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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

The present study aimed to examine elemental contamination near the residential areas of four coal thermal power plants in India. Water and surface soil samples were collected from various geographic sites around Chennai, Korba, Rupnagar, and Udupi power plants. The study identified aluminum (Al), arsenic (As), chromium (Cr), cobalt (Co), copper (Cu), cadmium (Cd), iron (Fe), lithium (Li), magnesium (Mg), manganese (Mn), mercury (Hg), nickel (Ni), zinc (Zn), and lead (Pb) in water and soil samples. Further, soil morphology was also studied using the SEM and EDX. Additionally, using non-cancerous and cancerous risk indices, human health hazards through consuming contaminated water and soil were estimated. Results indicated that Fe and Mn concentrations in water exceeded the standard limits, i.e., the Fe (0.36 mg/l) at site 2 (Chennai), 0.490 mg/l at site 1, and 1.907 mg/l at site 3 (Udupi), while Mn was found as 0.28 mg/l at site 4 (Chennai), 0.27 mg/l at site 3 (Udupi), and 1.52 mg/l at site 4 (Rupnagar). In the case of soil, the maximum metal concentration (mg/kg) was found in Rupnagar, followed by Chennai, Korba, and Udupi. The hazard index (HI) for non-cancerous and cancerous risks was found within the USEPA standard limits, indicating insignificant health risks to the adjoining population of coal thermal power plants. This study provides baseline information regarding the elemental composition in water and soil and the associated health risk status around Indian coal thermal power plants.

The seasonal quality of groundwater and its appropriateness for drinking and irrigation were assessed using a multiple indexing approach in this study. Physicochemical and ionic parameters were examined in groundwater samples near the industrial zone of Rupnagar, Punjab. To assess groundwater quality, water quality index (WQI) and pollution index were used. The Durov's, piper, wilcox and stiff diagrams were plotted to understand the hydro-chemistry. Similarly, the irrigation indices, i.e., salinity hazard, sodium adsorption ratio, soluble sodium percentage (Na%), magnesium adsorption ratio, residual sodium carbonate, permeability index and Kelley's ratio were applied to ascertain the water quality for agricultural purposes. As a result, total hardness, calcium (Ca2+), magnesium (Mg2+) and fluoride (F−) were found above the standard permissible limits. WQI analysis showed 12% samples of pre-monsoon (PRE-M) and 28% samples of post-monsoon (POS-M) were of poor quality, which may pose health risks. Hydrochemistry revealed the predominance of Ca2+, Na+, Mg2+ and HCO3− ions in the groundwater attributed to natural and anthropogenic sources. Piper diagram revealed Ca2+-Mg2+-Cl−, Na+-Cl−, Ca2+-Na+- HCO3−, Ca2+- HCO3− and Ca2+-Cl, Ca2+-HCO3− water types exist in the study area. USSL diagram showed that the samples from both seasons come under the low salinity hazard. In addition, total dissolved solids and electrical conductivity showed a strong positive association, indicating the saline nature of groundwater. Furthermore, hierarchical clustering classified groundwater into three groups (I, II and III), revealing that groundwater quality varies due to natural and anthropogenic effects. Based on the findings, the groundwater was found marginally suitable for drinking and irrigation purposes. It is therefore recommended that the groundwater is examined on a regular basis in order to maintain its quality.

Groundwater over-exploitation leading to quality deterioration is an accepted fact, but limited work in this direction has been carried out in the Indian state of Punjab, where groundwater development is 172 %, the highest of any state in India. This paper makes an assessment of the groundwater quality in three administrative blocks of Rupnagar district in Punjab, in two of which groundwater exploitation has already reached about 200 %. Sixty groundwater samples were collected from shallow tubewells and hand pumps in premonsoon season (May, 2013) and were analyzed for major chemical parameters. Analytical results do not show any perceptible deterioration in groundwater quality; all the parameters are well within the permissible limits of the Indian standards, except for electrical conductivity (EC), total dissolved solids (TDS), Ca and Mg, which exceed the desirable limits in few groundwater samples. Abundance of ions in the water samples is in the order: HCO 3 −  > Cl −  > SO 4 2−  > NO 3 − and Mg 2+  > Ca 2+  >N a +  > K + . Data plotted on the US Salinity Laboratory diagram show that most of the samples fall in the category of C 2 S 1 and C 3 S 1 , which makes the groundwater suitable for irrigation in all types of soil. Other chemical indices such as % sodium (%Na), sodium absorption ratio (SAR), and residual sodium carbonate (RSC) also show that almost all samples are fit for irrigation purposes. This work thus concludes that groundwater quality deterioration due to irrigation has not yet been well perceived in the state of Punjab, even if much of its groundwater resources have been over-exploited. However, the paper warns against indiscriminate drilling and over-exploitation of the groundwater resources for their long-term usage and sustainability.

Water is a fluctuating resource making it difficult to measure in time and in space. To demonstrate the efficiency of the geographic information system (GIS) for groundwater studies, information on the parameters controlling groundwater such as lithology, geomorphology and lineament analysis were analyzed. LISS-III and Landsat satellite image of the area was used to infer information on the geologic lineaments and geomorphology. To delineate linear features enhancement and direction, filtering was performed on single bands of Landsat images. Thematic maps for geology, slope, geomorphology and lineament were prepared and integrated in GIS by assigning the weights and ranking to various parameters controlling the occurrence of groundwater to generate the groundwater potential map for the study area. The results indicate that the floodplain of river and its adjoining areas have very good groundwater potential, whereas the steeply sloping area in the northern part having high relief and slope possesses poor groundwater potential.

The dependency of people on groundwater has increased in the past few decades due to tremendous increase in crop production, population and industrialization. Groundwater is the main source of irrigation in Shiwaliks of Punjab. In the present study the samples were collected from predetermined location as was located on satellite image on basis of spectral reflectance. Global positioning system was used to collect samples from specific locations. Principal components analysis (PCA) together with other factor analysis procedures consolidate a large number of observed variables into a smaller number of factors that can be more readily interpreted. In the present study, concentrations of different constituents were correlated based on underlying physical and chemical processes such as dissociation, ion exchange, weathering or carbonate equilibrium reactions. The PCA produced six significant components that explained 78% of the cumulative variance. The concentration of the few trace metals was found to be much higher indicating recharge due to precipitation as main transport mechanism of transport of heavy metals in groundwater which is also confirmed by PCA. Piper and other graphical methods were used to identify geochemical facies of groundwater samples and geochemical processes occurring in study area. The water in the study area has temporary hardness and is mainly of Ca–Mg–HCO 3 type.

Groundwater, a renewable and finite natural resource, vital for man’s life, social and economic development and a valuable component of the ecosystem, is vulnerable to natural and human impacts. The aim of present study is to evaluate hydrogeochemical parameters and heavy metals in groundwater and to study their spatial distribution in the Rupnagar District of Punjab. The spatial distribution of physico-chemical parameters were studied using Arc GIS 9.2. It was observed that the concentration of parameters, such as NO₃, Cd, Cr, Mn and Pb was above permissible limit (World Health Organization, WHO) in southern part of the study area. The heavy metal pollution index (HPI) was calculated for all sampling locations and it was found much above the critical limit of pollution. Geochemical reaction models of selected water groups were constructed using Phreeqc. Geochemical modeling suggests that sodium has source other than halite-albite and calcium has alternate source other than gypsum-carbonate or silicates. It also suggests that evaporites, ion exchange, dissolution along with anthropogenic activities are controlling the hydro-geochemistry of groundwater in the region. Various indices, such as heavy metal pollution index, permeability index, sodium adsorption ratio, were studied to verify suitability of groundwater for drinking and irrigation.

The groundwater resource is a multidimensional concept; it is defined by its location, its occurrence over time, its size, properties, conditions of accessibility, the effort required to mobilize it and therefore, all of which are to be considered in the context of demand. Groundwater, a renewable and finite natural resource, vital for man’s life, social and economic development and a valuable component of the ecosystem, is vulnerable to natural and human impacts. There is a great need for the assessment and monitoring of quality and quantity of groundwater resource required at local level to develop an exact scenario of watershed. In this study qualitative assessment of groundwater was done and a ground water quality index criterion was used to understand the suitability of groundwater for irrigation and drinking purpose in the study area. A GIS based multicriteria analysis was done by assigning weight to different water quality parameters. The water quality was grouped into six classes from very good to unfit for drinking. It was found that the in most part of the study area the water quality varied from moderate to good except in some areas where it is poor to unfit. An assessment of change in landuse and landcover was done from the year 1989 using Landsat data to year 2006 using LISS III satellite data. The change in LULC was correlated with water quality data and it was found that the areas around which rapid urbanisation as well as industrialisation is taking place showed poor to unfit groundwater in terms of quality.

Human activities have exerted small to large scale changes on the hydrological cycle. The current scenario regarding groundwater resources suggests that globally there is a water crisis in terms of quantity (availability) and quality. Therefore there is a great need for the assessment and monitoring of quality and quantity of groundwater resources at local level. This paper presents a case study of the lower Shiwalik hills, in Rupnagar, Punjab, India, to trace land-use and land-cover changes during the past 17 years, with an emphasis on groundwater quality and quantity. This study was performed in alluvial and hilly terrain. The results show that the quantity of groundwater increased with the help of natural and artificial recharge due to change in land-use and land-cover pattern (increased area of fallow land). The quality of groundwater deteriorated due to input of fertilizers for enhancing the short-term soil fertility. Using a Remote Sensing and GIS based approach, we show the final results in map form. In particular we highlight a potential groundwater exploration site, which could be useful for district level planning. Our research shows that the change in land-use and land-cover affects the quantity and quality of groundwater.

Radon and its progeny are major contributors in the radiation dose received by general population of the world. Keeping this in mind, the environmental monitoring of radon–thoron and their progeny in dwellings of district Rupnagar, Punjab, India has been carried out. Both radon–thoron twin dosimeter cups and the newly developed pin-hole dosimeters cups by BARC, India were used for the study. The study reveals good agreement between the values measured by the two types of dosimeters. Radon exhalation rate from soil samples of these dwellings/areas have been carried out using “Canister Technique.” The radon exhalation rates of some soil samples of these dwellings/areas were also measured by an active technique using a continuous radon monitor. Both the active and passive techniques show the exhalation rate values to be lower than the worldwide average. The study of the exhalation rate of the soil samples of Nangal and Anandpur Sahib of the district Rupnagar and the sand samples available from the study area has also been carried out for the possible use as construction material. The in situ gamma dose varied from 0.13 to 0.33 µSv/h.