Goal 3: Health and Well Being

Several health issues such as mortality rate, epidemics of diseases, drug abuse, sexual and reproductive health have been existed throughout the decade. Goal 3 of UN Sustainable Development Goals states “Ensure healthy lives and promote well-being for all at all ages” (UN, 2016). Multi-centric health improvement model has been necessitated to unravel existing health issues at different levels.

A number of neglected tropical diseases including buruli ulcer, chagas disease, cysticercosis, dengue fever, dracunculiasis, echinococcosis, fascioliasis, leishmaniasis, leprosy, lymphatic filariasis, onchocerciasis, trachoma and others are prevalent in low to middle income countries of Asia, Africa and Latin America (CDC, 2011; Global Network, 2015; londonntd, 2016). Intervention measures such as mass treatment, individual treatment and cure, water, sanitation and hygiene (WASH), vector control and veterinary public health have been taken against neglected tropical diseases and national elimination of NTDs was achieved by 50 countries in 2014(WHO,2016). More than 5.9 million children under 5 years old died in 2015 and target 3.2 of UN sustainable development goals aims to achieve under 5 mortality rate as low as 25 per 1000 live births by 2030 (WHO,2016).

Road traffic accidents and associated deaths and injuries has alarming trend worldwide and global health observatory (GHO) data suggests 1.25 million road traffic deaths  globally in 2013 (WHO, 2016). Minimization of road traffic accident related deaths and injuries have been taken as urgent priority by UN Sustainable Development Goals.

Environmental hazards and pollution are causing significant health damages. Water, air, and soil pollution caused about 40 percent deaths worldwide (Lang, 2007). Anderson (2015) identified carbondioxide, ammonia, chlorine, hydrochloric acid and sulfuric acid as top five hazardous chemicals causing injuries from acute chemical incidents. Approximately 6.5 million deaths have been attributed to household and ambient air pollution in 2012 (UN, 2016). Infectious diseases are likely to occur from faecal contamination of water and soil and poor environmental conditions. Reducing the deaths and injuries caused by hazardous chemicals and environmental pollution by 2030 is one of the key targets of UN Sustainable Development Goals.

Information and empowerment of sexual and reproductive health and safe reproductive system has been considered as centre of development. Universal access to sexual and reproductive health care and knowledge and education of family planning and reproductive health is addressed by target 3.7 of SDG Goals. Prevention of unintended pregnancy and reduction of adolescent childbearing has been prioritized to improve women, children and adolescent’s health (UN, 2016). Joint actions from international agencies and national governments with appropriate policy measures and actions are required to combat health sector challenges.

  

 References

Anderson, A. R.  (2015) Top Five Chemicals Resulting in Injuries from Acute Chemical Incidents- Hazardous Substances Emergency Events Surveillance, Nine States, 1999-2008. Surveillance Summaries, 64(SS02); 39-46. 

Centre for Disease Control (CDC) Neglected Tropical Diseases [Online] Available at http://www.cdc.gov [Accessed on 2016].

Lang, S.S. (2007) Water, Air and Soil Pollution Causes 40 Percent of Deaths Worldwide, Cornell Research Survey Finds. [Online] Available at http://www.news.cornell.edu [Accessed on 08 October 2016].

London Centre for Neglected Tropical Diseases Research (2016) About NTDs [Online] Available at http://www.londonntd.org [Accessed on 08 October 2016].

The Sabin Vaccine Institute (2015) The Most Common NTDs [Online] Available at http://www.globalnetwork.org [Accessed on 08 October 2016].

United Nations (2016) Sustainable Development: Knowledge Platform [Online] Available at http://www.sustainabledevelopment.un.org [Accessed on 08 October 2016].

World Health Organization (2016) Global Observatory Data [Online] Available at http://www.who.int [Accessed on 2016].

World Health Organization (2016) Water Sanitation Hygiene [Online] Available at http://www.who.int [Accessed on 2016].

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Urban Water Management

Sustainable management of urban water has been necessitated to ensure urban sustainability. Growing population and aging infrastructure are creating challenges for efficient water management in cities (NRDC, 2016). Groundwater decline is major problem across the cities relying on groundwater as a source of drinking water. Higher rate of abstraction of groundwater than its replenishment causes water table to decline. Declining levels of groundwater have been assessed in cities such as Barcelona, Houston, Los Angeles, Mexico City, New York, Rome, many large cities in China, Libya, India and Pakistan and Middle East and Central Asian regions in a study using global hydrological model PCR-GLOBWB (Sutanudaja and Erkems, 2016). Dhaka, capital city of Bangladesh, faces groundwater depletion problems as 84% of present municipal water comes from groundwater (Mohammad et al, 2007). Groundwater levels in 54 percent of the wells in India have been found to be decreasing and 16 percent are declining by more than one meter per year (Shiao et al, 2015).

A positive effect of urbanization on groundwater includes increases in recharge by water-mains leakage, waste water seepage, storm-water soakaways and excess garden irrigation. However, contamination from in-situ sanitation, sewer leakage, industrial chemical pollution and disposal of liquid effluents and solid wastes are pitfalls of urbanisation (IAH, 2015).

Management of water supply infrastructure is challenging and expensive. Water supply pipes are mostly underground and monitoring is arduous task. The leakage statistics of average UK home is 133 litres per day (Geovation, n.d.). Huge proportion of purified water could be lost because of aging and leaky pipes, broken water mains and faulty meters (Schaper, 2014).

Increasing water demand, higher rate of water abstraction and rapid urbanization might induce effects such as induced seepage of contaminated water, land subsidence and coastal saline intrusion (IAH, 2015). Government initiatives will be less effective if vacuum exists for responsibility and accountability of urban water management (IAH, 2015). Integrated approach with wider participation of stakeholders, public and private agencies will be more effective in managing urban water.

References

Geovation (n.d.) Aging Infrastructure [Online] Available at http://www.geovation.uk [Accessed on 26 April].

Hoque, M. A., Hoque, M. M. and Ahmed, K. M. (2007) Declining Groundwater Level and Aquifer Dewatering in Dhaka Metropolitan Area, Bangladesh: Causes and Quantification. Hydrogeology Journal, Vol 15, pp 1523-1534.

International Association of Hydro geologists (IAH) (2015) Resilient Cities and Groundwater [Online] Available at http://www.iah.org [Accessed on 26 April 2016].

Schaper, D. (2014) As Infrastructure Crumbles, Trillions of Gallons of Water Lost [Online] Available at http://www.npr.org [Accessed on 26 April 2016].

Shio, T., Maddocks, A., Carson, C. and Loizeaux, E. (2015) Three Maps Explain India’s Growing Water Risks [Online] Available at http://www.wri.org [ Accessed on 26 April 2016].

Goal 1: UN Sustainable Development Goals

Goal 1 of UN Sustainable Development Goals states “end poverty in all its forms everywhere”. Reducing poverty worldwide has long been debated and stated in Millennium Development Goals. Millennium Development Goals was met five years early to reduce 1990 poverty levels by half in 2015 (World Bank, 2015). Target 1.1 of UN Sustainable Development Goals is aiming to eradicate extreme poverty for all people everywhere who are living on less than $1.25 a day by 2030 (UN, 2015). A lot of progress on reducing extreme poverty has been made around the different regions of the world in the past few decades. Extreme poverty has been sharply declined in East Asia from 80 percent in 1981 to 7.2 percent in 2012  and it has been reduced to 18.7 percent in 2012 in South Asia from 58 percent in 1981(World Bank, 2015). However, more than 77.8 percent of extremely poor of the world lived in South Asia and Sub-Saharan Africa in 2012(World Bank, 2015).

Target 1.3 of the UN Sustainable Development Goals is aiming to cover poor and vulnerable people by implementing nationally appropriate social protection system (UN, 2015). Social protection schemes can cover children, women, older people, people living with disabilities, and unemployed. Social assistance such as cash transfers, social pensions, in-kind transfers and public work programs, social insurance, labour market interventions are effective social protection tools (Browne, 2015). About 80% of the world people lived in less than $10 per day in 2012(Shah, 2013) and people are vulnerable in every parts of the world however social protection measures and national level government strategic measures play a vital role to prevent disaster.

Reducing poverty means ensuring adequate nutrition, basic health, education and housing to everyone (Development Initiatives, 2013) and it will be a big challenge to eradicate extreme poverty by 2030. Economic growth alone won’t be sufficient to eliminate extreme poverty and additional measures need to be considered (Development Initiatives, 2013). Oxford Poverty and Human Development Initiative (OPHI) generated global multidimensional poverty index based on ten indicators and health, education and living standard as three dimensions (OPHI, 2016). Multidimensional approach to poverty reduction has been necessitated to tackle extreme poverty and achieve sustainable goals and targets.

 

References

Browne, E. (2015) Social Protection [Online] Available at www.gsdrc.org [Accessed on 28 December 2015].

Development Initiatives (2013) Investments to End Poverty [Online] Available at www.devinit.org [Accessed on 28 December 2015].

Shah, A. (2013) Global Issues [Online] Available at http://www.globalissues.org [Accessed on 28 December 2015].

Oxford Poverty and Human Development Initiative (OPHI) (2016) Global Multidimensional Poverty Index [Online] Available at www.ophi.org.uk [Accessed on 10 January 2016].

United Nations (UN) (2015) Goal 1 [Online] Available at www.un.org [Accessed on 28 December 2015].

World Bank (2015) Overview [Online] Available at www.worldbank.org [Accessed on 28 December 2015].

Carbon Pricing

Carbon pricing is an effective policy instrument to reduce greenhouse gas emission. Carbon pricing is based on polluter pay principle that a carbon emitter pays price to cut the emissions (Bowen, 2011; World Bank, 2015). Polluters have decision making power to cut their emissions and avoid carbon price for their production. Carbon pricing policy discourages carbon emissions, adding more greenhouse gas burden to the environment and encourages divestment to clean energy options (Vaughan, 2015). Carbon emitted at one place of the world will have impacts on every parts of the world. Wider participation of governments of the world and implementation is necessary to cut the emissions.

Carbon pricing can be emission trading system (ETS) or carbon taxes. Tradable individual emission quotas or cap and trade system creates a business environment of carbon emission supply and demand (Bowen, 2011; World Bank, 2015). Companies will have individual quotas for maximum carbon emission which they can utilize or sell to another company based on their requirements in emission trading system. In contrast, carbon tax is direct costs to greenhouse gas emission. Complexities may arise in the implementation of both carbon pricing system. Cost effectiveness of regulating international cap and trade system has been a question (Bowen, 2011). Further, carbon pricing will be less effective if it is not implemented globally and Bowen (2011) referred it as ‘carbon leakage’.

States and cities across the world have been planning, acting and implementing carbon pricing schemes. Fixed price tag from July 2012 and trading scheme from July 2014 has been applied in Australia and cap and trade system in New Zealand and carbon tax in Switzerland has been operated since 2008 (Bowen, 2011). China is planning to create a national emission trading system in 2016 with a 40 to 45 percent emission reduction goal by 2020 compared to 2005 levels. (World Bank, 2015). China already covered 1115 megatons of carbon dioxide emissions with regional cap and trade schemes (Carbon Brief, 2014). Carbon tax is starting in Chile in 2018, ETS was started in South Korea in January 2015 and European Union covered 11000 power stations and industrial plants including airlines with international emission trading (World Bank, 2015).

Various initiatives and private sectors across the world have been engaged with carbon pricing. Twenty nine major US companies including Dow Chemical Company, Bank of America and Exxon Mobil are pricing carbon, 496 global companies are part of global carbon trading scheme and global companies such as Alstrom, Bayer and Canadian Tire Corporation operating in China and South Korea have agreed Chinese emission trading schemes (CDP, 2014). EU ETS have covered companies such as Lafarge and Rockwool international and 212 companies are negotiating with policy makers on carbon pricing (CDP, 2014).

Globally, governments and environmental leaders are operating to achieve two degree Celsius temperature target however carbon pricing policy won’t be sufficient. Carbon pricing policy acting together with other policies will likely to make a difference. Carbon pricing policy will be more effective if it focuses on green innovations rather than just taxing. Universal application of the carbon price schemes is most desirable to achieve the environmental goals.

References

Bowen, A. (2011) The Case for Carbon Pricing [Online] Available at http://www.lse.ac.uk [Accessed on 16 October 2015].


Carbon Brief (2014) The State of Carbon Pricing: Around the World in 46 Carbon Markets [Online] Available at http://www.carbonbrief.org [Accessed on 16 October 2015].


CDP (2014) Global Corporate Use of Carbon Pricing: Disclosures to Investors [Online] Available at http://www.cdp.net [Accessed on 16 October 2015].

Vaughan, S. (2015) Climate Investment, Low-Carbon Innovation and Green Industrial Policy [Online] Available at http://www.isd.org [Accessed 25 September 2015]

World Bank (2015) Pricing Carbon [Online] Available at http://www.worldbank.org [Accessed on 16 October 2015].

Renewable Energy Support Schemes

Promotion of solar PV as a renewable energy and implementing energy policies has been a priority for more than 80 countries of the world. Renewable energy contributed 22.6% of gross electricity generation in Germany in 2012 and it is targeting to achieve 80% share of renewable energy in the total electricity supply by 2050 (Lutkenhorst and Pegels, 2014). A number of renewable energy programmes in Germany such as renewable energies loan programme (KFW), federal energy research programme, solar PV storage loan programme, innovation alliance PV has been launched to support solar energy and renewable energy installation (Lutkenhorst and Pegels, 2014).

Growth of PV market in Australia has been supported by programmes such as Australian Government’s Solar Homes and Communities Plan (SHCP), Renewable Energy Target (RET) mechanisms, National Solar Schools Program (NSSP) and feed-in-tariffs (Moosavian et al., 2013). Solar energy market in China, the leading renewable energy investor in 2009, is supported by central government with various initiatives such as ‘Golden Roof’ (Moosavian et a., 2013).

Production of renewable energy has been supported by various schemes across the world. Market actor is obliged in quota based support to provide a certain share of electricity from renewable energy sources (Held et al , 2014; Sayigh, 2012). Renewable energy producers are remunerated for the energy production in tender systems. Customer producer can take advantage of net metering when they are connected to central grid and provided a meter which can turn backward (Sayigh, 2012; Sunlighelectric, 2013). If energy is produced more than consumption, consumer gets remuneration.

Producer can sell all the renewable energy produced to grid operator in a fixed set price with feed-in-tariff schemes and Government can provide tax avoidance, tax write-off, capital grants and soft loans services for the development of renewable energy (Sayigh, 2012). In USA, the energy policy act of 2005 has provision of providing tax credit for residential energy property (energy.gov, n.d.). Support mechanisms can be generation based or capacity based and government can support the solar industry either by total remuneration or partial payment (Held et al., 2014). Feed-in-tariff is total price coverage scheme whereas quota based supports get partial financial coverage (Held et al., 2014).

References

Energy.gov (n.d.) Residential Renewable Energy Tax Credit. [Online] Available at http://www.energy.gov [Accessed on 11 August 2015].

Held, A., Ragwitz, M., Gephart, M., Visser, E.D., Klessmann, C. (2014) Design Futures of Support Schemes for Renewable Electricity. [Online] Available at www. ec.europa.eu [Accessed on 11 August 2015].

Lutkenhorst, W. and Pegels , A. (2014) Germany’s Green Industrial Policy Stable Policies- Turbulent Markets : The Costs and Benefits of Promoting Solar PV and Wind Energy. [Online] Available at http://www.iisd.org/gsi [Accessed on 21 August 2015]

Moosavian, S.M., Rahim, N.A., Selvaaj, J. and Solangi, K.H. (2013) Energy Policy to Promote Photovoltaic Generation. Renewable and Sustainable Energy Reviews 25, pp. 44-58.

Sayigh, A. (2012) Comprehensive Renewable Energy: Photovoltaic Solar Energy. Vol 1 , Elesevier, Italy.

Urban Sustainability

Urban sustainability has been debated in the past few years. More than 54 percent of world population are living in urban areas and economic activities are centred in the urban areas. Sustainability of urban areas of developing and developed nations has been linked to their environment and economy. Cities account for 55 percent of GDP in low income countries, 73 percent in middle income countries and 85 percent in high income countries (Pisano et al., 2014). According to UN (2014) projection, 2.5 billion more people will be added to the world’s urban population by 2050 and 90 percent will be concentrating in Asia and Africa. Increasing urban population leads to increased demand of energy, water and other resources questioning sustainability of the city. Environmental problems such as air and water pollution have aroused in cities and vulnerabilities to climate change have increased.

Higher levels of literacy and education, better health and social services and increased opportunities for cultural and political participation are positive aspects of urbanisation however pollution, environmental degradation, unsustainable production and consumption patterns are pitfalls (UN, 2014). Global change factors such as economic change, scarcity of resources, rapid technological and social change, environmental and climate change affects have been questioning sustainability of the cities (UNEP, 2012). Higher level of income and increasing level of resource consumption leading to larger ecological footprint have been caused by unchecked urbanization (UNEP, 2012). Rising number of slum population in the urban areas of developing countries and increasing ‘urban-divide’ or social and economic inequality among urban populations need to be addressed to ensure sustainability (UNEP, 2012).

Policy measures such as equitable and sustainable share of the benefits of urban growth, planned and managed spatial distribution of the urban population, balanced distribution of urban growth, access to urbanization trend information have to be taken to minimize adverse effects of urbanization (UN, 2014). Effective leadership, political commitments, the process of learning, participation, negotiation and co-ordination are required to drive cities towards sustainability (UNEP, 2012). Planned developmental projects, capacity building and institutional strengthening have been necessitated to maintain sustainable practices and behaviours (UNEP, 2012).

References

Pisano, U., Lepuschitz, K. and Berger, G. (2014) Framing Urban Sustainable Development: Features, Challenges and Potentials of Urban SD from a Muli-level Governance Perspective. European Sustainable Development Network [Online] Available at http://www.sd-network.en [Accessed on 12 November 2014].

United Nations (2014) World Urbanization Prospects [Online] Available at http://www.un.org [Accessed on 16 November 2014].

United Nations Environment Protection (UNEP)(2012) Sustainable, Resource Efficient Cities- Making it Happen ! [Online] Available at http://www.unep.org [Accessed on 16 November 2014]

Groundwater Microbes

Groundwater has been believed to be free of microbial contamination because of long vertical transport for microbes to reach aquifers (Krauss, 2011). However, leakage from sanitation systems, disposal systems, underground storage tanks and accidental waste water discharge are potential sources of pathogenic entry to groundwater (Krauss, 2011; Selvam et al., 2014). Common pathogens contaminated from various sources with groundwater includes bacteria such as Escherichia coli, Salmonella species, Shigella species, Vibrio Cholerae and Legionella species, viruses such as Piconaviridae, Caliciviridae, Reoviridae, Adenoviridae and Coronaviridae and protozoans such as Crptospiridium pavum, Giardia lambia, Taxoplasma gondii and Entamoeba histolytica (Close et al, 2008; Krauss, 2011).

A number of factors such as number of pathogens released to the environment, the persistence of the pathogens in the environment, filtration of pathogens through the soil and the hydrological conditions influence the pathogenic contamination of groundwater (Close et al., 2008). Groundwater with greater depth and fine grained soil can filter more pathogens.

Various factors influence the transport and survival of microorganisms in groundwater. The processes such as advection, dispersion, diffusion, size exclusion, retention and release from solid-water or air-water interfaces has effects on the transport and survival of micro-organisms (Bradford et al., 2014 ). Higher concentration of microorganisms can be found in the capillary fringe, the region of the subsurface above the groundwater table (Horn et al., 2014). Further, microbial transport and survival in groundwater is affected by physio-chemical, biological and hydrodynamic factors (Bradford et al., 2014). Bacterial transport through a porous medium has been found to be affected by cell shape, the ratio of cell width to cell length (Newby et al., 2014).

References

Bradford, S.A., Wang, Y., Kim, H., Torkzoban, S. and Simunek, J. (2014) Modeling Microorganism Transport and Survival in the Subsurface. Journal of Environmental Quality, Vol 43, pp. 421-440.

Close, M., Dann, R., Ball, A., Pirie, R., Savill, M. and Smith, Z. (2008) Microbial Groundwater Quality and its Health Implications for a Border-Strip Irrigated Dairy from Catchment, South Island, New Zealand. Journal of Water and Health, Vol 6(1), pp. 83-98.

Horn, P., Jost, D., Bastian, P. and Ippisch, O. (2014) Microbial Growth and Transport in Saturated and Unsaturated Porous Media [Online] Available at http://www.meetingorganizer.copernicus.org [Accessed on 16 August 2014].

Krauss, S. and Griebler, C. (2011) Pathogenic microorganisms and viruses in Groundwater [Online] Available at http://www.acatech.de [Accessed on 15 August 2014].

Newby, D.T., Pepper, I.L. and Maier, R. M. (n.d.) Microbial Transport [Online] Available at http://www.scholar.enu.kz [Accessed on 16 August 2014].

Selvam, S., Antony Ravindaran, A., Rajamanickam, M. and Sridharan, M. (2014) Microbial Contamination in the Sediments and Groundwater of Tuticorin Corporation, South India using GIS. International Journal of Pharmacy and Pharmaceutical Sciences, Vol 6(4), pp. 337-340.

DNA Methylation

DNA Methylation is an epigenetic mechanism with addition of methyl group into nitrogenous bases of DNA. The mechanism involves the transfer of methyl group into the C5 position of the cytosine and formation of 5-methylcystosine (Moore et al., 2013). DNA Methylation facilitates X-chromosome inactivation, imprinting and suppression of parasitic DNA sequences however methylation increases the rate of mutation (Robertson and Jones, 1999). Cell functions are affected by epigenetic regulation of gene expression. Genomic stability and mammalian development have been associated with methylation pattern (Tost, 2009).

Prediction and monitoring the response to antineoplastic treatment, detection of cancer at early stages and classification of tumour can be carried out with the help of DNA methylation pattern (Tost, 2009). Enzymes responsible for DNA methylation have been categorised into writers, erasers and readers by Moore et al (2012). Addition of methyl groups onto cytosine is categorised by writers, modification and removal of the methyl group is conducted by erasers and readers influence gene expression (Moore et al., 2012).

In the human genome, CpG or Cytosine (C) linked by a phosphate bond to the base Guanine (G) dinucleotide is methylated and methylation causes suppression of gene expression in the cells. (Lim and Maker, 2010; Robertson and Jones, 1999). Methylation and epigenetic changes has adverse effects on cancer cells. DNA Methylation has been believed to have direct role in carcinogenesis (Robertson and Jones, 1999). Deamination of methylated cytosine converts cytosine to thymine leading to inactivation of tumour suppression genes (TSGs), a vital factor for normal growth and differentiation (Lim and Maker, 2010).

 

References

Moore, L.D., Le, T., Fan, G. (2012) DNA Methylation and Its Basic Function Neuropsychopharmacology Reviews, pp 1-16.

Robertson, K.D. and Jones, P.A. (1999) DNA Methylation: Past, Present and Future Directions, Carcinogenesis, Vol. 21 (3), pp. 461-467.

Lim, D.H.K. and Maker, E.R. (2010) The Obstetrician and Gynaecologist. Vol 12, pp. 37-42.

Tost,J. (2009) DNA Methylation:  An Introduction to the Biology and Disease-Associated Changes of a Promising Bio-marker Methods, Molecular Biology, Vol 507, pp. 3-20. 

 

Pulmonary Atresia

Pulmonary valve lets the blood flow in pulmonary artery between the right ventricle and lungs for oxygenation. Blockage of blood flow between the right ventricle and pulmonary artery due to narrowing or absence of pulmonary valve causes pulmonary atresia (AHA, 2009). The flow of oxygen-rich blood (red in color) into the lung is obstructed and low-oxygen blood (blue-in-color) circulates in the body which causes blue appearance of the child (AHA, 2009; BHF, 2010).

Wide range of the levels of defect can be found. Rodriguez-Cruz (2013) suggested considering the pulmonary atresia with ventricular septal defect as most severe. According to Rodriguez-Cruz (2013), the prevalence of pulmonary atresia is higher in males and children of patients with the defect. Ultrasound scan of the heart or echo cardiogram, chest radiography and MRI are diagnostic tools for pulmonary atresia (BHF, 2010).

Treatment of pulmonary atresia involves maintaining the normal blood flow and correcting the septal defects. Palliative treatment or the improvement of the heart condition is one of the treatment methods of pulmonary atresia but complete repair may also be possible with several operations (CHFED, n.d.; Royal Children’s Hospital, 2012). Percutaneous perforation of pulmonary valve and dilation of the valve is carried out in palliative surgery (Rodriguez-Cruz, 2013).

Valvotomy, Shunt operation, heart catheterization and heart-lung transplantation are treatment options for pulmonary atresia (Rodriguez-Cruz, 2013). According to BHF (2010), valvotomy or the process of opening the blocked valve can be catheter valvotomy or surgical valvotomy. Shunt or tube is the synthetic material placed between the pulmonary artery and the aorta (Cave Point Foundation, 2011).

References
American Heart Association (AHA) (2009) Pulmonary Atresia/ Intact Ventricular Septum. [Online] http://www.heart.org/idc/ [Accessed on 5 June 2013].

British Heart Foundation (BHF) (2006) Understanding Your Child’s Heart Pulmonary Atresia with Intact Ventricular Septum. [Online] Available at http://www.bhf.org.uk [Accessed on 6 June].

Cave Point Foundation (2011) Congenital Heart Disease. [Online] Available at http://www.pted.org/ [Accessed on 17 June 2013].

Children’s Heart Federation (CHFED, n.d.) Pulmonary Atresia with Intact Ventricular Septum. [Online] Available at http://www.youngatheart.org.uk/ [Accessed on 6 June 2013].

Rodriguez-Cruz, E. (2013) Pulmonary Atresia with Ventricular Septal Defect Treatment and Management. [Online] Available at http://emedicine.medscape.com/%5BAccessed on 17 June 2013].

Royal Children’s Hospital Melbourne (2012) Pulmonary Atresia with Intact Ventricular Septum. [Online] Available at http://www.rch.org.au/ [Accessed on 6 June 2013].