Objective FMRI activation of the mesial temporal lobe (MTL) may be important for epilepsy surgical planning. We examined MTL activation and lateralization during language fMRI in children and adults with focal epilepsy. Methods 142 controls and patients with left hemisphere focal epilepsy (Pediatric: epilepsy, n = 17, mean age = 9.9 ± 2.0; controls, n = 48; mean age = 9.1 ± 2.6; Adult: epilepsy, n = 20, mean age = 26.7 ± 5.8; controls, n = 57, mean age = 26.2 ± 7.5) underwent 3T fMRI using a language task (auditory description decision task). Image processing and analyses were conducted in SPM8; ROIs included MTL, Broca’s area, and Wernicke’s area. We assessed group and individual MTL activation, and examined degree of lateralization. Results Patients and controls (pediatric and adult) demonstrated group and individual MTL activation during language fMRI. MTL activation was left lateralized for adults but less so in children (p’s < 0.005). Patients did not differ from controls in either age group. Stronger left-lateralized MTL activation was related to older age (p = 0.02). Language lateralization (Broca’s and Wernicke’s) predicted 19% of the variance in MTL lateralization for adults (p = 0.001), but not children. Significance Language fMRI may be used to elicit group and individual MTL activation. The developmental difference in MTL lateralization and its association with language lateralization suggests a developmental shift in lateralization of MTL function, with increased left lateralization across the age span. This shift may help explain why children have better memory outcomes following resection compared to adults.

The focus of Swachh Bharat Mission (Clean India Mission) was to build toilets to make India open defecation free. While India has succeeded in achieving this goal, to move toward "safely managed sanitation" as per target 6.2 of the Sustainable Development Goals, it is necessary to ensure that all fecal waste is safely collected and treated. The common practice for desludging of septic tanks is "demand-based desludging" rather than a regular service. Such practices have adverse social and environmental impacts. To overcome these shortcomings, scheduled desludging is advocated. This paper first reviews the need for regular desludging of septic tanks. It then outlines the emerging experience of design and implementation of scheduled desludging for inclusive, equitable, and sustainable sanitation to achieve social and environmental benefits in two Indian cities. In these cities, a performance-linked annuity payment framework is used to engage a private desludging enterprise. Payment is met through a sanitation tax and transfer from the general property taxes. It outlines the benefits of scheduled desludging in Indian cities and argues that it is critical to achieve improved sanitation.

No abstract

In 2014, the Indian Government embarked on a major programme to end open defecation. The government allocated significant public funds to ensure that the goal is reached by the year 2019. The Swachh Bharat Mission (SBM) programme for rural sanitation is ambitious and probably no government has ever attempted to tackle sanitation at this scale and with such a large financial commitment. The main objectives of this paper are to assess sufficiency of financial commitments for SBM and to review efficiency and effectiveness in fund utilization against its stated objectives. In a large country like India, the programme achievements are not even. Some states are on track while others will need more attention and more funds to ensure that the goal is reached by 2019. An important challenge is to ensure sustainability of open defecation free (ODF) villages and communities. Supplementing public finance with innovative financing is needed to ensure that lack of finance does not become a constraint in achieving the ODF status and to ensure sustainability.

Monitoring sanitation has generally focused on basic access with its implicit links to health impacts. The new thinking on urban sanitation monitoring goes beyond the household level facilities to encompass wider dimensions of equity, public health and natural environment. This requires an assessment of the full value chain from the user interface to storage, conveyance, treatment and disposal or reuse. In developing country context, this also necessitates incorporating other sanitation dimensions beyond excreta management, especially management of greywater, storm water and solid waste as these are often interlinked on the ground. In this context, it is important to revisit the concept of the sanitation ladder, widely used by the Joint Monitoring Programme (JMP), which has focused on household access. This paper suggests a framework for outcome-based citywide assessment of the full sanitation value chain across different sanitation sub-sectors. The ladder is redefined using a city sanitation score to assess city level performance. The suggested outcome-based assessment for different components of the value chain also provides a basis for city level monitoring of overall sanitation performance.