Toilet Use Research Articles

Determinants of Delayed Menstrual Period among Students of Tertiary Institutions in Rivers State

Menstrual period is a normal and significant process that every female who have attained the age of puberty must experience in life and it is a monthly process. However, delayed in having this normal process every monthly is a concern. Several factors may be responsible for delayed menstrual period experienced by females. This research states to examine the Determinants of Delayed Menstrual Period among Students of Tertiary Institutions in Rivers State. Sample size for the study was 250 and participant were randomly selected and the questionnaire were issued to the participants to fill and return it to the researcher. Data was analyzed with SPSS version 26 and P value < 0.05 was considered significant. Results from the study revealed that some of the determinants that are precursors of delayed menstrual period observed were unprotected sex, use of contraceptives, alcohol consumption, use of public toilet, unwanted pregnancy, vaginal discharge, abortion, stress and infection. Also, 98.8% of the responders have started dating and 78.00%) respondents agreed that they have been involved in intermittent sex without protection. The findings revealed that 98.4% of the participants have used contraceptives for more 5 years. However, 62.8% of the responders affirmed that they experienced milky discharge from their breast and 69.2% have done abortion. The study shows that 68.4% of the respondents used public toilet and 62.4% respondents experienced vaginal discharge. Furthermore, 65.20%) of responders have been pregnant without knowing. Results also shows that 73.2% of the respondents have conducted hormonal profile and 64.4% of respondents have hormonal imbalance while 94.4% of the participants consumed alcohol.

Residential Water Consumption Patterns: A Theoretical Review

The global water crisis and acute increase in water demand have increased stress on water resources in urban areas, particularly in water-scarce regions like Egypt. Many current strategies of sustainable water demand management show low effectiveness due to a lack of understanding of how water is used in households, and a failure to consider the environmental and urban diversity that shapes water consumption patterns in Egypt. This understanding requires knowing how water is consumed for micro-components of water use (i.e., end-uses such as bathing, cooking, and toilet use). This research aims to develop a conceptual/theoretical framework for probable worldwide water consumption patterns and their shaping factors, to be used as an auxiliary tool in future data collection and analysis in Egypt, which is an essential step to contextualize water consumption patterns and develop more sustainable water demand management strategies. The study reviews and analyzes water end-use data from 39 major cities in developed and developing countries to identify trends and critical factors in household water consumption. It documents six different major trends in household water consumption patterns with main water activities: cooking, bathing, washing machines, faucets, and toilet use. It also identifies and categorizes the patterns-shaping factors into five main groups: socioeconomic characteristics, physical, spatial, climatic conditions, and political restrictions. Moreover, significant correlations emerge between pattern elements and shaping forces such as income and washing machine usage, the presence/absence of children/elders and use of basin, and dietary culture and cooking consumption. Given the research findings, household consumption patterns in Egyptian cities are expected to be high in kitchens, showers, and toilets, and average in laundry and faucets. The study underscores the importance of considering factors such as socio-economic characteristics, water policies, spatial influences, water supply efficiency, and consumer health in forthcoming investigations, as these are believed to substantially influence household water consumption in Egypt.

321 - A mapping review of Assistive Technology products for continence containment and toilet use

321 - A mapping review of Assistive Technology products for continence containment and toilet use

Abdominal muscles infiltration analgesia for donor-site pain in autologous ear reconstruction: A randomized controlled clinical trial

BackgroundCostal cartilage donor-site pain is an adverse effect of autologous ear reconstruction. This study aimed to introduce rectus abdominis and external oblique muscle infiltration analgesia (RAM+EOM-IA) for costal cartilage donor-site pain and evaluate its efficacy and safety. MethodsThe study was a randomized controlled clinical trial. Patients were randomized between intermittent RAM+EOM-IA combined with intravenous patient-controlled anesthesia (IPCA) and IPCA alone. Thirty patients were followed in the RAM+EOM-IA combined with the IPCA group and 30 patients in the IPCA alone group. The primary outcome was the numerical rating score (NRS) of pain recorded during 48 h postoperatively. Secondary outcomes included the Barthel index (BI) and rescue analgesic consumption. Sensory block areas were tested using a cold stimulus. ResultsNRS was significantly lower with RAM+EOM-IA combined with IPCA than with IPCA alone at 28 h (P < 0.01), 32 h (P < 0.01), 36 h (P < 0.01), 44 h (P < 0.001), and 48 h (P < 0.01) postoperatively. The number of patients who received rescue analgesics (P < 0.01) and consumption (P < 0.01) was significantly higher for IPCA alone. RAM+EOM-IA improved the BI at 24 h postoperatively (P < 0.001), especially for mobility (P < 0.001), using the stairs (P < 0.001) and toilet use domains (P < 0.001). At 10 and 60 min after RAM+EOM-IA, the total sensory block area in the abdomen had not extended proximally beyond the xiphoid, distally beyond the navel, and beyond midaxillary and midsternal lines on either side. ConclusionRAM+EOM-IA effectively and safely prevented costal cartilage donor-site pain by blocking anterior and lateral cutaneous branches of intercostal nerves from T6 to T10 in microtia patients.

Enhancing Preschoolers' Independence through Toilet Training: A Case Study of Two Daycares in Semarang City

Toilet training is one of the important efforts in improving the independence and personal hygiene of preschool children, especially in the context of thaharah values in Islam. This study aims to describe the efforts to improve thaharah and independence of preschool children through toilet training in two daycare centers in Semarang City. This research used a qualitative approach with a case study approach model. Data were collected through observation, in-depth interviews with educators, and documentation. The results showed that both daycare centers have integrated the values of thaharah in their toilet training programs. The approaches used include habituation, modeling, and the use of language that is suitable for children's understanding. In addition to increasing independence in toilet use, the toilet training program also succeeded in fostering children's awareness of the importance of maintaining personal hygiene in accordance with religious teachings. Challenges faced in implementing toilet training include differences in children's characteristics, lack of parental support, and limited facilities. This study contributes to the development of toilet training programs that are oriented towards religious values. Recommendations include the importance of collaboration between educators, parents, and religious leaders in instilling the values of thaharah from an early age. In addition, it is necessary to develop a more comprehensive curriculum that integrates cognitive, affective, and psychomotor aspects in the toilet training process.

Women's toilet use behaviors and water use in a urine diversion squat pan toilet pilot

ABSTRACT Understanding user behavior is critical to the adoption of technology; however, there is a paucity of data related to gender-specific sanitation practices and water-use patterns in toilet use despite the global imperative to increase attention toward the needs of women and girls. This user-focused study sought to understand the role of women's behavior related to the urine diversion performance of a novel toilet design. Forty-one female users of urine diversion toilets installed in two shared bathroom sites in Coimbatore, India, were surveyed about their behavior during toilet use. About 32% of respondents reported behaviors that reduce urine separation efficiency in this system, including aiming urine directly into the hole of the squat pan instead of the ceramic surface (15%); facing backwards (12%); squatting only part way down (7%); and pouring water onto the pan while urinating (5%). Separately, 88% of respondents use available water to clean the floor around the toilet, a practice that may alter the relative volumes of generated blackwater and graywater. These findings may aid the design of future sanitation solutions. Most respondents did not identify the specific toilet design as different from conventional ones, suggesting that these behaviors may apply to broader use cases.

Longitudinal Analysis of Functional Capacity in Nursing Home Residents During the COVID-19 Pandemic.

The COVID-19 pandemic has raised concerns about nursing home (NH) residents' well-being, with recent studies indicating a significant increase in functional decline rate during this critical period. However, a comprehensive exploration of functional capacity trajectories in NH residents during the pandemic remains unexplored. This study aims to address this research gap by conducting an in-depth analysis of the impact of the COVID-19 pandemic on NH residents' functional capacity. A 24-month multicenter prospective study involving 123 NH residents from Spain, with data collected at 6-month intervals over 5 waves, starting just before the pandemic's onset. Functional capacity was assessed using the Modified Barthel Index, and data were analyzed employing the actuarial method, log-rank test, and Cox's regression. The likelihood of maintaining functional capacity was unfavorable, with only a 19.3% chance of preservation for a 1-point decline (FD-1) in Barthel scores and a 50.5% probability for a 10-point decline (FD-10). Personal hygiene, eating, and toilet use were identified as the most affected activities of daily living. Urinary continence decline emerged as a risk factor for FD-1, while fecal continence decline was associated with FD-10. The probability of maintaining functional capacity in the initial 6months of a pandemic was comparable to a 2-year non-pandemic follow-up. Pandemic-induced isolation strategies significantly impacted toileting and personal hygiene. Urinary decline was associated with minor functional decline (FD-1), while fecal decline correlated with major functional decline (FD-10). Notably, the number of days spent in room confinement did not significantly contribute to the observed decline. A substantial increase in the risk of FD among NH residents during the COVID-19 pandemic compared to the pre-pandemic period was found. It is crucial to implement urgent, targeted interventions that prioritize promoting physical activity and the implementation of mobility and toileting programs. These measures are pivotal for mitigating functional decline and enhancing the overall health and well-being of NH residents in a pandemic context.

Anaemia among school-going adolescents in Burkina Faso: Prevalence and associated factors.

Adolescence, a stage of growth between 10 and 19 years, is a transitional period of intense cognitive, emotionaland physical development. Though iron deficiency is theleading cause of morbidity and mortality among this age group, nutritional interventions targeting adolescents are rare. To inform policy and practice aimed at adolescent health, we established the burden of anaemia among school-going adolescents in Center West Burkina Faso and investigated the potential explanatory factors. A cross-sectional survey was conducted between January and March 2021. Blood samples, socio-demographic, socioeconomic, anthropometric, dietaryand water, sanitation and hygiene data from 2947 students aged 10-18 years were collected. Anaemia was determined by the World Health Organization's sex- and age-specific haemoglobin concentrations. χ2 tests and logistic regressions were used to identify factors associated with anaemia. The prevalence of anaemia among adolescents in the sample was 36.2%, including 24.2% mild, 11.6% moderateand 0.4% severe anaemia. Compared to males, females were 19% less likely to have mild anaemia (adjusted Odds Ratio [aOR] = 0.81; 95% confidence intervals [CI]: 0.689, 0.955) but 42% more likely to be moderately or severely anaemic (aOR = 1.42; 95% CI: 1.102, 1.831). Among iron-rich foods, tamarind (aOR = 0.75; 95% CI: 0.610, 0.929) and pumpkin leaves (aOR = 0.77; 95% CI: 0.605, 0.974) were associated with lower odds of anaemia. Several water, sanitation and hygiene factors were associated with higher haemoglobin, including handwashing after toilet use (β = 0.50; 95% CI: 0.031, 0.966)andtooth brushing twice daily (β = 0.19; 95% CI: 0.030, 0.354). Anaemia among adolescents in Burkina Faso should be addressed with interventions targeting diet, sanitationand hygiene.

Optimization of the Photo-Fenton process for the effective removal of chemical oxygen demand and phenols in portable toilet wastewater: A treatment study under real world conditions

Wastewater from portable toilets (WWPT) is characterized by a high content of organic matter and a variety of chemical compounds that retain bad odors, especially phenols, a type of pollutant that is difficult to degrade by conventional treatments; in addition, it is persistent, toxic, and accumulates in the aquatic environment. Although different successful experiences with the use of Photo-Fenton are reported in the scientific domain, its application in WWPT is scarce and warrants study due to the wide use of portable toilets. The objective of this study was to evaluate the Photo-Fenton oxidation process in the removal of organic matter expressed as COD in a WWPT, as well as the reduction of phenols and BOD5. The experimental runs were carried out in a 0.50 L batch reactor to evaluate the effect of the factors (H2O2: 0.019, 25.56, 40.67, 87.24, 148.91, 174.45 g L−1 and pH: 2.80, 3.00, 3.27, 4.40, 5.53, 6.00 UNT) on COD removal and sludge production. It was found that the optimum operating conditions of pH 4.72 and H2O2 dosage of 174.45 g L−1 reduced the concentration of phenols by 97.83 % and 95.49 % of COD. In addition, 98.01 % of BOD5 was reduced, resulting in a biodegradability ratio (BOD5/COD) of 0.23 compared to the untreated wastewater of 0.53. From a cost perspective, the use of Photo-Fenton to treat wastewater under these conditions would be US$ 1.15 per liter.

Understanding global perspectives for the acceptance of community sanitation welfare schemes through a localised qualitative survey in Kho Nagorian, Jaipur, India

Community sanitation is a fundamental human right and need. Every year, as per the World Bank, total cost of providing sanitation services is estimated at around 114 billion USD per year. In India, Swachh Bharat Abhiyan (SBA), a public welfare scheme (PWS), is aimed at addressing community sanitation problems. Despite the successful implementation of SBA, local communities still practise open defaecation. To deduce the behavioural patterns governing communal toilet use, interviews were conducted with the local communities in the Kho Nagorian area of Jaipur, Rajasthan, India. This qualitative survey examined attitudes towards the construction of a toilet, awareness towards the SBA scheme, and the willingness to use excreta-based pit humus. The study then discusses the factors that increase the local community’s willingness to use these toilets. Results show that open defaecation is still prevalent in society. One way to foster the adoption of toilets is that the construction materials should mainly consist of local materials. As a recourse, places of worship could be used to influence people’s perception of hygiene. In addition, community toilets should be cleaned often as well. PWS should not be made accessible at no cost to prevent a sense of entitlement among the people. A small sum should be charged to increase social responsibility towards the PWS. Another way to curb open defaecation is to tap into the sense of entitlement by making effective use of social campaign programs. Further, cross-table analysis revealed that the locals were inclined to use a toilet if they have invested in it. Advertisements were found to be ineffective, and proposals were made to make them effective. These findings aid in understanding public perceptions and can guide the development of public policies. The findings also assist in making tax distribution decisions that reflect public concerns, attitudes, and values.

IMPLEMENTASI PROGRAM TOILET TRAINING DALAM MENUMBUHKAN KEMANDIRIAN ANAK USIA TODDLER DI KELOMPOK BERMAIN

Toilet training young children is an essential milestone in a child's journey towards independence. This study explored the implementation and outcomes of a structured toilet training program in a playgroup setting. The aim is to assess its effectiveness in fostering independence in toddlers aged 1.5 to 3 years. The program takes a gradual approach, emphasizing positive reinforcement and consistency in the routine. This research uses a qualitative approach with a case study type of research. The data collection techniques used included observations of participating toddlers over six months, with data collected through interviews with teachers and direct observation during playgroup activities. The data analysis technique used is Miles and Huberman. The research results showed that, first, in the Al-Fatih KB, 5 of the 14 children had difficulty using the toilet. Second, teachers' structured and consistent approach has proven effective in helping children understand and internalize toilet use skills. Third, the supporting factors in training children's independence in using toddler toilets at Al-Fatih KB Palembang City include good cooperation between teachers and parents, mental and psychological readiness of children, mature age, and complete and adequate facilities and infrastructure in Toilet Training learning. Meanwhile, the inhibiting factors include the child's age, mental and psychological not being ready to learn Toilet Training and the lack of cooperation from parents who still use disposable diapers on their children.

Cutoff values of motor and cognitive measures for predicting and discriminating levels of activities of daily living after stroke: a scoping review.

The various assessments performed by rehabilitation professionals not only indicate the patient's current functional status but can also help determine the future status (prediction) or the ability to perform untested tasks (discrimination). In particular, the cutoff values are the simplest predictive and discriminative tool that can be widely used in clinical practice. The purpose of this scoping review was to summarize the current literature on cutoff values of motor and cognitive function for predicting or discriminating levels of activities of daily living after stroke. A literature search was conducted using the PubMed, CINAHL, and Scopus databases. The creation of the search criteria, primary screening of titles and abstract, and secondary screening by full-text review were performed by two rehabilitation professionals. A total of 54 articles were included. The summary of the cutoff values for prediction based on longitudinal studies revealed that an NIHSS score ≤8 and mRMI score ≥19 at acute hospitalization can predict good functional independence and walking independence, respectively, indicating reliable cutoff values. Cutoff values for predicting specific ADLs, such as toilet use or dressing, were not reported, which was a potential research gap identified in this review. Alternatively, the summary of the cutoff values for discrimination based on cross-sectional studies revealed that 288-367.5 m on the 6-min walk test and 25.5-27.6 points on the FMA-LL can discriminate community and noncommunity walkers. Considering the difference between prediction and discrimination, the reliable predicted cutoff values revealed in this review are useful for planning an intervention based on early prediction. Conversely, cutoff values for discrimination can estimate different performances with simpler test, or use as target values during rehabilitation.

Prevalence, Determinants, and Antibiotic Resistance Patterns of Urinary Tract Infections in Antenatal Women in an Urban Resettlement Colony and Slum in Delhi, India: A Cross-sectional Study

Abstract Background: Urinary tract infection (UTI) is the most common bacterial infection occurring in pregnant women with untreated, recurrent, and inadequately treated bacteriuria accentuating the risk of multiple adverse fetal and maternal health outcomes. The study objective was to determine the proportion of UTIs and their predictors along with antibiotic resistance patterns of causative organisms in pregnant women. Materials and Methods: This cross-sectional study was conducted among 348 pregnant women in an urban resettlement and slum colony. Urine samples were examined through semi-quantitative culture on plated Mac Conkey and blood agar. Antibiotic susceptibility testing was done on Muller Hinton agar using the modified Stokes’ disc diffusion method. Results: At least one symptom related to UTI was reported by 35.7% (95% CI: 30.7-41.1) of the participants. The proportion of pregnant women detected having UTI on urine culture was 7.4% (n = 24, 95% CI: 5.1-10.8) with 13 (54.2%) asymptomatic and 11 (45.8%) symptomatic cases. Overcrowding was a significant predictor of UTI. The most common organisms detected were Escherichia coli (n = 12), Klebsiella pneumoniae (n = 7), Staphylococcus aureus (n = 3), and Acinetobacter species (n = 2). Conclusions: The use of individual toilets and active screening for UTI through culture and sensitivity testing in pregnant women should be promoted in low-resource settings irrespective of symptoms. The initiation of presumptive antibiotic therapy for UTI cases in pregnant women should be restricted to painful micturition due to high false positivity of other symptoms with Nitrofurantoin being a likely preferred drug for empirical administration due to its low resistance pattern among isolated organisms.

On the Move pad – a portable multipurpose pad: User feedback

Context/Objective Hard-shell toilet seats may compromise safety and hinder the participation of individuals at risk for pressure injuries (PIs) when using these facilities away from home in public, hotel, or family/friend restrooms. Moreover, people often add “wash-cloths” for additional padding for comfort, and to reduce the risk of PIs due to pressure or shearing on their wheelchairs surfaces. This study investigated the utilization of portable pads, initially designed for toilet use but adaptable to various places and contexts, while examining pad usability. Design A cross-sectional descriptive survey design. Setting Inpatient care, outpatient care, and community setting. Participants 45 individuals at risk of PIs. Results Participants extended the use of these pads beyond toilets, employing them as wheelchair armrest and leg rest pads in other settings. Feedback from a customized questionnaire indicated high levels of usefulness (8.5/10) and ease of use (9.1/10) attributed to the pads. Among the features, the top three favored were ease of use, comfort/cushioning, and function. Participants expressed a desire for a variety of sizes and colors to enable versatile usage and suggested incorporating a pocket for storing small items. Conclusions and Relevance Individuals at risk of PIs require cushioning not only on hard-shell toilet seats, but also for additional padding, protection and enhancing the use of wheelchairs. Rehabilitation professionals can play a crucial role in educating and training both clients and caregivers to understand PI prevention, enabling them to effectively leverage the pads in appropriate situations, thereby enhancing their comfort in their wheelchairs during social engagement.

COMMUNITY SYMPATHY-BASED SLUM SANITATION PLANNING CONCEPT IN BATU BARA DISTRICT, NORTH SUMATERA, INDONESIA

ABSTRACT Slums in the Tanjung Tiram area of Batu Bara Regency are caused by high and uneven population density, limited habitable land and low awareness of environmental conservation among residents. This results in poor environmental sanitation and potentially affects environmental sustainability. The local government is trying to improve this situation through slum upgrading and community empowerment programs. Objectives: This study aims to examine community sympathy for the spatial concept and environmental sanitation improvement programs in Tanjung Tiram neighborhood, as well as the factors that influence it. Methodology and Results: The research method was qualitative with a rationalist approach. The study began with literature analysis and continued with field studies to describe community sympathy in sanitation management, identify patterns of behavior change, and analyze the factors that influence it. Conclusion, Significance, and Implication: The results highlight that the community demonstrated empathy through responsibility and mutual concern for the interests of others, such as involvement in the sanitation improvement process from preparation to monitoring in terms of toilet and bathroom use. Community motivation comes from cadre interventions that provide understanding, increase empathy and responsibility, and strengthen community motivation in sanitation management. Community cooperation and awareness must be increased through community empowerment programs.

Second trimester vaginal Candida colonization among pregnant women attending antenatal care in Bukavu, Democratic Republic of the Congo: prevalence, clinical correlates, risk factors and pregnancy outcomes

IntroductionVaginal Candida colonization (CC) can lead to vulvovaginal candidiasis, the second most prevalent vaginal condition worldwide, and has been associated with adverse birth outcomes. However, no data on CC in the Democratic Republic of the Congo are available. We investigated the prevalence, Candida species, clinical correlates, risk factors and pregnancy outcomes in women with CC in the second trimester of pregnancy.Material and methodsIn Bukavu, the Democratic Republic of the Congo, pregnant women were recruited during antenatal care between 16 and 20 weeks of gestation from January 2017 to October 2017 and followed until delivery. Sociodemographics, sexual behavioral, hygienic and clinical characteristics, microbiological data and pregnancy outcomes were collected. Candida detection and speciation was performed with microscopy (Gram-stained smears and wet-mount) and/or quantitative PCR. Multivariate regression models were used to estimate the different associations with CC.ResultsThe prevalence of CC by wet mount, microscopy of Gram-stain smears and qPCR was 27.9%, 28.1% and 38.2%, respectively. C. albicans was the most prevalent Candida species (91.0%). Previous genital infections, an intermediate vaginal microbiota, bacterial vaginosis, and the use of pit toilets were risk factors for CC. Clinically, CC was associated with itching only. Women with CC had twice the odds for preterm birth, if Candida concentration was high, the odds were four times higher.ConclusionsIn Bukavu, the Democratic Republic of the Congo, the prevalence of CC was high and associated with microbiological and modifiable risk factors. Screening and treatment for CC during antenatal care should be investigated as a possible strategy to reduce preterm birth.

The process, outcomes and context of the sanitation change induced by the Swachh Bharat Mission in rural Jharkhand, India

BackgroundThe Indian Swachh Bharat Mission (SBM) was launched in 2014 with the goal to make India open defecation (OD) free by October 2019. Although it is known that the ambitious goal was not achieved, the nature of the sanitation change brought about by the SBM in different parts of India is poorly understood. One reason is a dearth of case studies that would shed light on the performance of the SBM simultaneously across its different domains. This article provides an example of such study. Employing a Process, Outcomes, Context approach, the objective is to understand the process and outcomes of the SBM-induced sanitation change in a specific context of rural Jharkhand.MethodsThe study utilizes data collected through field research conducted in the rural areas of Ranchi district, Jharkhand, a state in east-central India. This data was obtained via repeated cross-sectional household surveys conducted at the beginning and at the end of the SBM, supplemented by key informant interviews with SBM stakeholders.FindingsWe identified political support of SBM implementation and its acceptance amongst the population. Female community workers became key agents of SBM implementation at local level. The SBM increased toilet coverage in the study area from 15% to 85% and lowered the OD rate from 93% to 26%. It substantially reduced structural inequalities in access to toilets, furthered social sanitation norms, improved some of the attitudes towards toilet use, but impacted less on hygiene and sanitation knowledge. The implementation mainly concentrated on the construction of subsidized toilets but less on improving public understanding of safe sanitation practices.ConclusionsAlthough the SBM reduced sanitation inequalities in access to toilets in the study area, the behaviour change component was underplayed, focusing more on spreading normative sanitation messages and less on public education. Sustainability of the observed sanitation change remains a key question for the future. This article calls for more systematic production of geographically situated knowledge on the performance of sanitation interventions.

Wastewater treatment in semi-arid industries: A focus on technologies and potential for reuse

The aim of this article is to identify, based on a literature review, the most suitable water treatment technologies for the production of reuse water to be used by industries that are often present in the Brazilian semi-arid region. For this research, we selected studies on water treatment with low implementation costs and advanced development for implementation. This study identified water treatment technologies for the production of reuse water in the leather and footwear, textile, metallic and non-metallic mineral extraction and food and beverage industries. The search was carried out in the scientific databases Scopus and Web of Science, with no restrictions on the year of publication. Based on the selected articles, a summary was made of the most suitable water treatment systems for each industrial sector, providing an overview of the treatments recommended for water-scarce regions. Water reuse can be implemented in various industrial activities, including the use of boilers, cooling towers, toilet flushing, local irrigation and reintroduction into the process as a by-product. There are various methods of water treatment, although it is necessary to assess which is most suitable for each type of industry. Aspects such as the amount of effluent generated, the necessary properties of the water to be reused and the cost of the project must be carefully evaluated if the benefits are to be achieved.

Flush toilet use and its impact on health and non‐health expenditures

AbstractThis study analysed the effects of flush toilet use on health and non‐health expenditures incurred by rural Chinese. The instrumental‐variable‐based Tobit and endogenous treatment regression models were used to analyse the 2016 China Labour Force Dynamics Survey data while addressing the selection bias inherent in flush toilet use. The results showed that by improving rural residents' physical and mental health, flush toilet use reduced per capita health expenditure while increasing non‐health expenditure. Furthermore, using flush toilets had positive spillover effects, reducing the health expenditures of even those who did not use them. Factors affecting flush toilet use were also analysed.

Les facteurs de risque d’acquisition des infections à BMR: Etude analytique

In recent years, there has been a considerable increase in the prevalence of bacteria increasingly resistant to multiple families of antibiotics, which constitutes a major problem for public health. To determine the prevalence and different risk factors for the acquisition of multi-resistant bacteria. This is an analytical and prospective study including patients hospitalized in the Batna University Hospital during the period from January 2023 to March 2023 presenting a documented infection with isolation of sensitive or multi-resistant strains. An operating sheet based on the different risk factors for acquiring multi-resistant bacteria has been established. We collected 250 patients. There are 160 men and 90 women with an average age of 44 years. Of all the strains that were identified, 100 isolates were multi-resistant bacteria. ESBL-producing Enterobacteriaceae are the most frequently isolated multi-resistant bacteria. Multivariate logistic regression analysis identified four risk factors that are significantly related to the risk of acquiring multi-resistant bacteria infection: prior antibiotic therapy [P = 0,029], use of invasive medical care [P = 0,024], the nosocomial origin of the infection [P = 0,036] and the use of public toilets [P = 0,015]. Our results clearly demonstrate that the inappropriate use of antibiotics, especially broad-spectrum antibiotics, and hand-held cross-transmission play a major role in the spread of multi-resistant bacteria in our hospital.