RESUMEN
The transport and deposition of atmospheric pollutants in the Himalayas have a adverse impact on the climate, cryosphere, ecosystem, and monsoon patterns. Unfortunately, there is a insufficiency of data on trace element concentrations and behaviors in the high-altitude Himalayan region, leading to limited research in this area. This study presents a comprehensive and detailed comprehension of trace element deposition, its spatial distribution, seasonal variations, and anthropogenic signals in the high-altitude Kashmir region of the Western Himalayas. Our investigation involved the analysis of 10 trace elements (Al, Cr, Mn, Fe, Co, Ni, Cu, Zn, Cd, and Pb) in glacier ice, snow pits, surface snow, and rainwater collected at various sites including Kolahoi, Thajwas, Pahalgam (Greater Himalayan ranges), and Kongdori and Shopian (Pir Panjal Ranges) during 2021. The study reveals distinct ranges of concentrations for the trace elements at different sampling sites. Our analysis of trace element concentration depth profiles in snow pits reveals seasonal fluctuations during the deposition year. The highest concentrations were found in the autumn (below 20 cm) and summer (top layer), compared to the winter concentration (10-20 cm). The high enrichment factors (EFs) suggest the severity of human-induced trace metal deposition in the western Himalayan region, relative to surrounding regions. Surprisingly, the concentrations and EFs of trace elements showed seasonal contradictions, with lower concentration values and higher EFs during the non-monsoon season and vice versa. A source apportionment analysis using the positive matrix factorization (PMF) technique identified five sources of trace element deposition in the region, including crustal sources (32.33%), coal combustion (15.62%), biomass burning (17.63%), traffic emission (18.8%), and industrial sources (15.6%). Additionally, the study incorporated backward trajectories coupled with δ18O using the NOAA HYSPLIT model to estimate moisture sources in the region, which suggests atmospheric pollutants predominately deposited from the large-scale atmospheric circulation from westerlies (75%) during non-monsoon season. These findings underscore the urgent need for enhanced monitoring and research efforts in the future.
Asunto(s)
Contaminantes Atmosféricos , Monitoreo del Ambiente , Estaciones del Año , Oligoelementos , Oligoelementos/análisis , Contaminantes Atmosféricos/análisis , Nieve/química , India , Humanos , HimalayasRESUMEN
Physiotherapy as a health profession is continuously evolving in high-income countries (HIC). The highest burden of disease globally, however, is in low-resource and conflict contexts (LR-CC), resulting in unmet rehabilitation needs. Rehabilitation service models from HIC often face challenges when applied to the fragile health systems of LR-CC. It is important to engage rehabilitation experts living and working in LR-CC to guide service development. This study aims to understand physiotherapists' views and perspectives of current rehabilitation services, of how these services can be strengthened over the next 10 years and of the role of physiotherapy within this development. Focus group discussions (FGDs) were conducted with 31 physiotherapists from 18 LR-CC using English as a common language. Audio recordings were transcribed verbatim. Data analysis was guided by thematic analysis. Participants provided deep insights into the complexity of developing rehabilitation services within fragile health systems. Participants agreed that physiotherapy lacked recognition and resources to be utilised effectively. Interacting themes as crucial prerequisites for strengthening the sector included (1) significance of context, (2) professional identity, and (3) professionalisation supported by workforce development and advocacy. These results are an important evidence base for informing the development of rehabilitation programmes in LR-CC and for future research.
Asunto(s)
Medicina , Fisioterapeutas , Grupos Focales , Humanos , Modalidades de Fisioterapia , Investigación CualitativaRESUMEN
Objective: We aimed to describe the causes, types, and consequences of lower limb amputation and the demographics of subjects with such amputation who attended a tertiary rehabilitation center in Bangladesh, Centre for the Rehabilitation of the Paralysed.Methods: Cross-sectional data were collected from subjects with lower limb amputation who attended a specialized rehabilitation center between January 2014 and August 2016. Telephone interviews were conducted using a structured questionnaire. Descriptive analysis, paired t-test, and Fisher's exact test were conducted as well as a regression analysis was performed.Results: A total of 332 respondents, aged 5 to 76 years (mean 37.5± SD 13.8), with lower limb amputation participated in the study. Of the respondents, the majority were male (87.7%) and lived in rural areas (64.8%). Road traffic accidents were the leading cause (58.7%) of amputation followed by peripheral vascular diseases (7.5%) and hit by sharp objects (7.2%). Age (odds ratio: 0.9) and driving as occupation (odds ratio: 7.3) were found to be statistically significant covariates for amputation from road traffic accidents. The mean duration between having an amputation and receiving the first prosthetic fitting was 6.4 years (±8.9). Among the study participants, 30.7% lost their jobs after amputation and their mean monthly income reduced significantly (p < 0.01) from US$119.9 (±421.5) to US$45.8 (±63.1).Conclusion: Majority of the lower limb amputations resulted from traumatic road traffic accidents. Younger males and drivers were found to be more prone to amputation from road traffic accidents. Lower limb amputation creates great health and economic disparity in the amputee's lives.Implications for rehabilitationMajority of the lower limb amputation cases in Bangladesh were attributable to road traffic accidents-a largely preventable cause.The mean time between amputation and prosthetic fitting was more than 6 years which implies lack of awareness and inaccessibility of prosthetic management.Policymakers, regulators, law enforcement, and traffic safety advocates should take urgent actions to prevent road traffic accidents and raise awareness about and improve availability of prosthetic rehabilitation in Bangladesh.