In recent times, surface water resource in the Western Region of Ghana has been found to be inadequate in supply and polluted by various anthropogenic activities. As a result of these problems, the demand for groundwater by the human populations in the peri-urban communities for domestic, municipal and irrigation purposes has increased without prior knowledge of its water quality. Water samples were collected from 14 public hand-dug wells during the rainy season in 2013 and investigated for total coliforms, Escherichia coli, mercury (Hg), arsenic (As), cadmium (Cd) and physicochemical parameters. Multivariate statistical analysis of the dataset and a linear stoichiometric plot of major ions were applied to group the water samples and to identify the main factors and sources of contamination. Hierarchal cluster analysis revealed four clusters from the hydrochemical variables (R-mode) and three clusters in the case of water samples (Q-mode) after z score standardization. Principal component analysis after a varimax rotation of the dataset indicated that the four factors extracted explained 93.3 % of the total variance, which highlighted salinity, toxic elements and hardness pollution as the dominant factors affecting groundwater quality. Cation exchange, mineral dissolution and silicate weathering influenced groundwater quality. The ranking order of major ions was Na+ > Ca2+ > K+ > Mg2+ and Cl− > SO4
 2− > HCO3
 −. Based on piper plot and the hydrogeology of the study area, sodium chloride (86 %), sodium hydrogen carbonate and sodium carbonate (14 %) water types were identified. Although E. coli were absent in the water samples, 36 % of the wells contained total coliforms (Enterobacter species) which exceeded the WHO guidelines limit of zero colony-forming unit (CFU)/100 mL of drinking water. With the exception of Hg, the concentration of As and Cd in 79 and 43 % of the water samples exceeded the WHO guideline limits of 10 and 3 μg/L for drinking water, respectively. Reported values in some areas in Nigeria, Malaysia and USA indicated that the maximum concentration of Cd was low and As was high in this study. Health risk assessment of Cd, As and Hg based on average daily dose, hazard quotient and cancer risk was determined. In conclusion, multiple natural processes and anthropogenic activities from non-point sources contributed significantly to groundwater salinization, hardness, toxic element and microbiological contamination of the study area. The outcome of this study can be used as a baseline data to prioritize areas for future sustainable development of public wells.

Total coliforms, arsenic and cadmium exposure through drinking water in the Western Region of Ghana: application of multivariate statistical technique to groundwater quality

Multivariate statistical analysis and geochemical modeling for geochemical assessment of groundwater of Delhi, India

A study has been carried out in crystalline hard rock aquifers of Madurai district, Tamil Nadu, to identify the spatial and temporal variations and to understand sources responsible for hydrogeochemical processes in the region. Totally, 216 samples were collected for four seasons [premonsoon (PRM), southwest monsoon (SWM), northeast monsoon (NWM), and postmonsoon (POM)]. The Na and K ions are attributed from weathering of feldspars in charnockite and fissile hornblende gneiss. The results also indicate that monsoon leaches the U ions in the groundwater and later it is reflected in the (222)Rn levels also. The statistical relationship on the temporal data reflects the fact that Ca, Mg, Na, Cl, HCO3, and SO4 form the spinal species, which are the chief ions playing the significant role in the geochemistry of the region. The factor loadings of the temporal data reveal the fact that the predominant factor is anthropogenic process and followed by natural weathering and U dissolution. The spatial analysis of the temporal data reveals that weathering is prominent in the NW part and that of distribution of U and (222)Rn along the NE part of the study area. This is also reflected in the cluster analysis, and it is understood that lithology, land use pattern, lineaments, and groundwater flow direction determine the spatial variation of these ions with respect to season.

A multivariate statistical approach to identify the spatio-temporal variation of geochemical process in a hard rock aquifer.

Background The COVID-19 pandemic and associated restrictions caused major global disruption. Individuals with long-term physical health conditions (LTCs) are at higher risk of severe illness and often subject to the strictest pandemic guidance, so may be disproportionally affected. The aim of this study was to qualitatively explore how living with a LTC during the COVID-19 pandemic affected people's mental health and wellbeing. Methods Participants were people living with LTCs who participated in telephone/video call interviews based on a semi-structured topic guide. Key themes and subthemes were determined using deductive and inductive thematic analysis. Results The sample included 32 participants with LTCs (most commonly cancer, respiratory conditions or cardiovascular diseases), mean age 57 (SD 13) years, 66% female and 72% white British. There were four overarching themes specific to living with a LTC. These were 1) high levels of fear and anxiety related to perceived consequences of catching COVID-19, 2) impact of shielding/isolation on mental health and wellbeing, 3) experience of healthcare during the pandemic and 4) anxiety created by uncertainty about the future. Fourteen subthemes were identified, including concerns about accessing essential supplies and the importance of social support. Individuals who lived alone and were advised to shield could be profoundly negatively affected. Conclusions This study found that there were a number of aspects of living with a LTC during the pandemic that had a significant impact on mental health and well-being. There should be focus on how best to provide practical and social support to people with LTCs during a pandemic, particularly if they have to shield or isolate.

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The impact of the COVID-19 pandemic on mental health and well-being of people living with a long-term physical health condition: a qualitative study.

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COVID-19 Vaccine Acceptability Among Women Who are Pregnant or Planning for Pregnancy in Saudi Arabia: A Cross-Sectional Study

People with chronic conditions are disproportionately prone to be affected by the COVID-19 pandemic but there are limited data documenting this. We aimed to assess the health, psychosocial and economic impacts of the COVID-19 pandemic on people with chronic conditions in India. Between July 29, to September 12, 2020, we telephonically surveyed adults (n = 2335) with chronic conditions across four sites in India. Data on participants’ demographic, socio-economic status, comorbidities, access to health care, treatment satisfaction, self-care behaviors, employment, and income were collected using pre-tested questionnaires. We performed multivariable logistic regression analysis to examine the factors associated with difficulty in accessing medicines and worsening of diabetes or hypertension symptoms. Further, a diverse sample of 40 participants completed qualitative interviews that focused on eliciting patient’s experiences during the COVID-19 lockdowns and data analyzed using thematic analysis. One thousand seven hundred thirty-four individuals completed the survey (response rate = 74%). The mean (SD) age of respondents was 57.8 years (11.3) and 50% were men. During the COVID-19 lockdowns in India, 83% of participants reported difficulty in accessing healthcare, 17% faced difficulties in accessing medicines, 59% reported loss of income, 38% lost jobs, and 28% reduced fruit and vegetable consumption. In the final-adjusted regression model, rural residence (OR, 95%CI: 4.01,2.90–5.53), having diabetes (2.42, 1.81–3.25) and hypertension (1.70,1.27–2.27), and loss of income (2.30,1.62–3.26) were significantly associated with difficulty in accessing medicines. Further, difficulties in accessing medicines (3.67,2.52–5.35), and job loss (1.90,1.25–2.89) were associated with worsening of diabetes or hypertension symptoms. Qualitative data suggest most participants experienced psychosocial distress due to loss of job or income and had difficulties in accessing in-patient services. People with chronic conditions, particularly among poor, rural, and marginalized populations, have experienced difficulties in accessing healthcare and been severely affected both socially and financially by the COVID-19 pandemic.

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Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: a mixed methods study.

In recent decades low- and middle-income countries (LMICs) have been witnessing a significant shift toward raised blood pressure; yet in LMICs, only 1 in 3 are aware of their hypertension status, and ≈8% have their blood pressure controlled. This rising burden widens the inequality gap, contributes to massive economic hardships of patients and carers, and increases costs to the health system, facing challenges such as low physician-to-patient ratios and lack of access to medicines. Established risk factors include unhealthy diet (high salt and low fruit and vegetable intake), physical inactivity, tobacco and alcohol use, and obesity. Emerging risk factors include pollution (air, water, noise, and light), urbanization, and a loss of green space. Risk factors that require further in-depth research are low birth weight and social and commercial determinants of health. Global actions include the HEARTS technical package and the push for universal health care. Promising research efforts highlight that successful interventions are feasible in LMICs. These include creation of health-promoting environments by introducing salt-reduction policies and sugar and alcohol tax; implementing cost-effective screening and simplified treatment protocols to mitigate treatment inertia; pooled procurement of low-cost single-pill combination therapy to improve adherence; increasing access to telehealth and mHealth (mobile health); and training health care staff, including community health workers, to strengthen team-based care. As the blood pressure trajectory continues creeping upward in LMICs, contextual research on effective, safe, and cost-effective interventions is urgent. New emergent risk factors require novel solutions. Lowering blood pressure in LMICs requires urgent global political and scientific priority and action.

Hypertension in Low- and Middle-Income Countries.

Groundwater samples from Pambar subbasin were analyzed for chemical parameters. For present study 61 water samples were collected the study area in a regular distribution. The higher values of most of the parameters were found in the area of old settlement, while lower values observed in new settlements. This shows clear impact of land use on groundwater. Water quality data collected from different localities are used in conjunction with multivariate statistical technique to identify key variables. The first four components were chosen for interpretation of the data, which accounts for 76.47% of the total variance in the data set. The maximum number of variables, i.e. Cl, Na, TH, TDS and EC were characterized by first component, while second component is characterized by PO4 and NO2. The third and fourth components were characterized by Na and K respectively. This shows that hydrochemical constituents of the groundwater are mainly controlled by TDS and EC. For cluster analysis Wards linkage method was used. The findings of the cluster analysis are presented in the form of dendrogram of the sampling stations (cases) as well as hydrochemical variables, which produced three major groupings, suggests that groundwater monitoring can be consolidated.

Sailesh Mohan

Papers

Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: a mixed methods study.

Hypertension in Low- and Middle-Income Countries.

Integrating Multivariate Statistical Analysis with GIS for Groundwater in Pambar SubBasin, Tamil Nadu, India