requiere, al menos, la consideración y el análisis de distintas dimensiones, siendo una de ellas la economía regional y, en especial, las actividades productivas, su dinámica empresarial y el desarrollo de las instituciones presentes dentro de la región. En este sentido, parece apropiado preguntarnos si, en las actuales condiciones sociales y económicas de la región, los actores organizacionales asumen un papel activo o pasivo frente a la necesidad de incorporación de innovación en las organizaciones empresariales. En función de lo planteado, el punto nodal debe ubicarse en la relación que se establece entre las políticas internas de las empresas regionales, la incorporación de innovación y su impacto en las instituciones locales

Igualitarismo, estructura básica y contextualismo rawlsiano

En este trabajo se analiza si es apropiado evaluar acciones individuales con los principios de justicia aplicables a las instituciones. Para lograr este objetivo, el artículo examina la teoría de la justicia rawlsiana y algunas de las principales objeciones en su contra. Los críticos niegan que los principios de justicia de esta teoría estén configurados para evaluar exclusivamente las instituciones sociales básicas. Es más: afirman que la justicia no sólo exige instituciones justas sino que además exige acciones individuales justas. La hipótesis de este trabajo afirma que principios aptos para ciertos contextos sociales no son adecuados para evaluar otro tipo de interacciones sociales. El argumento apela a una interpretación normativa de la noción de estructura básica, elemento clave para defender el carácter institucional de la justicia rawlsiana

Hacer las reglas del hacer : Concepciones y rutinas bibliotecarias en los reglamentos de las bibliotecas populares en la Argentina (1870-1875)

El artículo aborda los vínculos sostenidos por la Comisión Protectora de las Bibliotecas Populares y las bibliotecas populares con relación a la elaboración de reglas adecuadas para ordenar el funcionamiento de estas instituciones. A partir de un análisis del Boletín de las Bibliotecas Populares, se estudia la manera en que la Comisión insistió en la difusión de dos servicios: la lectura gratuita en la sala y el préstamo domiciliario de libros a cambio de una cuota accesible. Se observa cómo las bibliotecas incorporaron progresivamente esas pautas y, al hacerlo, colaboraron con sus propios reglamentos con la estrategia pedagógica del Boletín. Se examinan, asimismo, las indicaciones técnicas presentes en la revista para contribuir con el desarrollo de los procesos bibliotecarios necesarios para sustentar dichos servicios. Se concluye que entre 1870 y 1875 estas acciones renovaron la tradición bibliotecaria en la Argentina, aun cuando es posible detectar diversas deficiencias y contrasentidos en la transmisión de esta nueva concepción bibliotecológica. Finalmente, se evalúa la pertinencia de los reglamentos y otros documentos institucionales para desenvolver los estudios históricos sobre los contextos de la lectura

Instituciones, población y mercados de tierra locales en perspectiva comparada. Los ejidos y colonias agrícolas de Chascomús y Junín [Buenos Aires, Argentina], 1860-1914

El objetivo de esta ponencia es analizar el funcionamiento del mercado de tierras privadas ejidales y de colonias cuando la provincia de Buenos Aires estaba impulsando la mayor expansión territorial del siglo y recibía un importante flujo de inmigrantes, entre 1860 y la primera guerra mundial. Enfocaremos nuestra indagación en los partidos de Chascomús y Junín. Ya hemos estudiado el mercado de tierras de campos y estancias en los partidos elegidos y también hemos comparado esos datos con el único trabajo que se ocupa de un ejido en la provincia (Mercedes), cuyos resultados nos indican un comportamiento diferente en los actores y en la conformación del mercado, nos parece pertinente estudiar el impacto que tuvieron en las transacciones y en la formación del precio el crecimiento demográfico, los cambios institucionales, las políticas públicas sobre tierras (especialmente las relacionadas con las colonias y la expansión de los ejidos). De esta manera podremos estimar las interrelaciones entre los mercados en campos de grandes dimensiones y los más reducidos de los ejidos y colonias

Igualitarismo, estructura básica y contextualismo rawlsiano

En este trabajo se analiza si es apropiado evaluar acciones individuales con los principios de justicia aplicables a las instituciones. Para lograr este objetivo, el artículo examina la teoría de la justicia rawlsiana y algunas de las principales objeciones en su contra. Los críticos niegan que los principios de justicia de esta teoría estén configurados para evaluar exclusivamente las instituciones sociales básicas. Es más: afirman que la justicia no sólo exige instituciones justas sino que además exige acciones individuales justas. La hipótesis de este trabajo afirma que principios aptos para ciertos contextos sociales no son adecuados para evaluar otro tipo de interacciones sociales. El argumento apela a una interpretación normativa de la noción de estructura básica, elemento clave para defender el carácter institucional de la justicia rawlsiana