Techno-economic evaluation for the improvement of MSW collection in Somaliland and Puntland.

This paper is based on a study, which aim is to provide an overview of the current MSW management in the main cities in Somaliland and Puntland and to identify strategies to improve the present situation. In particular, this article illustrates assessments concerning waste collection and technical solutions identified for its improvement, whereas waste treatment and disposal phases will be discussed in a further paper. The survey, which has been carried out in close collaboration with local administrators and technicians, has shown that MSW management is very lacking and needs both structural and operational actions. Waste collection in the surveyed cities covers 65% of population at its best, whereas it is substantially absent in Gardo and Sheik. The extension of waste collection service to the entire population of each city would need investment costs varying between 17,500 USD for Sheik and 200,000 USD for Galkayo, whereas total operational costs would vary between 1.17 USD/ inh/y in Boroma and 5.73 USD/inh/y in Garowe. Anyway, technical interventions are necessary to provide a larger number of citizens with a regular waste collection service and they should be preceded and accompanied by public awareness campaigns on environmental protection and capacity building services addressed to local administrators and technicians.

Air pollution, aeroallergens, and emergency room visits for acute respiratory diseases and gastroenteric disorders among young children in six Italian cities.

BACKGROUND: Past studies reported evidence of associations between air pollution and respiratory symptoms and morbidity for children. Few studies examined associations between air pollution and emergency room (ER) visits for wheezing, and even fewer for gastroenteric illness. We conducted a multicity analysis of the relationship between air pollution and ER visits for wheezing and gastroenteric disorder in children 0-2 years of age. METHODS: We obtained ER visit records for wheezing and gastroenteric disorder from six Italian cities. A city-specific case-crossover analysis was applied to estimate effects of particulate matter (PM), nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide, adjusting for immediate and delayed effects of temperature. Lagged effects of air pollutants up to 6 prior days were examined. The city-specific results were combined using a random-effect meta-analysis. RESULTS: CO and SO(2) were most strongly associated with wheezing, with a 2.7% increase [95% confidence interval (CI), 0.5-4.9] for a 1.04-microg/m(3) increase in 7-day average CO and a 3.4% (95% CI, 1.5-5.3) increase for an 8.0-microg/m(3) increase in SO(2). Positive associations were also found for PM with aerodynamic diameter < or = 10 microg and NO(2). We found a significant association between the 3-day moving average CO and gastroenteric disorders [3.8% increase (95% CI, 1.0-6.8)]. When data were stratified by season, the associations were stronger in summer for wheezing and in winter for gastroenteric disorders. CONCLUSION: Air pollution is associated with triggering of wheezing and gastroenteric disorders in children 0-2 years of age; more work is needed to understand the mechanisms to help prevent wheezing in children.

Bilateral serous retinal detachments following organ transplantation.

PURPOSE: The authors report the physiopathogenetic features of bilateral serous neurosensory retinal detachments occurring in patients who have undergone organ transplantation. METHODS: The clinical and photographic findings of four patients who have undergone renal (3 cases) and liver (1 case) transplantation in whom bilateral serous retinal detachment developed early after surgery were reviewed. The patients were processed for clinical symptoms, visual acuity evaluation, slitlamp and fundus examinations, tonometry and fluorescein angiography. RESULTS: Ocular examination, in patients complaining of blurred vision and metamorphopsia, revealed loss of visual acuity, bullous serous neurosensory retinal detachment with retinal pigment epithelial detachments in fundus examination and areas of dye leakage in fluorescein angiography, despite tonometry and slitlamp examination were unremarkable. These alterations were spontaneously resolved with the normalization of renal function. CONCLUSION: The only common factor in each of the four patients resulted in alterations of the kidney function. This finding provides further evidence that renal failure may cause alterations in electrolytes extracellular distribution, leading to the formation of serous neurosensory retinal detachments.