Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000-17

Background Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000-17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2 center dot 5th and 97 center dot 5th percentiles of those 250 draws. Findings While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62 center dot 6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000-7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910-68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Copyright (c) 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Comment on "The dielectric relaxation studies on poly(vinyl acetate)"

It is shown that the abnormality in the relaxation frequency as reported by Nozaki and Mashimo [J. Chem. Phys. 84, 3575 (1986); 87, 2271 (1987)] in the case of poly(vinyl acetate) can be removed by the use of an equation of the type of a critical power law slowing down, which is believed to be fundamental to the cooperative process occurring within certain regions of the supercooled liquid which lead to the primary $(\alpha)$ relaxation process

The Nature of Glass Transition Process in Alcohols

Evidence is presented to show that the observed glass transition process in simple alcohols may be represented as a hard to resolve combination of two glass transition processes: one due to the hydrogen (H-) bonded molecules and the other due to the non H-bonded molecules in the system. The experimentally observed secondary relaxation process is shown to be intermolecular in nature and corresponds to the latter glass transition process. A detailed discussion of the dielectric and mechanical-relaxation studies in the H-bonded systems is made

The nature of freezing process in glasses

The analogy between ordinary glass and other glasses formed by the freezing of certain degrees of freedom, is examd. The dynamic and static quantities during the freezing process are shown to obey a crit. power law slowing down on lowering the temp. There exists a scaling law between the dynamic and the static quantities. A strong qual. similarity of the freezing process to the ordinary glass transition is suggested due to observation of secondary relaxations in and below the region of criticality. A general cluster model has been suggested to the problem of the 'freezing'

Anomalous dielectric behavior of some ferrites

The dielectric behavior of some powdered polycrystalline samples has been studied in the frequency range of 200 Hz–100 kHz. It is shown that the dielectric behavior in these systems below the Curie temperature is not purely relaxational in its character and cannot be described by any of the models of the dielectric relaxation hitherto put forward. It is also shown that ‘‘isolation’’ of the particles in the powder samples plays a very important role. The origin of this abnormality is thought to be due to the mechanical resonance arising out of the magnetostrictive property of the material

Analysis of grid connected induction generators driven by hydro/wind turbines under realistic system constraints

Results of an investigation dealing with the behaviour of grid-connected induction generators (GCIGs) driven by typical prime movers such as mini-hydro/wind turbines are presented. Certain practical operational problems of such systems are identified. Analytical techniques are developed to study the behavior of such systems. The system consists of the induction generator (IG) feeding a 11 kV grid through a step-up transformer and a transmission line. Terminal capacitors to compensate for the lagging VAr are included in the study. Computer simulation was carried out to predict the system performance at the given input power from the turbine. Effects of variations in grid voltage, frequency, input power, and terminal capacitance on the machine and system performance are studied. An analysis of self-excitation conditions on disconnection of supply was carried out. The behavior of a 220 kW hydel system and 55/11 kW and 22 kW wind driven system corresponding to actual field conditions is discusse