scholarly journals Territorial strategy of medical units for addressing the COVID-19 pandemic in the metropolitan area of Mexico City: analysis of mobility, accessibility and marginalization

2021 ◽  
Author(s):  
Mateo Carlos Galindo-Pérez ◽  
Manuel Suárez ◽  
Ana Rosa Rosales-Tapia ◽  
José Sifuentes-Osornio ◽  
Ofelia Angulo-Guerrero ◽  
...  

The COVID-19 pandemic has caused an exponential increase in the demand for medical care worldwide. In Mexico, the COVID Medical Units (CMU) conversion strategy was implemented. Objective. To evaluate the CMU coverage strategy in the Mexico City Metropolitan Area (MCMA) by territory. Materials. The CMU directory was used, as were COVID-19 infection and movement statistics and 2020 Mexican census information at the urban geographic area scale. The degree of urban marginalization by geographic area was also considered. Method. Using descriptive statistics and the calculation of a CMU accessibility index, population aggregates were counted based on coverage radii. In addition, two regression models are proposed to explain 1) the territorial and temporal trend of COVID-19 infections in the MCMA and 2) the movement of the COVID-infected population to medical units. Results. The findings of the evaluation of the CMU strategy were 1) in the MCMA, COVID-19 followed a pattern of contagion from the urban center to the periphery; 2) given the growth in the number of cases and the overload of medical units, the population traveled greater distances to seek medical care; 3) after the CMU strategy was evaluated at the territory level, it was found that 9 out of 10 inhabitants had a CMU located approximately 7 kilometers away; and 4) at the metropolitan level, the lowest level of accessibility to the CMU was recorded for the population with the highest levels of marginalization: those residing in the urban periphery.

Author(s):  
Mateo Carlos Galindo-Pérez ◽  
Manuel Suárez ◽  
Ana Rosa Rosales-Tapia ◽  
José Sifuentes-Osornio ◽  
Ofelia Angulo-Guerrero ◽  
...  

Background. The COVID-19 pandemic has caused an exponential increase in the demand for medical care worldwide. In Mexico, the COVID Medical Units (CMUs) conversion strategy was implemented. Objective. To evaluate the CMU coverage strategy in the Mexico City Metropolitan Area (MCMA) by territory. Materials. The CMU directory was used, as were COVID-19 infection and mobility statistics and Mexican 2020 census information at the urban geographic area scale. The degree of urban marginalization by geographic area was also considered. Method. Using descriptive statistics and the calculation of a CMU accessibility index, population aggregates were counted based on coverage radii. In addition, two regression models are proposed to explain (1) the territorial and temporal trend of COVID-19 infections in the MCMA and (2) the mobility of the COVID-infected population visiting medical units. Results. The findings of the evaluation of the CMU strategy were (1) in the MCMA, COVID-19 followed a pattern of contagion from the urban center to the periphery; (2) given the growth in the number of cases and the overload of medical units, the population traveled greater distances to seek medical care; (3) after the CMU strategy was evaluated at the territory level, it was found that 9 out of 10 inhabitants had a CMU located approximately 7 km away; and (4) at the metropolitan level, the lowest level of accessibility to the CMU was recorded for the population with the highest levels of marginalization, i.e., those residing in the urban periphery.


2011 ◽  
Vol 11 (24) ◽  
pp. 13305-13323 ◽  
Author(s):  
V. A. Karydis ◽  
A. P. Tsimpidi ◽  
W. Lei ◽  
L. T. Molina ◽  
S. N. Pandis

Abstract. One of the most challenging tasks for chemical transport models (CTMs) is the prediction of the formation and partitioning of the major semi-volatile inorganic aerosol components (nitrate, chloride, ammonium) between the gas and particulate phases. In this work the PMCAMx-2008 CTM, which includes the recently developed aerosol thermodynamic model ISORROPIA-II, is applied in the Mexico City Metropolitan Area in order to simulate the formation of the major inorganic aerosol components. The main sources of SO2 (such as the Miguel Hidalgo Refinery and the Francisco Perez Rios Power Plant) in the Mexico City Metropolitan Area (MCMA) are located in Tula, resulting in high predicted PM1 (particulate matter with diameter less than 1 μm) sulfate concentrations (over 25 μg m-3) in that area. The average predicted PM1 nitrate concentrations are up to 3 μg m−3 (with maxima up to 11 μg m−3) in and around the urban center, mostly produced from local photochemistry. The presence of calcium coming from the Tolteca area (7 μg m−3) as well as the rest of the mineral cations (1 μg m−3 potassium, 1 μg m−3 magnesium, 2 μg m−3 sodium, and 3 μg m−3 calcium) from the Texcoco Lake resulted in the formation of a significant amount of aerosol nitrate in the coarse mode with concentrations up to 3 μg m−3 over these areas. PM1−10 (particulate matter with diameter between 1 and 10 μm) chloride is also high and its concentration exceeds 2 μg m−3 in Texcoco Lake. PM1 ammonium concentrations peak at the center of Mexico City (2 μg m−3) and the Tula vicinity (2.5 μg m−3). The performance of the model for the major inorganic PM components (sulfate, ammonium, nitrate, chloride, sodium, calcium, and magnesium) is encouraging. At the T0 measurement site, located in the Mexico City urban center, the average measured values of PM1 sulfate, nitrate, ammonium, and chloride are 3.5 μg m−3, 3.5 μg m−3, 2.1 μg m−3, and 0.36 μg m−3, respectively. The corresponding predicted values are 3.7 μg m−3, 2.7 μg m−3, 1.7 μg m−3, and 0.25 μg m−3. High sulfate concentrations are associated with the transport of sulfate from the Tula vicinity, while in periods where southerly winds are dominant; the concentrations of sulfate are low. The underprediction of nitrate can be attributed to the underestimation of OH levels by the model during the early morning. Ammonium is sensitive to the predicted sulfate concentrations and the nitrate levels. The performance of the model is also evaluated against measurements taken from a suburban background site (T1) located north of Mexico City. The average predicted PM2.5 (particulate matter with diameter less than 2.5 μm) sulfate, nitrate, ammonium, chloride, sodium, calcium, and magnesium are 3.3, 3.2, 1.4, 0.5, 0.3, 1.2, and 0.15 μg m−3, respectively. The corresponding measured concentrations are 3.7, 2.9, 1.5, 0.3, 0.4, 0.6, and 0.15 μg m−3. The overprediction of calcium indicates a possible overestimation of its emissions and affects the partitioning of nitric acid to the aerosol phase resulting occasionally in an overprediction of nitrate. Additional improvements are possible by improving the performance of the model regarding the oxidant levels, and revising the emissions and the chemical composition of the fugitive dust. The hybrid approach in which the mass transfer to the fine aerosol is simulated using the bulk equilibrium assumption and to the remaining aerosol sections using a dynamic approach, is needed in order to accurately simulate the size distribution of the inorganic aerosols. The bulk equilibrium approach fails to reproduce the observed coarse nitrate and overpredicts the fine nitrate. Sensitivity tests indicate that sulfate concentration in Tula decreases by up to 0.5 μg m−3 after a 50% reduction of SO2 emissions while it can increase by up to 0.3 μg m−3 when NOx emissions are reduced by 50%. Nitrate concentration decreases by up to 1 μg m−3 after the 50% reduction of NOx or NH3 emissions. Ammonium concentration decreases by up to 1 μg m−3, 0.3 μg m−3, and 0.1 μg m−3 after the 50% reduction of NH3, NOx, and SO2 emissions, respectively.


Author(s):  
Patricia Rojas ◽  
Elizabeth Ruiz-Sánchez ◽  
Camilo Ríos ◽  
Ángel Ruiz-Chow ◽  
Aldo A. Reséndiz-Albor

The use of the medicinal plant Ginkgo biloba has increased worldwide. However, G. biloba is capable of assimilating both essential and toxic metals, and the ingestion of contaminated products can cause damage to health. The aim of this study was to investigate the safety of manganese (Mn), copper (Cu), lead (Pb), arsenic (As), and cadmium (Cd) in 26 items containing Ginkgo biloba (pharmaceutical herbal products, dietary supplements, and traditional herbal remedies) purchased in the metropolitan area of Mexico City. Metal analysis was performed using a graphite furnace atomic absorption spectrometer. All of the products were contaminated with Pb, 54% of them with As, and 81% with Cd. The lowest values of Pb, As, and Cd were detected in pharmaceutical herbal products > dietary supplements > traditional herbal remedies. The daily intake dose (DID) of pharmaceutical herbal products was within the established limits for the five metals. Dietary supplements and traditional herbal remedies exceeded the DID limits for Pb. The hazard quotients estimation and non-carcinogenic cumulative hazard estimation index for Mn, As, and Cd indicated no human health risk. Our results suggest that products containing G. biloba for sale in Mexico are not a health risk.


2020 ◽  
Vol 3 (4) ◽  
pp. e000195
Author(s):  
Meagan E Wiebe ◽  
Anna C Shawyer

ObjectiveCentralization of medical services in Canada has resulted in patients travelling long distances for healthcare, which may compromise their health. We hypothesized that children living farther from a children’s hospital were offered and attended fewer follow-up appointments.MethodsWe reviewed children less than 17 years of age referred to the general surgery clinic at a tertiary children’s hospital during a 2-year period who underwent surgery. Descriptive statistics were performed.ResultsWe identified 723 patients. The majority were male (61%) with a median age of 7 years (range 18 days to16 years) and were from the major urban center (MUC) (56.3%). The median distance travelled to hospital for MUC patients was 8.9 km (range 0.9–22 km) vs 119.5 km (range 20.3–1950 km) for non-MUC patients. MUC children were offered more follow-up appointments (72.7% vs 60.8%, p<0.05). No significant differences existed in follow-up attendance rates (MUC 88.5% vs non-MUC 89.1%, p=0.84) or postoperative complications (9.8% vs 9.2%, p=0.78). There were no deaths.ConclusionsPatients living farther from a hospital were offered fewer follow-up appointments, but attended an equivalent rate of follow-ups when offered one. Telemedicine and remote follow-up are underused approaches that can permit follow-up appointments while reducing associated travel time and expenses.


2005 ◽  
Vol 39 (5) ◽  
pp. 931-940 ◽  
Author(s):  
I. Schifter ◽  
L. Díaz ◽  
V. Múgica ◽  
E. López-Salinas

2017 ◽  
Vol 25 (5) ◽  
pp. 4739-4749 ◽  
Author(s):  
Sandra Gómez-Arroyo ◽  
Arisbel Barba-García ◽  
Francisco Arenas-Huertero ◽  
Josefina Cortés-Eslava ◽  
Michel Grutter de la Mora ◽  
...  

Fuel ◽  
2003 ◽  
Vol 82 (13) ◽  
pp. 1605-1612 ◽  
Author(s):  
I Schifter ◽  
L Dı́az ◽  
M Vera ◽  
E Guzmán ◽  
E López-Salinas

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