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Background According to WHO, in 2015, over 35% of ischaemic heart disease, the leading cause of death and disability worldwide, and about 42% of strokes, the second largest contributor to global mortality, could have been prevented by reducing or removing exposure to chemical pollutants. Heavy metal and cyanide pollution are prevalent in developing countries, especially in sub-Saharan Africa where the effects of industrial pollutants are more severe, partly due to poor regulation. In Zimbabwe, the mining industry alone contributed to 25% of occupational conditions and injuries in 2020. Therefore, to mitigate these problems, this study seeks to develop a health risk management framework for heavy metals and cyanide pollution in the industrial city of Kwekwe. Methods The convergent parallel mixed-method study design will be utilised. Qualitative and quantitative data will be collected, analysed, and merged in order to inform the development of the risk framework. An analytical cross-sectional survey would be used to determine levels of heavy metals in surface water, soil, and vegetables. Free cyanide will be determined in surface water samples only. The phenomenological qualitative inquiry will be used to investigate health events and risks associated with potentially toxic pollutants (heavy metals and cyanide) to describe or interpret participants' lived experiences. The qualitative and quantitative results will be used to develop and validate the framework to manage identified health risks. For data analysis, statistical analysis will be used in the quantitative study, while thematic analysis will be used in the qualitative study. The study was approved by the University of Venda Ethics Committee (Registration Number FHS/22/PH/05/2306) and the Medical Research Council of Zimbabwe (Approval Number MRCZ/A/2944). All ethical principles will be adhered to throughout the study in accordance with the Helsinki Declaration. Discussion While existing risk management frameworks have significantly contributed to human and environmental health protection, novel and comprehensive frameworks need to be developed to counter the ever-dynamic and evolving risks associated with chemical pollutants. If the management framework is successfully developed, it could offer an opportunity for the prevention and control of potentially toxic elements.

Context. The Mutual Impedance Probe (MIP) of the Rosetta Plasma Consortium (RPC) onboard the Rosetta orbiter which was in operation for more than two years, between August 2014 and September 2016 to monitor the electron density in the cometary ionosphere of 67P/Churyumov-Gerasimenko. Based on the resonance principle of the plasma eigenmodes, recent models of the mutual impedance experiment have shown that in a two-electron temperature plasma, such an instrument is able to separate the two isotropic electron populations and retrieve their properties. Aims. The goal of this paper is to identify and characterize regions of the cometary ionized environment filled with a mix of cold and warm electron populations, which was observed by Rosetta during the cometary operation phase. Methods. To reach this goal, this study identifies and investigates the in situ mutual impedance spectra dataset of the RPC-MIP instrument that contains the characteristics of a mix of cold and warm electrons, with a special focus on instrumental signatures typical of large cold-to-total electron density ratio (from 60 to 90%), that is, regions strongly dominated by the cold electron component. Results. We show from the observational signatures that the mix of cold and warm cometary electrons strongly depends on the cometary latitude. Indeed, in the southern hemisphere of 67P, where the neutral outgassing activity was higher than in northern hemisphere during post-perihelion, the cold electrons were more abundant, confirming the role of electron-neutral collisions in the cooling of cometary electrons. We also show that the cold electrons are mainly observed outside the nominal electron-neutral collision-dominated region (exobase), where electrons are expected to have cooled down. This which indicates that the cold electrons have been transported outward. Finally, RPC-MIP detected cold electrons far from the perihelion, where the neutral outgassing activity is lower, in regions where no electron exobase was expected to have formed. This suggests that the cometary neutrals provide a more frequent or efficient cooling of the electrons than expected for a radially expanding ionosphere.

To evaluate the management of postoperative pain in the Point G teaching hospital.We carried out a prospective study, in 2008. Inclusion criteria for the personnel: be a staff member from the department of surgery or anaesthesia reanimation; willing to fill out the questionnaire. Inclusion criteria for patients: to be operated and hospitalized in one of the departments of surgery and anaesthesia reanimation.We collated the responses of 600 patients and 113 personnel. 92% of the patients underwent post-operative analgesia. The delay between the request and treatment of the patient was extensive in 92% of cases. The medical personnel and nursing staff had not received specific training on treating the pain in respectively 55% and 70% of cases. We noted an absence of informational support and of pre-established consensual protocols, written and validated on the management of postoperative pains.The treatment of the postoperative pains shows important shortcomings within the Point G teaching hospital and these insufficiencies are found across levels.Evaluer la prise en charge de la douleur post opératoire au CHU du Point G.Il s'agissait d'une étude prospective réalisée en 2008. Critères d'inclusion du personnel: être agent dans l'un des services de chirurgie ou d'anesthésie réanimation, disposé à remplir le questionnaire proposé. Critères d'inclusion du patient: être opéré et hospitalisé dans l'un des services de chirurgie et d'anesthésie réanimation.Il a été colligé 600 patients et 113 personnels. 92% des patients ont bénéficié de l'analgésie post opératoire. Le délai de traitement après la demande était long dans 92%. Les personnels médical et soignant n'ont pas reçu de formation spécifique sur la douleur dans respectivement 55% et 70%. Nous avons constaté une absence de support informationnel, de protocoles consensuels préétablis, écrits et validés sur la prise en charge post opératoire de la douleur.La prise en charge post opératoire de la douleur connait des lacunes importantes au sein du CHU du Point G et les insuffisances sont à tous les niveaux.

Lumbar stenosis is a disease caused by a conflict between the neural structures (spinal cord and nerve roots) and spinal structures (bones and ligaments). The objectives of this study were to highlight the frequency, the diagnosis and therapeutics options, and to evaluate the treatment outcomes.It was a retrospective study from January 2012 to December 2012 including 24 patients admitted to the neurosurgical department of the Gabriel Touré Hospital.The frequency of lumbar stenosis was 6.19% of all neurosurgical diseases. The sex-ratio was 0.71. The age ranged from 28 to 81 years with an average of 52 years. The neurogenic claudication was found in 87.5%. The straight leg raising test was positive in 41.7% of cases. The most vertebras involved were L4 and L5. Lumbar disc herniation was associated in 70.83%. Degenerative lumbar stenosis was the most common form, found in 66.67% of cases. Surgical treatment was performed in 29.17% of cases. The outcome was good in 85.6% of cases.Lumbar stenosis is a prevalent disease that occurs typically occurs around 50 years of age. The diagnosis was confirmed by myelography and a post myelographic CT scan. Good outcomes are achieved with both surgical or medical treatments.Le canal lombaire étroit (C.L.E.) est une pathologie liée à un conflit entre le contenant (ostéo-discoligamentaire) et le contenu (moelle épinière et ses composantes). Les objectifs de ce travail étaient de déterminer la fréquence du CLE, de déterminer les méthodes de diagnostic et de traitement, d'évaluer les résultats du traitement.Il s'agissait d'une étude rétrospective portant sur 24 cas de canal lombaire étroit colligés entre le 1le CLE constitue 6,19% de nos patients opérés. Le sexe féminin prédominait avec 58%. L'âge moyen était 52 ans avec les extrêmes de 28 ans et de 81 ans. La claudication était retrouvée à l'interrogatoire chez 87,5% des cas. le signe de Sonnette était retrouvé chez 41,7% des patients. Les vertèbres L4 et L5 étaient les plus touchés. La hernie discale était associée dans 70 .83%. Le CLE acquis représentait 66,67% des cas, la forme constitutionnelle,25% et celle congénitale, 8,33%. Le traitement a été médical dans 70,83% des cas et chirurgical 29,17%. Les résultats étaient bons dans 85,6%.le CLE est une affection fréquente se manifestant vers l'âge de 50 ans. La confirmation du diagnostic était faite par la saccoradiculographie couplée au myéloscanner. Le traitement médical ou chirurgical donne des bons résultats.

Molecular epidemiology studies further our understanding of migrations of phytopathogenic bacteria, the major determining factor in their emergence. Asiatic citrus canker, caused by Xanthomonas citri pv. citri, was recently reported in Mali and Burkina Faso, a region remote from other contaminated areas. To identify the origin and pathways of these emergences, we used two sets of markers, minisatellites and microsatellites, for investigating different evolutionary scales. Minisatellite typing suggested the introduction of two groups of strains in Mali (DAPC 1 and DAPC 2), consistent with microsatellite typing. DAPC 2 was restricted to Bamako district, whereas DAPC 1 strains were found much more invasive. The latter strains formed a major clonal complex based on microsatellite data with the primary and secondary founders detected in commercial citrus nurseries and orchards. This suggests that human activities played a major role in the spread of DAPC 1 strains via the movement of contaminated propagative material, further supported by the frequent lack of differentiation between populations from geographically distant nurseries and orchards. Approximate Bayesian Computation analyses supported the hypothesis that strains from Burkina Faso resulted from a bridgehead invasion from Mali. Multi-locus variable number of tandem repeat analysis and Approximate Bayesian Computation are useful for understanding invasion routes and pathways of monomorphic bacterial pathogens.

SETTING: Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons.OBJECTIVE: To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries.DESIGN: We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n = 14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n = 6 programs) in 2012. Patient-level data were collected on 1002 adult TB patients seen at 40 of the participating ART programs.RESULTS: Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the entire course of treatment, 16 (34%) during the intensive phase only, and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line anti-tuberculosis regimens; 18 (38%) reported TB drug shortages.CONCLUSIONS: Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower-income countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance.

The research reported in this paper looks into Quebec households' response to groundwater quality degradation in terms of both the averting activities they undertake and the intensity of the costs they incur as a result. Of all the households suffering from water quality degradation problems, those facing water-related nuisances (odor, staining problems, and bad taste) are less inclined to take averting actions, and on average, they spend less to solve these problems than those suffering from water pollution by bacteria and minerals. Those on municipal water supply systems also tend to spend less on avoidance actions. Factors that determine households' averting behavior are their geographic location, their closeness to farming activities, the environmental orientation of the head of the household and the presence of children under 18 years of age. The intensity of averting costs is influenced by the geographic location, the source of drinking water, the income, the educational attainment and the age of the head of the household as well as the number of children under 18 years of age., Réaction de ménages du Québec face à la dégradation de la qualité des eaux souterraines. Cette recherche étudie la réaction de ménages québécois face à la dégradation de la qualité des eaux souterraines. Plus spécifiquement, elle tente d'identifier les déterminants qui i) motivent les décisions des ménages en ce qui a trait aux activités de protection encourus pour se protéger contre les problèmes occasionnés par cette dégradation et ii) expliquent les différences entre les coûts engagés par les ménages ayant entrepris des activités de protection. Parmi les ménages déclarant souffrir de problèmes de qualité de l'eau, ceux jugeant subir des nuisances qui renvoient à la couleur, à l'odeur et au goût désagréable, sont moins enclins à prendre des mesures de protection et dépensent, en moyenne, moins pour ces mesures que ceux estimant souffrir de problèmes de contamination de l'eau. Les facteurs qui déterminent le comportement de protection des ménages sont la localisation géographique, la proximité des activités agricoles, l'orientation environnementale du chef de ménage et la présence d'enfants de moins de 18 ans au sein du ménage. L'ampleur des coûts de protection est influencée par la localisation géographique, la source d'approvisionnement en eau potable, le revenu, le niveau d'éducation et l'âge du chef de famille, aussi bien que le nombre d'enfants de moins de 18 ans que compte le ménage., Traoré Namatié, Amara Nabil, Landry Réjean. Households' response to groundwater quality degradation. Results from a household survey in Quebec.. In: Cahiers d'Economie et sociologie rurales, N°52, 3e trimestre 1999. pp. 5-22.

The first experiments are reported on oestrus synchronization in cattle in the Republic of Mali. The animals recieved Bovisynchron twice a day orally over a period of 15 days. The synchronization effect was marked; insemination was performed on the 5th and 6th day p.s. The intensity of the oestrus and especially the results of pregnancy are in close relationship to the breeding conditions and the general status of the animals. The oestrus synchronization is considered a favourable biotechnical method for regulating the reproduction provided that the animals are kept stationary or temporarily stationary.