Global prospects to deliver safe drinking water services for 100 million rural people by 2030

The climate crisis and global pandemic have accelerated the urgency of providing safe drinking water services around the world. Global progress to safe drinking water is off-track with uncertain and limited data on the extent and performance of rural water service providers to inform policy and investment decisions. This report documents a global diagnostic survey to evaluate the status and prospects of rural water service providers from 68 countries. The service providers describe providing drinking water services to a population of around 15 million people through over 3 million waterpoints. The data provides information on the scale and sustainability of rural water services to examine: . The extent and type of professional water service provision in rural areas globally;. Self-reported metrics of operational and financial performance;and, . The size and scope of current rural service providers that could transition to resultsbased funding. Five major findings emerge. First, most service providers aim to repair broken infrastructure in three days or less. Second, almost all service providers reported at least one type of water safety activity. Third, most service providers collect payments for water services. Fourth, about one third of service providers reported major negative shocks to their operations from the COVID-19 pandemic. Fifth, non-governmental service providers in low income countries less often report receiving subsidies for operations, and more often report paying part of user fees to government, including through taxes. Most rural water service providers are working towards provision of affordable, safe and reliable drinking water services. Key barriers to progress include sustainable funding and delivery of services at scale. We propose four conditions to promote scale and sustainability based on policy alignment, public finance, professional service delivery, and verifiable data. To illustrate these conditions, we consider the differing context and service delivery approaches in the Central African Republic and Bangladesh. We conclude by identifying a group of 77 service providers delivering water services for about 5 million people in 28 countries. These 77 service providers report operational metrics consistent with a results-based contracting approach. Technical assistance might support many more to progress. We argue that government support and investment is needed to rapidly progress to the scale of 100 million people to provide evidence of pathways to universal drinking water services for billions more.

The attitude of the academic community towards distance learning: A lesson from a national lockdown

The number of online courses conducted at universities has been growing steadily worldwide. The demand for this form of education has jumped sharply in the 2019/2020 academic year as a consequence of the COVID-19 pandemic and the national lockdown. The following study uses the case of University of Wrocław and examines how this unprecedented situation would affect the attitude of members of the academic community toward distance learning. The examination, based on quantitative analysis of separated questionnaires distributed among teachers and students, reveals that the previous experience in distance learning strongly correlates with willingness to use it in the future, i.e. after fighting the coronavirus crisis. Thus, the research suggests that the implementation of distance learning may involve the need to put more emphasis on systematic and long-term actions. The results achieved in the study may contribute to improving the ways of implementing distance learning on a large scale in institutions dealing with higher education. ©ACPIL.

Thulium fiber laser results in shorter operating times during ureteroscopy and laser lithotripsy

INTRODUCTION AND OBJECTIVE: Ureteroscopy (URS) procedure duration has been associated with complications such as ureteral perforation and urosepsis, as well as higher costs. A new FDA approved lithotripter, the thulium fiber laser (TFL), was made commercially available in June of 2020 and was acquired by our institution. This retrospective study was designed to determine if TFL lithotripsy decreased operative time when compared to standard Holmium:YAG (Hol:YAG) lithotripsy without pulse modulation. METHODS: A retrospective review of URS with laser lithotripsy at a tertiary stone center was conducted for cases performed 2 months before and 2 months after conversion to TFL lasers for URS. 152 procedures were identified. Cases that involved bilateral procedures, aberrant anatomy, had no recorded kidney stone composition, and those that were aborted due to complications or tight ureters were excluded from analysis. 102 cases met inclusion criteria, 51 in each arm. Operative time was measured from scope in to scope out. Variables including stone size, location, chemical composition, prior ureteral stenting and ureteral access sheath use were recorded. In cases with 2 or more stones, the cumulative stone diameter was measured from preop CT imaging and reported as the summation of diameters from all treated stones. RESULTS: Baseline characteristics of the patients and stones treated did not differ significantly between laser groups (table 1). Compared to Hol:YAG, use of TFL resulted in an average decrease of 12.94 minutes per case (p=.021, 95% CI [2.03-23.85]). In subgroup analysis of cases with cumulative stone diameter less than 15mm, the difference was 13.95 minutes (p=.007, CI [3.95-23.95]). For cases less than 10mm, the mean difference was 17.27 minutes in favor of TFL (p=.002, 95% CI [6.89-27.62]). Stone free states confirmed by retroperitoneal ultrasound were similar between groups but could not be reliably estimated due to low (36%) compliance with post op imaging in the COVID era. CONCLUSIONS: TFL is a substantially faster means of laser lithotripsy than Hol:YAG with average case time reduced by 20% overall (13 min). As the number of URS laser lithotripsy procedures being performed in the United States continues to increase, reducing procedure times has the potential to improve patient outcomes and decrease costs. Longer term follow up is needed to see if recurrence rates are affected.