Application of a revised Water Poverty Index to target the water poor.

The Water Poverty Index (WPI) has been recognized as a useful tool in policy analysis. The index integrates various physical, social and environmental aspects to enable more holistic assessment of water resources. However, soundness of this tool relies on two complementary aspects: (i) inadequate techniques employed in index construction would produce unreliable results, and (ii) poor dissemination of final outcome would reduce applicability of the index to influence policy-making. From a methodological point of view, a revised alternative to calculate the index was developed in a previous study. This paper is therefore concerned not with the method employed in index construction, but with how the composite can be applied to support decision-making processes. In particular, the paper examines different approaches to exploit the index as a policy tool. A number of alternatives to disseminate achieved results are presented. The implications of applying the composite at different spatial scales are highlighted. Turkana District, in Kenya has been selected as initial case study to test the applicability and validity of the index. The paper concludes that the WPI approach provides a relevant tool for guiding appropriate action and policy-making towards more equitable allocation of water resources.

Leaving no one behind: Evaluating access to water, sanitation and hygiene for vulnerable and marginalized groups.

Achieving equitable access to water, sanitation and hygiene (WASH) services requires paying special attention to the most disadvantaged segments of the population. Yet, despite all the progress made to evaluate the access of vulnerable and marginalized groups, important knowledge gaps still remain with respect to identifying their specific barriers and needs. At the global level, for example, the two monitoring mechanisms for SDG 6 - the Joint Monitoring Programme (JMP) and Global Analysis and Assessment of Sanitation and drinking-water (GLAAS) - face difficulties in understanding how, and to what extent, vulnerable and marginalized groups access WASH services. In this context, this work examines the UNECE/WHO-Europe 'Equitable Access Score-card' for assessing the access to WASH services by vulnerable and marginalized groups. In particular, we: (i) analyse its strengths and limitations as a tool for revealing the needs of these groups in accessing WASH services; and (ii) propose an extended variant of the score-card that addresses these limitations. We test this version in two local-level case studies: Lima (Peru) and Castelló de la Plana (Spain). The score-card diagnosis is found to be particularly useful for collecting information on the level of access of the different vulnerable and marginalized groups, as well as the specific public policies and funding mechanisms in place that address and support their needs. However, the score-card should be complemented with specific assessments of all five normative dimensions of the human rights to water and sanitation (access, availability, quality, acceptability and affordability) in order to have a better understanding of the concerns for service delivery for the different vulnerable and marginalized groups.

Compositional data for global monitoring: The case of drinking water and sanitation.

INTRODUCTION: At a global level, access to safe drinking water and sanitation has been monitored by the Joint Monitoring Programme (JMP) of WHO and UNICEF. The methods employed are based on analysis of data from household surveys and linear regression modelling of these results over time. However, there is evidence of non-linearity in the JMP data. In addition, the compositional nature of these data is not taken into consideration. This article seeks to address these two previous shortcomings in order to produce more accurate estimates. METHODS: We employed an isometric log-ratio transformation designed for compositional data. We applied linear and non-linear time regressions to both the original and the transformed data. Specifically, different modelling alternatives for non-linear trajectories were analysed, all of which are based on a generalized additive model (GAM). RESULTS AND DISCUSSION: Non-linear methods, such as GAM, may be used for modelling non-linear trajectories in the JMP data. This projection method is particularly suited for data-rich countries. Moreover, the ilr transformation of compositional data is conceptually sound and fairly simple to implement. It helps improve the performance of both linear and non-linear regression models, specifically in the occurrence of extreme data points, i.e. when coverage rates are near either 0% or 100%.

The importance of clinical factors in parenteral nutrition-associated hypertriglyceridemia.

AIMS: The purpose of this study was to establish the relevance of several clinical factors associated with parenteral nutrition (PN) hypertriglyceridemia and to construct a predictive model for this complication. METHOD: This multicenter study included all patients with initial serum triglyceridemia <3 mmol and receiving a minimum of 7 days' PN therapy. The study ended for each patient when hypertriglyceridemia developed or PN was terminated. Two multivariate models were constructed, one to study the clinical factors and the second to predict plasma triglyceridemia. A total of 22 clinical factors studied as independent variables were included in the multiple-step regression models only when they showed a P-value over 0.1. Statistical significance was determined by the confidence interval of the odds ratio (OR) and the partial regression coefficient (b). RESULTS: The study included 260 patients from 14 hospitals. Lipid administration was 0.83+/-0.37 g/kg/day. Among the total, 68 patients (26.2%) showed hypertriglyceridemia. Variables included in both models were serum glucose (OR, 2.63; b, 0.06), renal failure (OR, 10.56; b, 1.70), corticoid administration >0.5 mg/kg (OR, 7.98; b, 0.97), pancreatitis (OR, 4.38; b, 0.64), sepsis (OR, 4.48; b, 0.24), lipids infused (OR, 3.03; b, 0.24) and heparin administration >3 mg/kg/day (OR, 0.11; b, -1.21). CONCLUSION: Although the rate of lipid infusion was low, certain clinical factors modified triglyceridemia. Nevertheless, relatively fast plasma clearance of lipids infused indicates that a reduction in lipid supply could be a quick, effective measure for controlling hypertriglyceridemia. Thus, careful monitoring of patients with clinical factors predicting risk in the model studied, with adjustment of lipid perfusion rates accordingly, is suggested to avoid hypertriglyceridemia.

Determination of hydrocarbon types in petroleum and coal-derived products by thin-layer chromatography/densitometry.

Different methodologies based on thin-layer chromatography (TLC)/densitometry were used to separate and quantitate hydrocarbon types in middle distillates (gas oil), heavy distillates (lubricant) from petroleum, and coal-derived products. Thus, petroleum products were separated into saturates and aromatics by development, using n-hexane (9 min) followed by dichloromethane (4.5 min), of silica gel plates impregnated with berberine sulfate. Detection of saturates and aromatics was performed by fluorescence scanning using 365 nm as the excitation wavelength. Alternative detection of aromatics can be performed on either silica gel or berberine-impregnated plates by using ultraviolet (UV) densitometry at 250 nm. On the other hand, polar coal-derived products were separated into aromatics, polar compounds, and uneluted components by using silica gel plates and development with toluene (12 min), followed by dichloromethane-methanol (95 + 5, v/v), with detection by UV densitometry at 250 nm. In all cases, external standard calibration was used for quantitation. Results were validated by using standard methods or well-established techniques of the petrochemical industry. The potential usefulness of TLC/densitometry is discussed.

Comparison of four nutritional screening tools to detect nutritional risk in hospitalized patients: a multicentre study.

BACKGROUND/OBJECTIVES: The prevalence of malnutrition in hospitals is high. No nutritional screening tool is considered the gold standard for identifying nutritional risk. The aims of this study were to evaluate nutritional risk in hospitalized patients using four nutritional screening tools. SUBJECTS/METHODS: Four nutritional screening tools were evaluated: nutritional risk screening (NRS-2002), the malnutrition universal screening tool (MUST), the subjective global assessment (SGA) and the mini nutritional assessment (MNA). Patients were assessed within the first 36 h after hospital admission. Date of admission, diagnosis, complications and date of discharge were collected. To compare the tools, the results were reorganized into: patients at risk and patients with a good nutritional status. The statistical analysis included the χ(2)-test to assess differences between the tests and the κ statistic to assess agreement between the tests. RESULTS: The study sample comprised 400 patients (159 women, 241 men), mean age 67.3 (16.1) years. The prevalence of patients at nutritional risk with the NRS-2002, MUST, SGA and MNA was 34.5, 31.5, 35.3 and 58.5%, respectively. Statistically significant differences were observed between the four nutritional screening tools (P<0.001). The agreement between the tools was quite good except for the MNA (MNA-SGA κ=0.491, NRS-2002-SGA κ=0.620 and MUST-SGA κ=0.635). Patients at nutritional risk developed more complications during admission and had an increased length of stay. CONCLUSIONS: The prevalence of nutritional risk in hospitalized patients was high with all the tools used. The best agreement between the tools was for NRS-2002 with SGA and MUST with SGA. At admission, NRS-2002 and MUST should be used to screen for nutritional status.

Berberine cation: A fluorescent chemosensor for alkanes and other low-polarity compounds. An explanation of this phenomenon

Alkanes in the presence of berberine sulfate provide an enhancement of fluorescent signal, which depends on alkane concentration and structure, when the system is irradiated with monochromatic UV light. Computational analysis suggests that an ion-induced dipole between alkanes and berberine sulfate is responsible for this phenomenon. This interaction can properly model the experimentally obtained fluorescent response. The proposed explanation allows other interacting systems to be designed, which have been experimentally confirmed.