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This article describes the results of a survey carried out during the years 2003-2004 to determine compliance with requisites to receive the Ministry of Social Protection's certification as decentralized in health in a representative sample of Colombian municipalities. The results are used to evaluate the validity of certification status as an indicator of decentralization and to construct an alternative decentralization scale. The study finds that despite being certified, municipalities do not meet all certification criteria. Although the number of fulfilled requisites seems to be related to certification status, there are no clear cut differences between certified and non certified municipalities in the type of requisites that are met. The proposed scale seems to capture both quantitative and qualitative differences in met requisites. The findings of the survey question whether certification status itself can be used as an indicator that adequately reflects the degree of health decentralization in municipalities. [ABSTRACT FROM AUTHOR]

Studies examining nanoparticles (NPs) and hazardous elements (HEs) contained in suspended sediments (SSs) are vital for watershed administration and ecological impact evaluation. The biochemical consequence of titanium-nanoparticles (Ti-NPs) from SSs in Colombia's Magdalena River was examined utilizing an innovative approach involving nanogeochemistry in this study. In general, the toxicity and the human health risk assessment associated with the presence of some Ti-NPs + HEs in SSs from riverine systems need to be determined with a robust analytical procedure. The mode of occurrence of Ti-NPs, total Ti and other elements contained within SSs of the Magdalena River were evaluated through advanced electron microscopy (field emission scanning electron microscope-FE-SEM and high resolution transmission electron microscope-HR-TEM) coupled with an energy dispersive X-ray microanalysis system (EDS); X-Ray Diffractions (XRD); and inductively coupled plasma-mass spectrometry (ICP-MS). This work showed that enormous quantities of Ti-NPs were present in the river studied and that they displayed diverse geochemical properties and posed various possible ecological dangers. Ti-NP contamination indices must be established for measuring the environmental magnitudes of NP contamination and determining contamination rank among rivers. Finally, SS contamination guidelines must be recommended on an international level. This study contributes to the scientific understanding of the relationship of HE and Ti-NP dynamics from SSs in riverine systems around the world. [Display omitted] • Titanium nanoparticles frequently occur in natural media and may control key chemical growths • Titanium agglomerated particles was detected in suspended sediments samples • Fluvial suspended sediments contained hazardous elements • Environmental variation in sampled samples affects engineered titanium detectability. [ABSTRACT FROM AUTHOR]

Scientific works examining coal-derived nanoparticles (NPs) containing potentially toxic elements (PTEs) confined in marine suspended sediments (MSSs) in port regions worldwide is an understudied topic, despite the fact that coal NPs have tremendous negative impacts on marine estuaries. The general objective of this study is to analyze the NP levels of coal, including PTEs, contained within MSSs in the general vicinity of the largest Caribbean port in Colombia. The morphology, size, chemical composition, and agglomeration states of NPs within MSSs of the sampled beaches were calculated through modern electron microscopy. The methodology used to detect chemical elements, unfortunately with EDS, it is not possible to precisely specify the chemical elements of low atomic weight (e.g. H, O, F, etc.) Therefore, with the EDS available today, it is only possible to have an idea of the chemical composition of each detected particle. Thus, it was possible to obtain the average frequency of the chemical elements identified in the 23 analyzed sampling points. Through the results, more than one thousand particles were detected in the most abundant phases, thus, the most frequent particles in the results of this manuscript were described. Sample point 8, located closest to the coal export port, had a higher concentration of nano-toxic elements (Al, Fe, Si, K, Mg, K) most concerning for human health in addition to being harmful to marine life. This study suggests that public policies dealing with MSS pollution need to be discussed by public managers to avoid further and sustained environmental degradation. The need to create projects will subsidize legacy liabilities generated by coal in seaports in other regions of the world., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Modern microscopy studies are capable of revealing ultra-fine particles (UFPs) and nanoparticles (NPs) that are produced in the processes related to traffic vehicular, industrial, metropolitan, and marine aerosol dry deposition in the coastal zones. Especially, secondary aerosol passages complexes categories of NPs and UFPs, which can be accumulated on construction compounds and by dry deposition, encourages multiples monuments deterioration routes. The advanced electron microscopies method is one of the most utilized in environmental studies. Between the different industrial areas in the world, the Caribbean area is the most relevant symbols of air quality due to climatic conditions with strong winds, but this study shows that regionally the most industrialized region does not have an adequate air quality. In the present work, electron microscopy analyses are used to describe of the extent of ultra-fine particle and nanoparticles in walls in contact to weathering. Numerous phases were recognized by advanced mineralogy methods. Thanks to the new analytical procedure it was feasible to understand NPs and UFPs; the occurrence of potential hazardous elements (PHEs), most of them as minerals but also combined in multiple accumulations with Al-Cr-Fe-K-Mg-Pb-Si-Ti-Zn amorphous; and carbonaceous phases., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To evaluate the effectiveness of alcohol-based handrubs (ABH) in reducing acute diarrheal diseases (ADD) and acute respiratory infections (ARI) among children 1-5 years of age in childcare centers with limited tap water., Methods: This was the first cluster-randomized controlled trial in a developing country. The study took place at 42 childcare centers with sporadic and limited water availability in six towns in Colombia. Participants were randomly assigned to use ABH as a complement to handwashing (intervention arm: 21 centers/794 children); or to continue existing handwashing practices (control arm: 21 centers/933 children). ADD and ARI cases were identified through teacher-reported signs and symptoms of illness. Adverse events were monitored. Hazard ratios (HR) were obtained using Cox proportional hazards multivariate regression shared frailty models., Results: Child-days of surveillance totaled 336 038. Loss to follow up was 14.5%. For both ADD and ARI, there were no differences in hazard ratios during the first trimester of the study. In the second and third trimesters, significant reductions in the risk of ADD were found in the intervention compared to control arm (HR = 0.55, P < 0.001 and HR = 0.44, P < 0.001, respectively). There were also significant risk reductions for ARI in the second trimester (HR = 0.80, P < 0.05) and in the third trimester (HR = 0.69, P < 0.001). No adverse events occurred., Conclusions: ABH effectively prevent ADD and ARI, and are safe. Colombia's national public health policies for prevention of these diseases should include use of ABH, especially in settings where handwashing with soap and water is limited by water availability.

Objectives: This article describes the difficulties encountered in obtaining information about health services, sanitation and health insurance coverage supply, use and coverage regarding a sample of Colombian municipalities during 1991-2000. The availability of information is also analysed in terms of decentralisation and municipal development., Method: This was a cross-sectional study of a random stratified sample of 495 Colombian municipalities; information regarding the variables of interest was requested at municipal and departmental level and from national sources. A scale was constructed for measuring the availability of information at local level. Non-parametric statistics were used for testing differences in availability of information in terms of certification and municipal category., Results: Applying the scale revealed 51% availability of data regarding health service supply, 39% for data regarding service use and 45% for both types of information (supply and demand taken together). No information was available in 32% of the municipalities. Information was more readily available in non-certified and less developed municipalities., Conclusions: Study findings provided indirect evidence of difficulty in obtaining information regarding health systems at both municipal and departmental levels; this represents an important obstacle for health system management and evaluating performance, as well as for research and widening knowledge (and availability to such knowledge) in this area.