<p>ABSTRACT</p><p>Billions of people are living without access to safe hygienic means of personal sanitation. The sanitation gap is wide in developing countries where more people are increasingly becoming urbanised. Sanitation related diseases are some of the leading cause of mortality and morbidity among the population in developing countries especially children under age of 5 years. The responsible institutions are faced with challenge to provide suitable and affordable services to this increasing population. In Uganda, the urban poor are residing in the peri urban areas with inadequate sanitation facilities. The provision of conventional sanitation facilities are seen not be sustainable options due to contamination of both surface and underground water sources, congested housing structure and at the same time makes recycling and reuse of nutrients difficult.</p><p>This study investigated attitudes towards urine diverting toilets in one of the peri urban areas in Kampala, with the aim of finding out strategies to improve on awareness of ecological sanitation as well as popularise their use as alternative sanitation. Respondents’ views were collected through face to face interviews with 40 household respondents using a semi structured questionnaire and field observations of the household’s toilet in use as well as solid waste disposal. Four focus group discussions and 6 key informant interviews were also performed.</p><p>The respondents’ acceptance of the urine diverting toilets was relatively positive. Most of the respondents reported that the ecosan toilets are a viable option due to congested housing pattern, desire to own a toilet (for those who never had a toilet before), improved privacy, and convenience among other factors. Respondents who have no urine diverting toilets also preferred urine diverting toilets and expressed their willingness to replicate them. It was also found that residents in Kamwokya II parish prefer a double vault design to one which uses bucket. The findings also reveal that reuse of sanitized urine and faecal matter within the community is not possible since there is no space for urban agriculture. However, the respondents acknowledged a willingness to eat or buy food from a garden fertilized with sanitized urine and faecal matter. It was also found that there are no cultural and religious beliefs against reuse of sanitized urine and faecal matter. Some challenges that affected implementation of the pilot project were people’s reluctance to adopt at the beginning, delayed completion of some facilities and part time employees. Currently there is limited replication of toilets because of low cash income among the residents, delayed completion of some facilities and sceptical views by some residents.</p><p>Among the difficulties faced in use of toilet include forgetfulness by some people to spray ash after defecating, misplaced water entering the toilet vault during cleaning, children playing with the urine container etc. The provision for anal cleansing for Muslims, squat hole covers, closed urine chamber among others were suggested for system improvements. The study recommends more awareness campaigns through social marketing of toilet and reuse of nutrients, modification of design, government’s commitment and household change of behaviours are fundamental for encouraging more adoption and replication of the toilets.</p>

ABSTRACT Billions of people are living without access to safe hygienic means of personal sanitation. The sanitation gap is wide in developing countries where more people are increasingly becoming urbanised. Sanitation related diseases are some of the leading cause of mortality and morbidity among the population in developing countries especially children under age of 5 years. The responsible institutions are faced with challenge to provide suitable and affordable services to this increasing population. In Uganda, the urban poor are residing in the peri urban areas with inadequate sanitation facilities. The provision of conventional sanitation facilities are seen not be sustainable options due to contamination of both surface and underground water sources, congested housing structure and at the same time makes recycling and reuse of nutrients difficult. This study investigated attitudes towards urine diverting toilets in one of the peri urban areas in Kampala, with the aim of finding out strategies to improve on awareness of ecological sanitation as well as popularise their use as alternative sanitation. Respondents’ views were collected through face to face interviews with 40 household respondents using a semi structured questionnaire and field observations of the household’s toilet in use as well as solid waste disposal. Four focus group discussions and 6 key informant interviews were also performed. The respondents’ acceptance of the urine diverting toilets was relatively positive. Most of the respondents reported that the ecosan toilets are a viable option due to congested housing pattern, desire to own a toilet (for those who never had a toilet before), improved privacy, and convenience among other factors. Respondents who have no urine diverting toilets also preferred urine diverting toilets and expressed their willingness to replicate them. It was also found that residents in Kamwokya II parish prefer a double vault design to one which uses bucket. The findings also reveal that reuse of sanitized urine and faecal matter within the community is not possible since there is no space for urban agriculture. However, the respondents acknowledged a willingness to eat or buy food from a garden fertilized with sanitized urine and faecal matter. It was also found that there are no cultural and religious beliefs against reuse of sanitized urine and faecal matter. Some challenges that affected implementation of the pilot project were people’s reluctance to adopt at the beginning, delayed completion of some facilities and part time employees. Currently there is limited replication of toilets because of low cash income among the residents, delayed completion of some facilities and sceptical views by some residents. Among the difficulties faced in use of toilet include forgetfulness by some people to spray ash after defecating, misplaced water entering the toilet vault during cleaning, children playing with the urine container etc. The provision for anal cleansing for Muslims, squat hole covers, closed urine chamber among others were suggested for system improvements. The study recommends more awareness campaigns through social marketing of toilet and reuse of nutrients, modification of design, government’s commitment and household change of behaviours are fundamental for encouraging more adoption and replication of the toilets.

Urinary tract infection (UTI) is a very common infection in humans and a majority is caused by Escherichia coli. UTI are commonly treated empirically. However, empiric treatment has become more problematic due to increased antibiotic resistance to commonly used antibiotic agents. It is therefore desirable with short turnover times for antimicrobial susceptibility testing and species identification to improve antibiotic treatment at an early stage. Matrix Assisted Laser Desorption/Ionisation Time of Flight (MALDI-TOF) can provide species identification faster than former routine methods. This study compared direct and standard susceptibility testing using disk diffusion on Enterobacteriaceae (EB) from urine samples. The possibility to standardise the inoculum for direct susceptibility testing via a pellet obtained by a series of centrifugations was also evaluated, as well as direct species identification with MALDI-TOF from the pellet. Results from direct susceptibility testing from urine samples with EB, performed either directly from the urine or with a standardised inoculum, correlated well to those obtained with standardised susceptibility testing using EUCAST disk diffusion methodology with few errors, of which most were associated with Proteus mirabilis. The concept of standardising the inoculum for direct susceptibility testing to 0.5 McFarland was labour intensive and did not improve the results further. However, direct species identification from the urine pellet using MALDI-TOF showed good correlation to routine identification. Of 238 samples, an EB was correctly identified in 148 samples using MALDI-TOF.

The purposes of this research were to: (1) describe selected fluid and electrolyte changes that occur during the first four hours after open heart surgery; (2) determine whether significant hourly changes occurred in: blood pH, fluid intake, exogenous potassum chloride replacement, fluid output, or serum and urinary sodium and potassium levels; and finally, (3) delineate which of the above variables were most strongly related to changes in serum and urinary, sodium and potassium levels. Fifty-three patients who had undergone cardiac surgery involving cardiopulmonary bypass were studied. Urine and blood samples were collected every hour for the first four hours postoperatively and were analyzed for sodium and potassium content using flame photometry. Blood pH and exogenous potassium chloride replacement were recorded from the anesthesiologist's and nurse's records. Fluid intake and fluid output were measured directly by the investigator. Analyses included both descriptive and correlational statistics. In addition, a repeated measures procedure (MANOVA) was performed to discern performance trends over time. The data showed that hypokalemia (defined as a serum potassium level less than 4.0 mEq/L) was present in approximately 52 percent of the subjects for the first two postoperative hours and that by the fourth hour only 15 percent of the subjects were hypokalemic. In addition, subjects were noted to retain 2.47 liters of fluid over the four hour period. Significant differences in fluid output were noted across time. Serum sodium levels did not change significantly across time even though serum potassium levels did. The data indicated that the best predictors of hypokalemia were fluid intake and fluid output. Both of these variables had a significance level of p = .000. Regression analysis showed that fluid intake and exogenous potassium chloride replacement explained 11.9 percent of the variance in serum potassium at a significance level of p = .008. Furthermore, fluid output explained 7.3 percent of the variance in urinary potassium (p = .030).

Background: Arsenic (As) is a naturally-occurring element with known toxicant effects. The primary exposure pathway is through ingestion, but the overall contribution of food versus water and the impact of specific dietary nutrients on urinary As excretion is not well understood. Methods: Secondary analyses of laboratory results from food, water and urine samples, questionnaire and anthropometric data, and dietary records were performed on four study populations: the National Health Exposure Assessment Survey (NHEXAS)-Arizona, Arizona Border Survey (ABS), the Arizona sub-group of the Binational Arsenic Exposure Survey (BAsES), and the 2003-2004 National Health and Nutrition Examination Survey (NHANES). Dietary As intake was measured in duplicate food samples and/or modeled from dietary records for each population using the U.S. Total Diet Study (TDS) arsenic residue database and a published market basket survey. Urinary total As, As⁵, As³, monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) were analyzed, and sum of species As was calculated as the sum of As⁵, As³, MMA and DMA. Regression analyses modeled the relation between urinary As biomarkers (total, sum of species, MMA:sum of species, and DMA:MMA) and dietary As, adjusted for drinking and cooking water As intake, current smoking, sex, age, ethnicity, body mass index, and nutrient intake. Results: Modeled dietary As based on TDS mean As residue data greatly underestimated exposure as compared with measured As in duplicate diet samples and estimates based on other residue data. Dietary As was a significant predictor of urinary total As in all four populations, of sum of species As in both BAsES and NHANES, and of %MMA and DMA:MMA in NHANES. Dietary protein intake was associated with decreased sum of species As in both BAsES and NHANES, but dietary folate was not. Conclusions: Dietary As contributes a markedly greater proportion of total ingested As and is a better predictor of urinary As than water As intake in the U.S. Among subjects who did not consume seafood, total As exposure from food and water exceeded the provisional tolerable daily intake of 2.1 µg/kg body weight/day in 3-15% of these study populations. Increased protein intake may mitigate the effects of As.

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Chronic noncommunicable diseases (NCDs) are the largest contributor to mortality rates worldwide including in low- and middle- income countries (LMICs) which already suffer from high rates of infectious disease. Among the four major NCDs that cause 38 million deaths annually, cardiovascular disease (CVD) causes 17.5 million of these annual deaths. The primary risk factor of CVD is hypertension. Kenya, a developing country in Sub-Saharan Africa, has a high rate of hypertension with low (2.6%) management rates. Prior research from our lab has identified a population of Kenyans with a high prevalence of hypertension that is not statistically correlated with typical known risk factors such as obesity, hypercholesterolemia, and behaviors of smoking and lack of exercise. This study investigated the hypothesis that high dietary salt consumption and low K+ dietary intake are contributing to the etiology of high blood pressure in this community. To test our hypothesis, two spot urine samples representing nocturnal excretions (evening and morning) and blood pressure measurements were collected from 135 participants. All samples were analyzed for Na+, K+ and Cl- content using the Smartlyte Electrolyte Analyzer. The average of each spot urine sample was extrapolated to an estimated 24-h value by the method of Mills, et al. The overall population mean urine electrolyte excretion values for Na+, K+ and Cl- were 170.6 ± 89.3 mmol/L, 82.0 ± 54.0 mmol/L, and 87.7 ± 42.1 mmol/L, respectively. While these values fall within the suggested levels for Na+ (40-220 mmol/L) and K+ (25-125 mmol/L), they are under normal excretion levels for Cl- (110-250mmol/L). Overall ion excretion was higher in females than males, although only K+ values were statistically significant (p < 0.05). Analysis of Na+ and Cl- excretion from individuals stratified by blood pressure, revealed significant differences (p < 0.05) between normotensive and hypertensive stage I individuals for both electrolytes (57.9 mmol/L vs. 88.9 mmol/L and 65.5 mmol/L vs. 96.7 mmol/L, respectively). Overall, these results suggest that our sample population consumes dietary salt within a normal range and thus, the observed prevalence of hypertension likely results from other genetic and environmental factors.

A dissertation submitted in partial compliance with the requirements for the Master's Diploma in Technology: Homoeopathy, TechniKon Natal, Durban, 1994. / This study contains a review of the major recognizable Industrial problem of chronic lead toxicity. Lead poisoning has been recognized for thousands of years, dating beclt to the Roman Empire. Today, Industries In South Africa and worldwide struggle to maintain low blood lead levels In their employees and companies have to abide by regulations to ensure they ere doing all that Is In their power. Cooltson Chemicals (Pty) Limited, In Durban, which has a factory which produces lead based chemicals, was approached with regard to treating the workers exposed to the lead dust and fumes with Homoeopathlc Slmlllimum. This Individualistic Homoeopathlc treatment depends on the person's symptoms and signs on a physical, mental and emotional level, and by treating the person as a whole, the excretion of toxic lead occurs. Thus lower lead levels result. According to Herneeepetntc methodology, It Is the sum of all the symptoms and signs In each Individual ease of a disease that Is the main pointer In the choice of the remedy. This Is where despite many complaining of a slmillar condition, or suffering from a common complaint, different Homoeopathlc remedies may be prescribed. Lower blood lead levels result In fewer retrenchments as once a factory employee continually presents with excessively high blood lead levels, he risks losing his Job. A sample group of twenty volunteers was obtained from this factory and each werker tooit his prescribed medication and had blood and urine tests talten at regular Intervals over five months. The precise methodology and the consequent results are explained In this paper. The results were analysed using the computer program, SGPLUS,to obtain summary statistics. The blood lead results were subjected to The Wilcoxon Signed RankTest to determine the 11kreasesand decreases In the levels over the monitoring period. Due to sample size and the presence to only one group In the research, the remaining results were from visual observation. Based on the problems encountered during this study, recommendations are made If further research Is to be done along similar guidelines. A final conclusion closes the study. The urine porphyrin tests are not a true Indicator of lead metabolism or excretion and these results are therefore not valid. A slight change did occur In the blood lead levels as Is discussed. A great deal of progress remains to be made with the aim of lowering blood lead levels In lead-exposed factory workers. Homoeopathy has the potential to alleviate this serious problem of chronic lead toxicity. Further research could provide Industry with the answer. Presently the emphasis Is on prevention of excessively high blood lead levels with only removal from exposure as the last possible means of alleviating the problem. If a method to solving lead toxicity In the Industrial sphere can be found, It has numerous possibilities In nonIndustry. Thus an opening exists for Homoeopathy. / M

Creatinine is a metabolic waste product, removed from the blood by the kidneys, and excreted in the urine. The measurement of creatinine is used in the assessment and monitoring of many medical conditions as well as in the determination or adjustment of absorbed dosage of pesticides. Earlier models to predict 24-hour urinary creatinine used ordinary least squares regression and assumed that the subjects' observations were uncorrelated. However, many of these studies had repeated creatinine measurements for each of their subjects. Repeated measures on the same subject frequently are correlated. Using data from the NIOSH-CDC "Pesticide Dose Monitoring in Turf Applicators" study, this thesis project built a model to predict 24-hour urinary creatinine using the Mixed Model methodology. A covariance structure, that permitted multiple observations for any one individual to be correlated, was identified and utilized. The predictive capabilities of this model were then compared to the earlier models investigated.

The main aim of this thesis was to evaluate the current state of iodine levels in horses from selected farms in South Bohemia. Out of the sample group, no animal with iodine deficiency was detected. Additional objective of this thesis was to assess whether selected horse owners supplement their horses with iodine and what form of supplementation they choose.