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At least 253 records · Page 14Linked to original sources
PubMed1989

An outbreak of puerperal fever caused by group C streptococci.

Between 19 February and 18 April 1987, 33 confirmed cases of puerperal fever caused by Streptococcus equisimilis serotype T204 occurred at three hospitals in and around Chelmsford. Most of the cases (70%) occurred on one ward, in which toilet seats and a shower are believed to have aided transmission, although insufficient data were obtained to exclude a role for person-to-person spread. Possession of M-protein antigen was demonstrated in the outbreak strain.

Adult↗
PubMed1990

An in-use evaluation of decontamination of polypropylene versus steel bedpans.

A prospective cross-over study in three different wards has demonstrated the lack of effect of two disinfectants compared with a detergent when added to the washing cycle of automatic bedpan washers that employ hot water centrally supplied at 60 degrees C. An unexpected and potentially important finding was that polypropylene pans were much more effectively cleaned and decontaminated than their stainless steel counterparts. The role, if any, of bedpans in the epidemiology of nosocomial infections remains a mystery. The continued absence of information clearly incriminating these ubiquitous devices in the transmission of potential pathogens, or of genes encoding antibacterial drug resistance, raises questions as to whether extensive efforts to achieve a high degree of decontamination of bedpans are necessary at all.

Cross Infection↗
PubMed1995

Potties, pits and pipes: explaining hygiene behaviour in Burkina Faso.

Stool disposal practices have been shown to be associated with childhood diarrhoea. However, efforts to promote improved hygiene behaviour are hampered by a lack of understanding of what determines those behaviours. Data from 2793 household interviews with mothers of children from the town of Bobo-Dioulasso in Burkina Faso were analyzed to examine what differentiated mothers who reported using safer stool disposal practices from those who did not. Three 'outcomes' were considered: where the child was reported to defaecate; where the mother reported disposing of the child stools; and whether excreta were observed in the compound. Regression models were developed to identify those factors with the strongest independent associations with the outcomes. There was a consistent association between the source of water and the outcomes. Mothers with access to a tap in the yard reported using safe hygiene practices three times more often than mothers using wells outside the compound and twice as often as mothers who used public standpipes or wells within the yard. The source of water showed a similar pattern of association with observations of faecal matter in the environment. Improved sources of water may contribute to safer stool hygiene by reducing the time spent on water collection or by encouraging mothers to conform to higher standards of hygiene. Other factors which played a role in predicting the hygiene behaviour of mothers were the husbands' occupation, the number of health education sessions that she had attended, her zone of residence and family ownership of certain valuable objects. These factors are likely to be related and to be, to some extent, proxies for the real determinants of her behaviour. A model of the cultural, psycho-social and infrastructural proximate determinants of hygiene behaviour is proposed. Data from focus group discussions suggested that the main purpose of hygienic behaviour is to conform to existing norms of social etiquette. Trials of interventions based on changing such norms are needed to test whether this is an effective means of promoting of safer hygiene practices.

Burkina Faso↗
PubMed1996

Reactivity and repeatability of hygiene behaviour: structured observations from Burkina Faso.

If interventions promoting improved hygiene behaviour to prevent childhood diarrhoea are to be implemented and evaluated, valid methods for measuring this behaviour will be required. This paper presents findings from a study to investigate the use of structured observations to measure hygiene behaviour in Burkina Faso. Two hundred mothers with young children (2-36 months) were observed on several occasions, with particular attention focused on events/behaviour surrounding defaecation. Child defaecation occurred most often in a potty (67% of occasions). Stools were most often disposed of into a latrine (79%). Following defaecation the child's bottom was usually rinsed using water alone with a bare hand (76%). Subsequent hand washing by the mother/caretaker was much rarer (29%). None of these behaviours appeared "reactive" to the presence of the observer. Less common behaviors showed some evidence of reactivity. The frequency of child defaecation in the yard increased over the course of three observations (5% to 16%; P = 0.01) and the proportion of occasions on which the child was observed to be cleaned after defaecation declined (95% to 85%; P = 0.01). Mothers usually took with them to the latrine a water recipient (91%). Hand washing after leaving the latrine was observed on 30% of occasions. This proportion declined from 36% to 22% over three observations (P = 0.05). Defaecation by older siblings (aged 3-5 years) was usually into a potty (48%) or directly in a latrine (30%). There was no evidence that this behaviour was reactive. The repeatability of behaviours at the individual level was generally low. The site of index child defaecation (kappa = 0.27), how the child's bottom was cleaned (kappa = -0.01) and whether the caretaker washed her hands afterwards (kappa = 0.26) all showed low repeatability. The method of stool disposal was more repeatable (kappa = 0.73). Hand washing by mothers after using the latrine showed moderate repeatability (kappa = 0.40). Older sibling's defaecation behavior had excellent repeatability (kappa = 0.90). Our findings suggest that, in studies which aim to measure behaviour at the population level, structured observations may provide a useful tool. Studies which investigate links between hygiene behaviour and diarrhoea incidence at the individual level will require repeated observations of mothers and children since measuring behaviour during a single observation will lead to misclassification of exposure status, resulting in bias which could mask any underlying association. This is likely to be very costly.

Adult↗
PubMed1988

Etiology and pathogenesis of diverticulosis coli: a new approach.

The paper describes a hypothesis as to the etiology and pathogenesis of diverticulosis coli. Colonic diverticulosis develops as a result of excessive straining at defecation due to habitual bowel emptying in a sitting posture, which is typical of Western man. The magnitude of straining during habitual bowel emptying in a sitting posture is at least three-fold more than in a squatting posture and upon urge. The latter defecation posture is typical of latrine pit users in underdeveloped nations. The bowels of Western man are subjected to lifelong excessive pressures which result in protrusions of mucosa through the bowel wall at points of least resistance. This hypothesis is consistent with recent findings of elastosis of the bowel wall muscles, the distribution of diverticula along the colon, as well as with epidemiological data on the emergence of diverticulosis coli as a medical problem and its geographic prevalence.

Defecation↗
PubMed1989

Primary constipation: an underlying mechanism.

Primary (simple) constipation is a consequence of habitual bowel elimination on common toilet seats. A considerable proportion of the population with normal bowel movement frequency has difficulty emptying their bowels, the principal cause of which is the obstructive nature of the recto-anal angle and its association with the sitting posture normally used in defecation. The only natural defecation posture for a human being is squatting. The alignment of the recto-anal angle associated with squatting permits smooth bowel elimination. This prevents excessive straining with the potential for resultant damage to the recto-anal region and, possibly, to the colon and other organs. There is no evidence that habitual bowel elimination at a given time each day contributes considerably to the final act of rectal emptying. The natural behavior to empty the bowels in response to a strong defecation reflex alleviates bowel emptying by means of the recto anal inhibitory reflex.

Constipation↗
PubMed1996

The development of the Port-a-Bidet: a portable bidet for people with minimal hand function.

Our Institute has investigated the expressed needs of many severely disabled people. One requirement was for a portable bidet that would fit on a standard toilet, so that they could still have some of the advantages of their automatic washing/drying/flushing toilet when away from their own house. Potential users were consulted, from the specification stage through to final production model testing, to ensure that the desired device was produced. The Port-a-Bidet is a lightweight device, with its own water container, spray unit, pump and power supply. It allows a user with very weak arms to wash themselves with warm water, and a hands-free drying method is explained in the instruction booklet. The whole unit is transported in a discreet carrying bag, and can easily be set up by an unskilled person. The Port-a-Bidet can be controlled by commercially available single switch activators, so that any user can operate it.

Biomedical Engineering↗
PubMed2006

Hand supports to assist toilet use among the elderly.

Improving the toilet environment holds promises for increasing the quality of life for elderly and disabled persons. This is one of the goals of the Friendly Rest Room (FRR) project. The study described in this article explored the preference and use of supports in the toilet environment during the entire toilet ritual. An adjustable test frame was built with a toilet and three types of supports. Fourteen subjects were asked which positions they favoured for each support. After using all three supports, they were asked which support they found most comfortable. In general, the preferred positions depended on personal preferences more than on dimensions of the body. It was concluded that there is a preference for vertical supports for sitting down and standing up. During toilet use the side supports were equally appreciated.

Aged↗
PubMed2005

Biological activity in the composting reactor of the bio-toilet system.

The bio-toilet is becoming commercially available and it is actually used in Japan in public parks, sightseeing areas, and households; however, the biological activity in the system during degradation of toilet wastes, particularly faeces, is unknown. Thus, in this study activity of microorganisms in the bio-toilet system during degradation of faeces was assessed through the quantification of reductions in total solids (TS), volatile solids (VS), and chemical oxygen demand (COD) during batch tests in laboratory-scale composting reactors. Additionally, the fate of nitrogen and its transformation processes in such reactors were evaluated. TS, VS, and COD reductions were on the order of 56%, 70%, and 75%, respectively, irrespective of the organic loading regarded. Total nitrogen (T-N) reductions quantified 94%, regardless of the organic loading. Furthermore, all T-N reductions observed during composting were equivalent to the NH(3)-N released from the reactor, i.e., 94% of ammonia was lost.

Aerobiosis↗
PubMed2006

Effect of temperature on anaerobic treatment of black water in UASB-septic tank systems.

The effect of northern European seasonal temperature changes and low temperature on the performance of upflow anaerobic sludge blanket (UASB)-septic tanks treating black water was studied. Three UASB-septic tanks were monitored with different operational parameters and at different temperatures. The results indicated the feasibility of the UASB-septic tank for (pre)treatment of black water at low temperatures with respect to removal of suspended solids and dissolved organic material. Inoculum sludge had little effect on COD(ss) removal, though in the start-up phase some poorly adapted inoculum disintegrated and washed out, thus requiring consideration when designing the process. Removal of COD(dis) was at first negative, but improved as the sludge adapted to low temperature. The UASB-septic tank alone did not comply with Finnish or Dutch treatment requirements and should therefore be considered mainly as a pre-treatment method. However, measuring the requirements as mgCOD l(-1) may not always be the best method, as the volume of the effluent discharged is also an important factor in the final amount of COD entering the receiving water bodies.

Anaerobiosis↗
PubMed2006

Demonstration of anaerobic stabilization of black water in accumulation systems under tropical conditions.

The anaerobic digestion of "human waste" was studied at Mlalakuwa residential settlement in Dar-es-Salaam, Tanzania at ambient tropical temperatures (24-31 degrees C). This settlement experiences a high water table with flooding during the rainy season, resulting in a very costly emptying of the latrines once per month. To improve the situation, two plastic tanks (while one is in use, the other one is on stand-by) of 3000 l capacity each, named as Improved Pit-Latrines Without Urine Separation (IMPLWUS), were used as latrine pits. They received faeces+urine+wash water; basically, an accumulation system. Septic tank seed sludge was used. The dissolved chemical oxygen demand (COD(dis)) remaining when the reactor was closed after 380 days was about 8 g COD/l, volatile fatty acids were 100 mg COD/l and total ammonium nitrogen was about 2.8 g N/l, implying the possibility of methanogenesis inhibition. Stability results indicated a need for more degradation time after reactor closure. Estimated biogas production from wastewater generated by 10 people was 544 g COD-CH(4)/day, not enough for cooking purposes.

Ammonia↗
PubMed2005

Do women with urinary incontinence really know where all the toilets are? The toilet paper.

AIMS OF STUDY: Aim of this study was to determine if women with overactive bladder really do have a more detailed knowledge about toilets and their conditions in their vicinity in comparison to women with urinary stress incontinence and those without any urinary symptoms. PATIENTS AND METHODS: A questionnaire survey of 270 women from three symptom groups, those with stress incontinence, overactive bladder and controls without any bladder symptoms from an inner city area and two local towns. The knowledge of the three groups was compared and measured by a score assessed by the authors who had visited the toilets themselves. RESULTS: Women with overactive bladder are more likely to exhibit precautionary voiding prior to leaving home and have significantly more detailed knowledge about toilets in their neighbourhood. DISCUSSION: The overactive bladder seems to have a greater influence on behaviour and on quality of life than stress incontinence which could mean that they are more tortured by their symptoms.

Adult↗
PubMed2003

Impacts of nutrient additions and digging for human waste disposal in natural environments, Tasmania, Australia.

Very little research has been undertaken on the impacts of human toilet waste disposal in non-serviced sites in the wild. The objective of the present project was to determine the relative impacts of the mechanical disturbance of digging during the burial of toilet waste (faeces and toilet paper), and urination, on Tasmanian vegetation types that occur in areas used for wild country camping, in order to develop appropriate guidelines. The mechanical disturbance of digging cat-holes 15 cm deep, typical of those used for toilet disposal in the Tasmanian wild, had largely negative effects on the growth of a few native plant species. These effects were of little or no conservation significance. The nutrient additions simulated by the addition of artificial urine to undug ground and dug ground had largely positive effects on nine distinct types of native vegetation, encouraging the growth of many plant species at many sites, while discouraging the growth of moss at one site. No weed species found at any of the sites were significantly affected by the treatments. Thus, it appears that scattered disposal of urine, even combined with digging, is unlikely to present a major conservation problem in the Tasmania's wild country, and that present guidelines are appropriate, where achievable.

Conservation of Natural Resources↗
PubMed2005

Achieving the 'good life': why some people want latrines in rural Benin.

Nearly half the world's population lacks basic sanitation to protect their environment from human fecal contamination. Building a latrine is the first step on the sanitation ladder in developing countries where a majority of the population defecates in open or public areas. Public health programs to improve sanitation have consistently framed promotional messages in terms of fecal-oral disease prevention and largely fail to motivate changes in sanitation behavior. A qualitative consumer study using in-depth interviews with 40 household heads was carried out to explore the decision to install a pit latrine in rural Benin. The motives for installing a latrine are reported and variations across the interviews are examined. The paper asserts that at least one active drive (desire for change or dissatisfaction) from among 11 found is needed to motivate latrine adoption. Drives involved prestige, well-being, and situational goals. Health considerations played only a minor role, and had little if anything to do with preventing fecal-oral disease transmission. Drives varied with gender, occupation, life stage, travel experience, education, and wealth, and reflected perceptions of the physical and social geography of the village, linked to availability of open defecation sites, social structure, road access, and urban proximity. The results have broad implications for new messages and strategies to promote sanitation in developing countries.

Adult↗
PubMed2005

Diarrhoea and garbage disposal in Salvador, Brazil.

The association of infantile diarrhoea with the presence of garbage in the environment was investigated in Canabrava, a peripheral neighbourhood of Salvador, northeast of Brazil. A cross-sectional study was conducted with all the 184 children aged less than two years residing in Canabrava, which is located close to the city garbage dump. Variables selected for study included the method used for the disposal of excrement, type of floor, mother's education, unemployment of the head of the family, regularity of the water supply, presence of toilet, storage of garbage inside the house, age, gender, duration of breastfeeding, and the number of people per room. The estimated prevalence of diarrhoea was 21.2%. Exposure to garbage in the environment was found to be the most important factor associated with diarrhoea (adjusted odds ratio [AOR] = 3.98, 95% CI 1.56-10.13). Other important variables were the mother's education (AOR = 2.79, 95% CI 1.09-7.13), maternal breastfeeding (AOR = 2.30, 95% CI 1.05-5.04), and unemployment of the head of the family (AOR = 2.09, 95% CI 0.93-4.69). These findings indicate the necessity of adopting solutions in the public domain and of intersectorial policies for the reduction of diarrhoea.

Brazil↗