Partnering with government and communities to achieve open defecation free status at scale: an example from the Indian state of Bihar

The Pusa Block of Samastipur District in the Indian State of Bihar accounted for very low sanitation coverage of 16%. This was coupled with poor understanding of roles and responsibilities amongst government functionaries as well as lack of knowledge on the benefits of safe sanitation. The AKDN Initiative demonstrated the impact of effective partnership with government functionaries and communities to achieve open defecation free status at scale. The partnership has focussed on community centred approaches, strengthening of service delivery, improved hygiene behaviours and capacity building of local institutions to improve sanitation access. A key differentiator of the AKDN Sanitation programme is the introduction of mobile monitoring tool-AKVO Flow, which allows project teams to undertake real time tracking of household sanitation coverage as well as monitor improvements in key hygiene behaviour over time. The key results of this programme has been to create ODF communities at scale and sustained hygiene behaviour

Perceived Stress among Students in Medical/Dental and Allied Health Universities in Pakistan due to COVID-19 Pandemic

  Objective: Aim of the study was to explore the perceived stress in students at various medical and dental universities across Pakistan during the COVID 19 pandemic, using a validated scale.Materials and Methods: The study took place at the Institute of Psychiatry (IOP) Rawalpindi Medical University (RMU). Results: About 400 medical students participated countrywide. The final analysis was conducted on 333 participants who completed the survey form. Study participants comprised 69.1% female and 30.9% male students. About 74.5% of the participants represented Punjab province, 1.2% were from Sindh, another 1.2% belonged to Baluchistan, 2.4% were from KPK, and 1.5% were from AJK while 19.2% of them resided in Islamabad. The majority of participants were enrolled in MBBS (78.4%) while the rest were from BDS (3%), Allied Health Sciences (12.9%), Clinical Psychology (3.6%), and Pharm D (2.1%).The mean perceived stress score was 21.34, SD=4.90 suggesting high perceived stress levels. Approximately 4.5% of students perceived low levels of stress, 80.2% perceived moderate stress, whereas 15.3% scored high on the perceived stress scale. Male students had statistically significant (p=0.38) lower stress levels (M=19.99, SD=5.91) as compared to females (M= 21.95, SD= 4.26). Conclusions: Perceived stress level in medical students was alarmingly high and requires urgent intervention by the Medical and Dental Universities for immediate action and policy guidance for early identification and effective management. This can be achieved by delivering targeted e-workshops and evidence-based e-trainings for stress management like psychological first aid and mindfulness techniques

Mobile-based tracking system to ensure sustainability of a sanitation programme: experiences from four Indian states

India’s goal of achieving 100% sanitation coverage has been a long-standing one. While the recent push to eliminate open defecation has made significant progress taking India to a level of 61% coverage, the functionality of sanitary latrines and sustainability of open defecation free villages remain major challenges mainly due to the absence of a strong mechanism to track the progress of infrastructure and improvement in hygiene behaviours. The benefits of significant public investment made in the sanitation sector hence remain only partially realized. Against this backdrop, the Aga Khan Development Network (AKDN) under its ambitious multi-state sanitation initiative spread across Bihar, Madhya Pradesh, Uttar Pradesh and Gujarat has introduced GPS enabled mobile-based monitoring system to track the progress of sanitation infrastructure and hygiene behaviours. The initiative with the help of AKVO flow has so far tracked 19400 units till January 2017 to get the completion status, quality of construction and awareness levels and behaviour pattern of targeted communities

A bridge too far: an analysis of WASH KAP study from four Indian states

In India though there has been improved WASH coverage in the last decade but yet only 35% of the population have access to drinking water within the premises and 600 million people continue to defecate in open. To understand challenges and analyze gaps in the knowledge and practices a facility survey and KAP study was conducted in one urban and three rural locations across four Indian states. The findings indicate that only 18% of the population have access to safe drinking water within premises, 86% of the population still practice open defecation and underlying causes are functional, physical and attitudinal barriers. Though there is improved awareness on key hygiene indicators, a huge gap remains in actual practices. A key finding indicates that 86 % of respondents are willing to construct toilet within households, which means people are willing to adopt improved practices if an enabling environment and required knowledge are ensured

The Nexus between Carbon Emissions and Per Capita Income of Households: Evidence from Japanese Prefectures

Household consumption is influenced by various factors. Despite this, the intricate nature of consumption behaviors and the lack of comprehensive data from the supply chain have led to an incomplete recognition of the attributes contributing to home emissions at the city level. Through the analysis of city-level household consumption in relation to energy demand, utilizing a city-scale input-output model and urban residential consumption inventories, this study considers the environmental responsibility inherent in residential consumption for Japanese Prefectures, this study reveals that variations in this responsibility based on household type and season. Various factors are taken into account when examining emissions by age and month, including emission type, source, fuel variety, and consumption items for the period 2013-2022. These assertions stem from emissions data computed using the system boundary method. The connection between residential emissions and GDP is also explored through regression analysis. We uncovered evidence indicating that carbon emissions in Japan fluctuate with the seasons and across diverse categories. These statistics illustrate a notable discrepancy in the regional distribution of carbon emissions, owing to evident variations in consumption rates and patterns.</p

Journey from fringe to centre - asserting rights and dignity: experiences of WASH intervention in India

The government efforts for improved WASH services in the rural areas eventually favour the socioeconomic well off groups rather than reaching the excluded communities. Against this backdrop, project intervention in Morena district of MP adopted a decentralized and inclusive approach for integrated planning and implementation of WASH-services. The intervention intended to address pro-poor and social exclusion concerns by reflecting the needs and voices of communities. The major focus of the project has been on capacity building of the community members, local institutions, and field level extension workers and collaborating with the government department to leverage resources and linkages with national flagship programmes like NBA and MGNREGA. In about three years of field intervention the project was able to influence the lives of hundreds of marginalized families by creating a number of water and sanitation facilities and empowered institutions capable of planning and executing WASH interventions

Association of aspirin use with mortality risk among older adult participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

Importance: Aspirin use has been associated with reduced risk of cancer mortality, particularly of the colorectum. However, aspirin efficacy may be influenced by biological characteristics, such as obesity and age. With the increasing prevalence of obesity and conflicting data regarding the effect of aspirin in older adults, understanding the potential association of aspirin use with cancer mortality according to body mass index (BMI) and age is imperative. Objectives: To investigate the association of aspirin use with risk of all-cause, any cancer, gastrointestinal (GI) cancer, and colorectal cancer (CRC) mortality among older adults and to perform an exploratory analysis of the association of aspirin use with mortality stratified by BMI. Design, Setting, Participants: This cohort study evaluated aspirin use among participants aged 65 years and older in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial at baseline (November 8, 1993, to July 2, 2001) and follow-up (2006-2008). Analysis began in late 2018 and was completed in September 2019. Main Outcomes and Measures: All-cause, any cancer, GI cancer, or CRC mortality. Multivariable hazard ratios (HRs) and 95% CIs were calculated using time-varying Cox proportional hazards regression modeling, adjusting for additional factors. Results: A total of 146 152 individuals (mean [SD] age at baseline, 66.3 [2.4] years; 74 742 [51.1%] women; 129 446 [88.6%] non-Hispanic white) were included in analysis. The median (interquartile range) follow-up time was 12.5 (8.7-16.4) years, encompassing 1 822 164 person-years. Compared with no use, aspirin use 1 to 3 times per month was associated with reduced risk of all-cause mortality (HR, 0.84; 95% CI, 0.80-0.88; P \u3c .001) and cancer mortality (HR, 0.87; 95% CI, 0.81-0.94; P \u3c .001). Aspirin use 3 or more times per week was associated with decreased risk of mortality of all causes (HR, 0.81; 95% CI, 0.80-0.83; P \u3c .001), any cancer (HR, 0.85; 95% CI, 0.81-0.88; P \u3c .001), GI cancer (HR, 0.75; 95% CI, 0.66-0.84; P \u3c .001), and CRC (HR, 0.71; 95% CI, 0.61-0.84; P \u3c .001). When stratified by BMI (calculated as weight in kilograms divided by height in meters squared), aspirin use 3 or more times per week among individuals with BMI 20 to 24.9 was associated with reduced risk of all-cause mortality (HR, 0.82; 95% CI, 0.78-0.85; P \u3c .001) and any cancer mortality (HR, 0.86; 95% CI, 0.79-0.82; P \u3c .001). Among individuals with BMI 25 to 29.9, aspirin use 3 or more times per week was associated with reduced risk of all-cause mortality (HR, 0.82; 95% CI, 0.79-0.85; P \u3c .001), any cancer mortality (HR, 0.86; 95% CI, 0.81-0.91; P \u3c .001), GI cancer mortality (HR, 0.72; 95% CI, 0.60-0.86; P \u3c .001), and CRC mortality (HR, 0.66; 95% CI, 0.51-0.85; P = .001). Conclusions and Relevance: In this cohort study, aspirin use 3 or more times per week was associated with a reduction in all-cause, cancer, GI cancer and CRC mortality in older adults

Glue That Pain: A Case Report and Review of Literature

Tarlov cysts are cystic lesions of the nerve root sheath in the lower spine. With a reported incidence ranging from 1 to 5%, these lesions are fairly rare, benign and often asymptomatic. When they cause neural compression they may become symptomatic with sensory, motor, bowel/bladder and sexual dysfunction. The treatment of symptomatic Tarlov cysts is a controversial issue, ranging from conservative management and local steroid injections to a bewildering assortment of surgical options including CSF diversion procedures and advance microsurgical approaches with various ways of cyst manipulation. All these surgical modalities carry a high risk of serious complications, recurrence with need of a redo operation and a very variable rate of symptomatic relief ranging from 38 – 100 % in different series. Developing from the CT guided needle aspiration of the cyst which suffered disappointment in the form of re accumulation and heralded by earlier reports of aseptic meningitis, CT guided aspiration and subsequent filling of the cyst with fibrin glue has now emerged as a safe, highly effective and first line of treatment for symptomatic Tarlov cyst

Ionic liquid tuned titanium dioxide nanostructures as an efficient colorimetric sensing platform for dopamine detection

Dopamine is a neurotransmitter distributed in the central and peripheral nervous system, its lower or higher production results in various pathological disorders. Various nanoparticles systems have been used in the sensing of dopamine while in the present work ionic liquid tuned titanium dioxide nanoparticles (TiO2 NPs) was first time evaluated in colorimetric detection of dopamine. TiO2 NPs have been synthesized by hydrothermal process and analyzed by different characterization techniques such as FTIR, XRD, and SEM that confirmed the desired synthesis. 1-H-3-methylimidazolium acetate (ionic liquid-a known conducting species) was prepared by the neutralization method. Colorimetric change in color from pinkish grey to reddish-brown with an increase in dopamine concentration was analyzed using a UV–Vis spectrophotometer. To optimize the protocol various parameters like nanoparticles loading, conc. of dopamine etc were optimized. The quantification and limit of detection for the proposed sensor were calculated as 2.55 × 10−7 M and 7.67 × 10−8 M respectively, and 1 × 10−8–3.6 × 10−6 M linear range with an R2 value of 0.9998. At an optimum temperature of 25 °C and at pH 12 the proposed sensor response time was just 4 min for dopamine detection. The proposed sensor has been also used for the dopamine detection in physiological solution. The proposed sensor showed good sensitivity and selectivity for dopamine sensing