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This study was part of the VUNA project aimed to develop an affordable sanitation system that produces a valuable fertiliser, reduces pollution of water resources and promotes health. Urine diversion dry toilets (UDDTs) simplify the on-site hygienisation of faeces and allow for nutrient recovery from urine. Social acceptance is vital for the implementation of the UDDT, because sanitation is only effective if the system not only provides a well-designed toilet and effective waste management, but also offers users a facility that caters to their needs and is sensitive to their cultural lifestyle. This study used qualitative and quantitative methods to investigate acceptance, use and maintenance of UDDTs. Key findings indicate lower levels of acceptance of UDDTs among the elderly, who are accustomed to traditional pit toilets. The users aspire to own a flush toilet, perceived to be indicative of household wealth. A dominant concern was emptying the pit and the quality of the building material. Community interventions are required that will promote acceptance, understanding and encourage proper use and maintenance of the UDDT, and may need some technology modification. There is an urgent need for increased community participation to address users’ perceptions, attitudes and behaviour concerning the UDDT.

ROC Analysis - Dichotomised BIE (majority read) vs categorical neuropathology. Comparison of the 4 histopathological criteria of assigning abnormal amyloid against a dichotomised (Abnormal/Normal) majority blinded PET Image evaluation. The 4 criteria shown are CERAD [43], National Institutes of Ageing – Reagan Institute AD diagnosis [26], National Institutes of Ageing – Alzheimer’s Association AD diagnosis [25] and Amyloid phase (Phase 3 or greater) [58]. (DOC 201 kb)

Example of the recording of pathology sampling to enable mapped cortical tracer retention SUVRs to be measured for correlation. Regions sampled from the lateral surface include the Midfrontal lobe (MFL), Superior Temporal Gyrus (STG), Middle Temporal Gyrus (MTG) and Inferior Parietal Lobe. Regions sampled from the medial surface include Anterior Cingulate Gyrus (ACG), Posterior Cingulate Gyrus (PCG), Precuneus (PRC) and Primary Visual Cortex (PVC). (DOC 90 kb)

Receiver operator characteristic (ROC) analysis of regional histometric measures and standard retention value ratios. Regional analysis of 32 brains provided retention correlation with plaque burden and provided a large data set (N = 256) with which to estimate the lower limit of detection. For regional analysis SUVR baselines which varied between regions due to variable adjacent white-matter signal bleed were used to define a threshold for each region. Thresholds were determined post-hoc by ROC analysis as the maximal sum of the sensitivity (true positive rate) and specificity (1 - false-positive rate). (DOC 59 kb)

ROC Analysis: Dichotomised pathology vs continuous SUVR. Comparison of 5 histopathological criteria of assigning abnormal amyloid against PET signal quantification (SUVR). Histopathological criteria used were: CERAD [43] moderate or frequent = abnormal; National Institutes of Ageing – Reagan Institute [26] Intermediate or High = abnormal; National Institutes of Ageing – Alzheimer’s Association [25] Intermediate or High = abnormal; Thal 3+ Thal amyloid phase [58] of 3 or higher = abnormal; Thal 4+ Thal amyloid phase [58] of 4 or 5 = abnormal. (DOC 241 kb)

Clinical Status of subjects at PET Scan. Spontaneously recorded clinical notes captured at the time of PET scan. The PET category provided reflects PET majority image assessment against pathology dichotomy normal/abnormal by mCERADSOT. (DOC 155 kb)

Amyloid plaque frequencies. In addition to the neuritic plaque frequencies assessed on Bielschowsky silver stained sections, semiquantitative plaque frequencies of none, sparse, moderate or frequent [43] were obtained from β-amyloid stained sections. In addition to the frequencies recorded in the CERAD neocortical regions, the Amyloid phase was recorded after examining multiple cortical, subcortical, midbrain and hindbrain regions [58]. (DOC 112 kb)