Improving Toilet Usability and Cleanliness in Public Schools in the Philippines Using a Packaged Operation and Maintenance Intervention.

This study evaluated the impact of packaged interventions for operation and maintenance (O&M) on the usability and cleanliness of toilets in public schools in the Philippines. In this cluster-randomized controlled trial, the divisions of Roxas City and Passi City were randomly assigned to the intervention or control group. Schools in Roxas City (n = 14) implemented the packaged O&M interventions; schools in Passi City (n = 16) formed the control group. Outcome variables were toilet usability-defined as accessible, functional and private-and toilet cleanliness, measured using the Sanitation Assessment Tool (SAT) and the Cleaner Toilets, Brighter Future (CTBF) instruments at baseline and at four months follow-up through direct observation of school toilets. SAT results showed that intervention schools had a 32.0% (4.6%; 59.3%) higher percentage of usable toilets than control schools at follow-up after full adjustment (p = 0.024). CTBF results found a similar result, although this was not statistically significant (p = 0.119). The percentage of toilets that were fully clean was 27.1% (3.7%; 50.6%) higher in intervention schools than in control schools after adjustment (p = 0.025). SAT results also showed an improvement in cleanliness of toilets in intervention schools compared to those in controls, but this did not remain significant after adjustment. The findings indicate that the additional implementation of O&M interventions can further stimulate progress towards reaching Water, Sanitation and Hygiene service levels aligned with the Sustainable Development Goals.

Cuadrilatero venoso de Rogie: variantes anatómicas / Rogie's Venous Quadrilateral: Anatomical Variants

El cuadrilátero venoso de Rogie es una región ana- tómica en donde las venas mesentérica inferior, esplénica y mesentérica superior van a tributar en la vena porta hepática. La vena porta hepática es un vaso de gran calibre que recoge la sangre ve- nosa del estómago, yeyuno, íleon, duodeno, colon y parte del sigmoide. En el laboratorio de anatomía macroscópica humana de la Universidad Nacional Autónoma de Honduras en el Valle de Sula (UNAH- VS) encontramos dos variantes anatómicas de las estructuras que componen el cuadrilátero venoso de Rogie en relación a la aorta abdominal y en la manera en que tributa la vena mesentérica inferior. La primera variante que se encontró fue la vena mesentérica inferior drenando directamente al án- gulo de unión entre la vena mesentérica superior y la vena esplénica. La segunda variante se encontró en la misma región del mismo cadáver, en el límite posteroinferior del cuadrilátero de Rogie, en donde la vena renal izquierda discurre posterior a la aorta abdominal. La posición retroaórtica de la vena renal izquierda puede resultar perjudicial para la persona en caso de ser comprimida por la aorta abdominal...(AU)