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 2·5th and 97·5th 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 (62·6%; 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

The Spontaneous Fission Decay Constant Of 238u Using Ssntd

This work reports the results of 5 measurements of the 238U decay constant for spontaneous fission, λ(f) carried out using solid state nuclear track detectors (SSNTD), resulting in a mean value of λ(f) = (8.35±0.24)·10-17 y-1. The neutron fluence of the irradiations needed for these measurements were monitored with thin films of natural uranium.2452441442Bigazzi, G., (1981) Nucl. Tracks, 5, p. 35Roberts, J.H., Gold, R., Armani, R.J., (1968) Phys. Rev., 174, p. 4847Bigazzi, G., Hadler Neto, J.C., Iunes, P.J., Oddone, M., Paulo, S.R., Zuniga, A., (1995) Nucl. Instrum. Meth. Phys. Res., 352 A, p. 588Bigazzi, G., Hadler Neto, J.C., Iunes, P.J., Osorio Araya, A.M., (1991) Nucl. Tracks Radiat. Meas., 19, p. 451Hadler Neto, J.C., Iunes, P.J., Mello, T.C.W.P., Navia, L.M.S., Paulo, S.R., (1996) Radiat. Meas., 26, p. 169Lederer, C.M., Shirley, V., (1978), p. 1443. , Table of Isotopes, 7th ed., Wiley-Interscience, New York, US

Absolute Thermal Neutron Fluence Determination By Thin Film Of Natural Uranium

An absolute monitor of thermal neutron fluence based on the 235U induced fission was developed. This monitor is constituted by a solid state nuclear track detector juxtaposed to a natural uranium film with a negligible self-absorption to fission fragments. In order to perform the calibration of the films, the alpha-activity was measured by using nuclear emulsions. The preparation, calibration and employment procedures of this monitor are presented. © 1995.3523588591International Atomic Energy Agency, (1970) Neutron Fluence Measurements, Technical Reports Series No. 107, , ViennaFleischer, Price, Walker, (1975) Nuclear Tracks in Solids: Principles and Applications, , Univ. of California Press, BerkeleyHurford, (1990) Chem. Geol. (Isot. Geosci. Sect.), 80, p. 171Hurford, Green, (1983) Isot. Geosci., 1, p. 285Tagami, Nishimura, (1992) Chem. Geol. (isot. Geosci. Sect.), 102, p. 277Green, Hurford, (1984) Nucl. Tracks, 9, p. 231Gold, Armani, Roberts, (1968) Nucl. Sci. Eng., 34, p. 13Wall, (1986) Nucl. Tracks, 12, p. 887Ruddy, (1986) Nucl. Tracks Radiat. Meas., 11, p. 197Lederer, Shirley, (1978) Table of Isotopes, , 7th ed., Wiley, New YorkYagoda, (1949) Radioactive Measurements With Nuclear Emulsions, , Wiley, New YorkBigazzi, Hadler, Iunes, Osorio, (1991) Nucl. Tracks Radiat. Meas., 19, p. 451Hadler, (1979) Master Thesis, , Universidade Estadual de Campinas, Campinas, SP, BrazilJ.C. Hadler N., P.J. Iunes, T.C.W.P. Mello, L.M.S. Navia and S.R. Paulo, On The Nuclear Emulsion Detection Efficiency For Alpha Particles And Fission Fragments, to be submitted to Radiation MeasurementsIunes, (1990) Master Thesis, , Universidade Estadual de Campinas, Campinas, SP, BrazilWestcott, Effective Cross Section Values For Well-Moderated Thermal Reactor Spectra, Atomic Energy Of Canada Limited (1960) AECL Rep. 1101, , (3rd ed. corrected

Measurement Of Low And Stationary Flux Density Of Thermal Neutrons Using A Fission Track Technique

A new monitor suitable for measurements of low and stationary flux density of thermal neutrons was developed. Its working principles, calibration and characteristics are presented. © 1994.3501-2291295IAEA, Neutron Fluence Measurements (1970) Technical Report No. 107, , ViennaFleischer, Price, Walker, (1975) Nuclear Tracks in Solids: Principles and Applications, , University of California Press, BerkeleyDragu, (1991) Nucl. Tracks and Rad. Meas., 19, p. 461Ritchie, Eldridge, (1961) Nucl. Sci. Eng., 9, p. 198U.S. Atomic Energy Commission, Reactor Physics Constants (1958) Report ANL-5800, , Lemont, IllinoisBarkas, (1963) Nuclear Research Emulsions, , Part I, Academic Press, New Yorkde Carvalho, The Processing and Loading of Nuclear Emulsions (1965) Progress in Nuclear Techniques and Instrumentation, 1. , 3rd edition corrected, North Holland, AmsterdamHadler, (1982) Ph.D. Thesis, , 3rd edition corrected, Universidade Estadual de Campinas, Campinas, SP, BrazilHadler, Lattes, Marques, Marques, Serra, Bigazzi, (1981) Nucl. Tracks, 5 (1-2), p. 45Hadler, (1979) Master Thesis, , 3rd edition corrected, Universidade Estadual de Campinas, Campinas, SP, BrazilDemers, (1955) Ionographie, , Les Émulsions Nucléaire, Les Press Universitaires de Montréal, OttawaBethe, Askin, Passage of Radiation through Matter (1955) Nuclear Experimental Physics, 1. , E. Segrè, 3rd edition corrected, WileyFalleiros, (1994) Ph. D. Thesis, , 3rd edition corrected, Instituto de Pesquisas Energéticas e Nucleares/Universidade de São Paulo, São Paulo, BrazilWestcott, Effective cross-section values for well-moderated thermal reactor spectra (1960) Atomic Energy of Canada Limited, , 3rd edition corrected, AECL report 1101Holden, Holden, Rep. BNL-NCS-36865 (1985) presented at the 33rd IUPAC (Inter. UnionvPure Appl. Chem.) Gen. Assem., , LyonCowan, Adler, (1976) Geochim. Cosmochim. Acta, 40, p. 148

Problems Related To The Employment Of Thin Uranium Films As Neutron Dosimeters

Thin uranium films built on muscovite mica basis and obsidian samples having known ages were irradiated with thermal neutrons at the IPEN/CNEN reactor, São Paulo. Comparing thin film performance with the obsidian one, it was observed that the latter "feel" a greater neutron fluence. Nominal fluences at the used facility are in agreement with the results obtained analysing the obsidian samples. A probable hypothesis to explain this disagreement, namely, the uranium loss from the thin films, was ruled out. © 1995.251-445946

Indoor Radon And Radon Daughters Survey At Campinas-brazil Using Cr-39: First Results

The first results of a radon and radon daughters (RD) survey performed at Campinas-SP, Brazil, are presented. We employed a technique that, potentially, makes possible to measure the radon and RD activity in the air and to separate from this result the activity of radon, alone. In this preliminary paper only the former activity is studied.311287290Hadler, J.C., Paulo, S.R., Indoor radon daughters contamination monitoring: The absolute efficiency of CR-39 taking into Account the plate-out effect and environmental conditions (1994) Radiat. Prot. Dosim., 51, pp. 283-296Paulo, S.R., (1991) Dosimetria Ambiental de Rn-222 e Filhos: Medida da Eficiência Absoluta do CR-39 Levando-se em Conta os Efeitos do Plate-out e Fatores Ambientais, , PhD. Thesis, IFGW, UNICAMP, Brazi