Assessing Sustainability Factors for Rural Household Sanitation Coverage in Bhutan, Kenya, Nepal, and Zambia: A Qualitative Analysis.

BACKGROUND: Few countries are likely to achieve universal sanitation within the next decade as sustaining household sanitation coverage remains a critical challenge. This study aimed to investigate factors that may have supported or hindered sustainability of sanitation coverage 1-2 years after the completion of an integrated, area-wide sanitation program in 4 countries. METHODS: We conducted qualitative analyses to identify factors related to the sustainability of sanitation coverage in Bhutan, Kenya, Nepal, and Zambia, 2 years after completion of the Sustainable Sanitation and Hygiene for All program. From November 2019 to March 2020, we conducted focus group discussions and key informant interviews with community members, project implementers, and decision makers. We triangulated the qualitative findings with data from household surveys to characterize subnational sanitation coverage throughout implementation and 1-2 years after. RESULTS: Our data revealed behavioral, contextual, and service delivery factors that were related to the sustainability of sanitation improvements. Service delivery factors included follow-up hygiene promotion, access to construction materials, local government commitment postimplementation, functioning monitoring systems, private sector uptake of supply chain improvements, and capacity for innovation. Contextual and behavioral factors included poverty, soil type, road networks, social cohesion, desire for improved latrines, maintenance and cleaning, and knowledge of sanitation benefits. CONCLUSION: The presence or absence of sustainability factors identified through this research may have implications on where certain programmatic approaches will work and where adaptations may be required. By comparing sustainability factors with subnational slippage rates, we were able to illustrate how local service delivery systems may respond to barriers and enablers. Understanding the programmatic and contextual factors that either drive or hinder long-term sanitation coverage may allow for greater program impact through adapting implementation based on existing challenges in service delivery and context.

Comparative evaluation of tooth substance loss and its correlation with the abrasivity and chemical composition of different dentifrices.

CONTEXT: In India, teeth cleaning with tooth powder is common in rural and semi-urban areas. These dentifrices may contain low-quality abrasives, which may have a deleterious effect on dental hard tissues. AIMS: This study aims to evaluate the tooth substance loss caused by different dentifrices and to correlate it with chemical composition, size, and shape of abrasives used. SETTINGS AND DESIGN: An indigenously made automated machine was used for brushing the specimens. MATERIALS AND METHODS: Sixty-four freshly extracted premolars were allocated to eight groups (n = 8). Colgate toothpaste was used as the control group. Each specimen was brushed in a vertical motion for 2½ h at 200 strokes/min with a constant applied load of 200 g corresponding to 6-month brushing. The difference in weight (pre- and post-brushing) was determined by an analytical weighing machine. Chemical analysis was done to determine the presence of iron oxide by Inductively Coupled Plasma Mass Spectrometry method. Shape and size of the abrasive particles was evaluated under scanning electron microscopy (SEM). STATISTICAL ANALYSIS USED: One-way analysis of variance and Paired t-test were used to analyze the data. RESULTS: Tooth substance loss was maximum in the group brushed with red tooth powder, which was shown to contain the highest amount of iron oxide and also exhibited large, irregularly shaped abrasive particles under SEM. CONCLUSIONS: Tooth substance loss was documented to be correlated with chemical composition (iron oxide) and the size and shape of abrasive particles used in dentifrices.

Synthesis, characterization and application of novel cationic and amphoteric flocculants based on amylopectin.

The synthesis of novel cationic flocculants based on amylopectin (AP), acrylamide (AM) and (3-acrylamidopropyl) trimethylammonium chloride (ATMAC) were done by free radical polymerization using ammonium persulphate (APS) as an initiator. Three different grades of novel cationic flocculants (AP-g-C 1 to AP-g-C 3) were synthesized by varying the proportion of acrylamide and (3-acrylamidopropyl) trimethylammonium chloride monomers. Through the hydrolysis of these flocculants, in presence of NaOH, three different grades of amphoteric polymers (AP-AT-C 1 to AP-AT-C 3) were synthesized. The synthesized polymers were characterized by various methods, namely, infrared spectroscopy, NMR spectroscopy, thermal analysis, viscosity measurement, scanning electron microscopy and X-ray diffractometry. The flocculation performance of AP-g-C and AP-AT-C were studied in kaolin suspension using jar test and settling test methods at neutral pH. Dye (Methylene blue) removal tests were performed using polymer beads and analysed by UV-vis spectroscopy.

Amphoteric amylopectin: a novel polymeric flocculant.

Novel flocculant based on amphoteric amylopectin for wastewater and industrial effluents treatment has been developed in authors' laboratory. Amphoteric flocculants have anionic and cationic moieties on the same macromolecule and is used to remove both positively and negatively charged contaminant particles in suspensions. Amylopectin based flocculants have been found to be highly efficient flocculant and hence it has been chosen as base polysaccharide. By grafting of polyacrylamide and subsequent hydrolysis, anionic amylopectin has been synthesized. Afterwards, a cationic moiety has been inserted both by chemical/microwave processing. The flocculation efficiency of the amphoteric amylopectin has been tested in kaolin and iron ore suspensions. The results indicate its high efficiency in comparison with anionic, grafted, and base amylopectin. The amphoteric amylopectin prepared via microwave irradiation showed best flocculation efficiency.

Aberrations in folate metabolic pathway and altered susceptibility to autism.

OBJECTIVE: To investigate whether genetic polymorphisms are the underlying causes for aberrations in folate pathway that was reported in autistic children. BASIC METHODS: A total of 138 children diagnosed as autistic based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria and Autism Behavior Checklist scoring and 138 age and sex matched children who are nonautistic were tested for five genetic polymorphisms, that is, cytosolic serine hydroxyl methyl transferase (SHMT1 C1420T), methylene tetrahydrofolate reductase (MTHFR C677T and MTHFR A1298C), methionine synthase reductase (MTRR A66G), methionine synthase (MS A2756G) using PCR-restriction fragment length polymorphism methods. Fisher's exact test and logistic regression analysis were used for statistical analyses. RESULTS: MTHFR 677T-allele frequency was found to be higher in autistic children compared with nonautistic children (16.3 vs. 6.5%) with 2.79-fold increased risk for autism [95% confidence interval (CI): 1.58-4.93]. The frequencies of MTRR 66A allele (12.7 vs. 21.0%) and SHMT 1420T allele (27.9 vs. 45.3%) were lower in autistic group compared with nonautistic group with odds ratios 0.55 (95% CI: 0.35-0.86) and 0.44 (95% CI: 0.31-0.62), respectively, indicating reduced risk. MTHFR 1298C-allele frequency was similar in both the groups (53.3 vs. 53.6%) and hence individually not associated with any risk. However, this allele was found to act additively in the presence of MTHFR 677T allele as evidenced by 8.11-fold (95% CI: 2.84-22.92) risk associated with MTHFR 677CT+TT/1298AC+CC genotypes cumulatively. CONCLUSION: MTHFR C677T is a risk factor, whereas MTRR A66G and SHMT C1420T polymorphisms reduce risk for autism. MTHFR A1298C acts additively in increasing the risk for autism.