Modelling Chaos? Sanitation Options; Support and Communication Tool

This study investigates the composition and characteristics of faecal sludge (FS) from different pit technologies (cesspits, pit latrines, septic tanks) and user categories (commercial, industrial, institutional, and residential) in Dar es Salaam, Tanzania, with a view for informed treatment and resource recovery strategies. FS samples exhibited varying concentrations of pH, electrical conductivity (EC), total solids (TS), and volatile solids (VS), COD and nutrients. pH values ranged from 2.83 to 8.41, with no statistically significant differences based on pit technology type or user category. However, the extremely low pH observed in samples from industrial pits suggests possible disposal of industrial chemicals in these sanitation systems. EC levels were notably higher in pit latrines and residential areas, likely due to waste disposal practices in homes, with concentrations 3-5 times above regulatory limits, raising concerns about their impact on treatment effectiveness and re-use potential. TS and VS concentrations also varied, with cesspits showing the highest TS levels and pit latrines exhibiting higher VS, indicating fresher sludge and potential for biogas production, as reflected by a VS/TS ratio ranging from 53.32% to 70.42%. Nutrient analysis revealed elevated levels of phosphate, nitrate and ammonia, particularly in pit latrines and residential pits, highlighting both resource recovery opportunities and challenges for treatment processes. While FS generally fell into the dilute category (TS < 3%), the high concentrations of other parameters underscore the need for a larger treatment footprint per unit volume of FS. The VS/TS ratio suggests that FS is not fully stabilized, indicating potential for further degradation and resource recovery. Additionally, the characteristics of FS suggest potential opportunities for deriving fertilizer and solid fuel. However, ensuring the hygiene of the sludge is crucial for its safe use, particularly in agricultural applications, and further studies are needed to confirm its sanitation.

Clinical Decision Support Tools

Gentle remediation options (GRO) are risk management strategies/technologies that result in a net gain (or at least no gross reduction) in soil function as well as risk management. They encompass a number of technologies, including the use of plant (phyto‐), fungi (myco‐), and/or bacteria‐based methods, with or without chemical soil additives or amendments, for reducing contaminant transfer to local receptors by in situ stabilization, or extraction, transformation, or degradation of contaminants. Despite offering strong benefits in terms of risk management, deployment costs, and sustainability for a range of site problems, the application of GRO as practical on‐site remedial solutions is still in its relative infancy, particularly for metal(loid)‐contaminated sites. A key barrier to wider adoption of GRO relates to general uncertainties and lack of stakeholder confidence in (and indeed knowledge of) the feasibility or reliability of GRO as practical risk management solutions. The GREENLAND project has therefore developed a simple and transparent decision support framework for promoting the appropriate use of gentle remediation options and encouraging participation of stakeholders, supplemented by a set of specific design aids for use when GRO appear to be a viable option. The framework is presented as a three phased model or Decision Support Tool (DST), in the form of a Microsoft Excel‐based workbook, designed to inform decision‐making and options appraisal during the selection of remedial approaches for contaminated sites. The DST acts as a simple decision support and stakeholder engagement tool for the application of GRO, providing a context for GRO application (particularly where soft end‐use of remediated land is envisaged), quick reference tables (including an economic cost calculator), and supporting information and technical guidance drawing on practical examples of effective GRO application at trace metal(loid) contaminated sites across Europe. This article introduces the decision support framework. ©2015 Wiley Periodicals, Inc.

This paper seeks to identify the most environmental friendly way of conducting a refurbishment of Broendby Strand, with focus on PCB remediation. The actual identification is conducted by comparing four remediation techniques using urban metabolism fused with life cycle assessment (UM-LCA) in combination with information relating to cost and efficiency of the compared techniques. The methodological goal of our paper is to test UM-LCA as a decision support tool and discuss application of the method in relation to large refurbishment projects. To assess the environmental performance of PCB-remediation techniques, the UM-LCA method was applied. By combining UM and LCA methodologies, the total environmental impact potentials of the remediation techniques were calculated. To build an inventory for each technique, we contacted and interviewed experts and studied existing literature, cases, and projects in order to compile information on practical details of the techniques. To process the collected inventory data, we used the simplified product system modeling software Quantis Suite 2.0 (QS2.0). In order to validate the results from the simplified software, we carried out the exact same analysis using a more complex tool—OpenLCA 1.5. Based on the assessment results, we compared the remediation techniques and identified the techniques with the smallest and largest environmental impact potentials. The results obtained are presented, and the technique with the smallest impact identified. A comparison between the two software tools applied is made, and differences between the two are discussed in detail. Further discussed is how possible inventory errors affect the results and if any assumptions should be considered as critical for the final results. Furthermore, are the remediation efficiencies of each technique and the cost of each method considered and compared. Finally, UM-LCA’s ability to work as a tool for decision support is discussed and possible ways of implementing the method in sustainable decision-making is considered. In this study, it is found that the most environmental friendly PCB-remediation technique is thermal desorption, whereas the technique with the largest environmental impact potential is sand blasting, due to the environmental impacts induced in relation to disposal of the building waste. It is concluded that the UM-LCA method can be applied as a tool for decision support, and if economic aspects are incorporated, the UM-LCA approach could be an essential approach for designing sustainable buildings.

The development of technology in the emergency sanitation sector has not been emphasised sufficiently considering that the management of human excreta is a basic requirement for every person. The lack of technology tailored to emergency situations complicates efforts to cater for sanitation needs in challenging humanitarian crisis. Sanitation response together with the provision of clean water and hygiene promotion are considered life-saving efforts in emergencies. Nevertheless, in an emergency, there is regularly lack of means and limited planning time available to provide an effective and safe sanitation response. Reviewing the existing practices, the emergency toilet options consist of very basic provisions, primarily trench and pit latrines. Whenever it is not possible to dig a pit or trench, the option left is using container based sanitation. This type of sanitation in particular requires a collection or emptying plan, and a subsequent treatment and safe disposal plan, which is usually overlooked in the realm of an emergency where there is limited time to plan for any requirements after toilet provisions.

This research tested the viability of using faecal sludge (FS) as solid fuel – an end use that could unlock an environmentally and financially beneficial replacement for disposal-oriented FS management, while replacing fossil energy. FS samples were collected from pit latrines, septic tanks, drying beds and stabilization ponds in three cities, Kumasi, Dakar and Kampala. For each sample, the average calorific value, solids and water content, and their variation with source and age were determined. The average calorific value of untreated FS across the three cities was 17.3 MJ/kg total solids (TS), which compares well with other biomass fuels. The age of FS did not affect its calorific value, nor did the reduction in chemical oxygen demand (COD) that occurred while it was in drying beds. The TS content of FS depended on its source but ranged from 1 to 6% for sludge from septic tanks and pit latrines, respectively. Harnessing net energy from FS requires partial drying. The results indicate that sufficient drying occurs within two weeks in open-air drying beds, or in a matter of days with simple drying bed innovations.

EFFECTIVE COMMUNICATION OF MACHINE LEARNING MODELS IN CLINICAL DECISION SUPPORT TOOLS FOR PAH RISK PREDICTION

An overview is given of the present types of sanitation systems used in both rural and urban areas in Southern Africa, with particular reference to Zimbabwe. On-site and off-site dry sanitation methods are described, including different types of pit latrines, with special reference to the Ventilated Improved Pit (VIP) Latrine. Wet systems with on or off-site disposal methods are briefly described, and details are given of two methods of off-site disposal which are widely used in Zimbabwe, viz Waste Stabilisation Ponds (WSP) and the Modified Activated Sludge (MAS) system for biological nutrient removal. The difficulties of implementing low-cost and incremental sanitation systems are mentioned, and suggestions are made of ways to overcome these difficulties.

Three water, sanitation and hygiene (WASH) support tools were applied to Kampala city, Uganda, to evaluate areas with the highest health hazard due to poor wastewater and faecal sludge management and to develop interventions to improve sanitation and reduce exposure. The Pathogen Flow and Mapping Tool (PFMT) assessed how different sanitation management interventions influence pathogen emissions to surface water using rotavirus as the indicator pathogen, while the HyCRISTAL health hazard tool evaluated how flooding and drainage infrastructure influence the presence of human excreta in the environment. The SaniPath tool identified common high-risk pathways of exposure to faecal contamination in food, open drains and floodwater. An overlap in high health hazard hotspot areas was identified by the PFMT and the HyCRISTAL tools. Across the city, the most important hazard sources were the indiscriminate disposal of faecal waste into open stormwater drains from onsite sanitation technologies, open defecation and the insufficient treatment of wastewater. The SaniPath tool identified drain water, floodwater, street food and uncooked produce as the dominant faecal exposure pathways for selected parishes in the city, demonstrating the presence of excreta in the environment. Together, the tools provide collective evidence guiding household, community, and city-wide sanitation, hygiene and infrastructure management interventions from a richer assessment than when a single tool is applied. For areas with high spatial risks, those practising open defecation, and for low-lying areas, these interventions include the provision of watertight pit latrines or septic tanks that are safely managed and regularly emptied. Faecal sludge should be emptied before flood events, direct connections of latrines to open storm drains should be prevented, and the safe handling of food and water promoted. The tools enhance decision making for local authorities, and the assessments can be replicated in other cities.

To characterize the relationship between child faeces disposal and child growth in low- and middle-income countries. We analysed caregiver responses and anthropometric data from Demographic and Health Surveys (2005-2014) for 202614 children under five and 82949 children under two to examine the association between child faeces disposal and child growth. Child faeces disposal in an improved toilet was associated with reduced stunting for children under five [adjusted prevalence ratio (aPR)=0.90, 95% confidence interval (CI) 0.89-0.92] and a 0.12 increase in height-for-age z-score (HAZ; 95% CI: 0.10-0.15) among all households. Among households with improved sanitation access, practicing improved child faeces disposal was still associated with a decrease in stunting (aPR=0.94, 95% CI: 0.91-0.96) and a 0.09 increase in HAZ (95% CI: 0.06-0.13). Improved child faeces disposal was also associated with reductions in underweight and wasting, and an increase in weight-for-age z-score (WAZ), but not an increase in weight-for-height z-score (WHZ). Community coverage level of improved child faeces disposal was also associated with stunting, with 75-100% coverage associated with the greatest reduction in stunting. Child faeces disposal in an unimproved toilet was associated with reductions in underweight and wasting, but not stunting. Improved child faeces disposal practices could achieve greater reductions in child undernutrition than improving toilet access alone. Additionally, the common classification of child faeces disposal as 'safe' regardless of the type of toilet used for disposal may underestimate the benefits of disposal in an improved toilet and overestimate the benefits of disposal in an unimproved toilet.

You can be too popular. residents of the west-central Senegalese city of Touba, situated some 200 km from the capital Dakar, know all that having seen their village swell from 5000 people in the mid-1960s to around 700 000 today. Indeed officially Touba is still a village, under the management of a rural department, but in reality it is a major conurbation with some big city problems. Touba was founded by Cheikh Amadou Bamba, the leader of the Mourides, a large Islamic Sufi order in 1887. city itself is built around an enormous 1960s-era mosque and the majority of the people who come here are Mouride adherents. Their leaders, known Marabouts, are the de facto administrators of the city and they work under the guidance of Cheikh Bara Mbacke, the sixth Caliph. So religion is a big draw here. But Touba offers two other attractions: free land and free The land is free in Touba because the founder and saint, Cheikh Amadou Bamba, owned the land and founded his holy explains Dr Masserigne Ndiaye, Medical Director of the Diourbel region, where Touba is located. water is free for the same reason. [ILLUSTRATION OMITTED] was the free land and water part of the package that got the attention of 24-year-old Ali Nguer who now lives with his family in the Omoul Khoura neighbourhood seven kilometres from central Touba. We came here in 2006 from Kaffrine because of the difficulties with the rain and the drought, he says. Omoul Khoura was opened up for settlement by one of the city's former Caliphs, and at that time it had no electricity, water or sanitation. Chiekh Faye, a member of Touba's Hygiene Brigade, which seeks to encourage hygienic practices in the general population, says such conditions are not unusual in neighbourhoods surrounding Touba. People come and settle without sanitation or water systems, he says. Women walk at least one kilometre to find water. Meanwhile septic tanks are a rarity. are too costly for most Faye says. It costs USS 340 (150 000 FCFA) for a septic tank and US$ 115 (50 000 FCFA) for a toilet. Even in the heart of the city, waste disposal is a huge issue. There is no sewage system, says Ndiaye, explaining the basic problem. people who can afford to dig their own septic tanks mostly put them in the street rather than inside their compounds, They are often situated near water pipes connected to bore holes beneath the city. This is not too much of a problem when the water pipes are sound, but when they get old, or when someone botches an improvised hook-up, contamination can and does occur. The evacuation of septic tanks is also a problem, Ndiaye says, as there is no system set up to handle it. These already fragile sanitation systems are overwhelmed during festivals, especially during the Magal, an annual pilgrimage during which the population swells to two million and which starts on 2 February this year. Consider that this festival (Magal) involves a lot of eating, says Ndiaye. resulting breakdown in sanitation leads to inevitable outbreaks of disease, including typhoid and, of course, cholera. In a city that has only one hospital, two health centres, and, according to Ndiaye about 20 health posts (roughly one post per 30 000 to 40 000 people, well below the World Health Organization's recommendation of one health post for every 5000 to 10 000 people) this is a major headache. last outbreak happened during the Magal in March 2007, when the Senegalese Ministry of Health reported a total of 2054 cases and eight deaths in the Diourbel region, including 48 cases and no deaths in Touba. …

Introduction: A higher level of specialization in various disciplines and technologies typical for the participants of modern investment and construction (development) projects creates the need for the advanced project management models. Decision support systems and tools for communication and organization of joint activities are the mandatory components for the efficient project management. Purpose-designed information systems allow to computerize such project management function as scheduling. However, the optimum decision is still found on the basis of personal assessment by decision makers. At the same time, as competition in the construction industry increases, the need for decision support systems to optimize investment and construction activities in the environment of multi-objective optimization becomes evident. Methods: The findings of DSS development projects in the construction industry have been used. The studies have been based on system integration approach to engineering, method of successive concession and the procedure for a search of the satisfactory values meeting STEM criteria under given weights. Results: Principles of development and functioning, architecture and organization and process aspects of DSS for scheduling under multi-objective optimization. Discussion: Integrated DSS capable for multi-objective optimization of the schedules has been proposed.

BackgroundDuring the COVID-19 pandemic, medical laypersons with symptoms indicative of a COVID-19 infection commonly sought guidance on whether and where to find medical care. Numerous web-based decision support tools (DSTs) have been developed, both by public and commercial stakeholders, to assist their decision making. Though most of the DSTs’ underlying algorithms are similar and simple decision trees, their mode of presentation differs: some DSTs present a static flowchart, while others are designed as a conversational agent, guiding the user through the decision tree’s nodes step-by-step in an interactive manner.ObjectiveThis study aims to investigate whether interactive DSTs provide greater decision support than noninteractive (ie, static) flowcharts.MethodsWe developed mock interfaces for 2 DSTs (1 static, 1 interactive), mimicking patient-facing, freely available DSTs for COVID-19-related self-assessment. Their underlying algorithm was identical and based on the Centers for Disease Control and Prevention’s guidelines. We recruited adult US residents online in November 2020. Participants appraised the appropriate social and care-seeking behavior for 7 fictitious descriptions of patients (case vignettes). Participants in the experimental groups received either the static or the interactive mock DST as support, while the control group appraised the case vignettes unsupported. We determined participants’ accuracy, decision certainty (after deciding), and mental effort to measure the quality of decision support. Participants’ ratings of the DSTs’ usefulness, ease of use, trust, and future intention to use the tools served as measures to analyze differences in participants’ perception of the tools. We used ANOVAs and t tests to assess statistical significance.ResultsOur survey yielded 196 responses. The mean number of correct assessments was higher in the intervention groups (interactive DST group: mean 11.71, SD 2.37; static DST group: mean 11.45, SD 2.48) than in the control group (mean 10.17, SD 2.00). Decisional certainty was significantly higher in the experimental groups (interactive DST group: mean 80.7%, SD 14.1%; static DST group: mean 80.5%, SD 15.8%) compared to the control group (mean 65.8%, SD 20.8%). The differences in these measures proved statistically significant in t tests comparing each intervention group with the control group (P<.001 for all 4 t tests). ANOVA detected no significant differences regarding mental effort between the 3 study groups. Differences between the 2 intervention groups were of small effect sizes and nonsignificant for all 3 measures of the quality of decision support and most measures of participants’ perception of the DSTs.ConclusionsWhen the decision space is limited, as is the case in common COVID-19 self-assessment DSTs, static flowcharts might prove as beneficial in enhancing decision quality as interactive tools. Given that static flowcharts reveal the underlying decision algorithm more transparently and require less effort to develop, they might prove more efficient in providing guidance to the public. Further research should validate our findings on different use cases, elaborate on the trade-off between transparency and convenience in DSTs, and investigate whether subgroups of users benefit more with 1 type of user interface than the other.Trial RegistrationDeutsches Register Klinischer Studien DRKS00028136; https://tinyurl.com/4bcfausx (retrospectively registered)

Tracking enteric pathogen contamination from on-site sanitation facilities to groundwater in selected rural areas of Vhembe District Municipality, Limpopo Province, South Africa

The effectiveness of an electronic clinical-decision support tool embedded into the patient medical record at the point of care to guide Mohs surgery utilization: A cohort study