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The purpose of this article is twofold, one is to provide a brief review on various lavatory cleaning devices while the other is to study the feasibility of using these devices in public toilets in developing countries. The article presents a literature review on various lavatory cleaning devices, focusing on various designs available as patent documents and commercially available toilet cleaning robots. The issues that prevent these devices from being deployed in multi-lavatory public toilet complexes in developing countries are discussed. Design considerations of a simple, cost-effective, semi-automated lavatory cleaning robot that may serve as a solution to these issues are also covered in this article.

Rural areas of India represent most of the population of this country. As per the census report of India 2011, about 70% Indians live in rural areas. Jharkhand is a newly formed state (2000) in eastern India that belongs to EAG. It has 24 districts among which an ethnographic study has been done in three districts, namely Saraikela-Kharsawan, Dhanbad and Godda. More precisely, the study has been conducted to understand the sanitary system in these areas. The research data has been gathered through observation and interviews with village people. It has been noticed that people of these villages are using open areas such as field, riverbank, forest and mountain areas for sanitary purpose. Though there are different schemes from Government of India for clean and healthy sanitisation (e.g. Swachh Bharat Abhiyan) however, the people of these villages are not changing their sanitary habit because they are traditionally used to it. Also, they have many cultural and social notions behind it. According to their perspective sanitisation in open area is water saving, time saving and as a whole money saving. So, they are not willing to change their habit. Eventually it has been found that though there is toilet but they are reluctant to use it for sanitisation. Therefore, a lack of awareness on hygiene and health is prevailing in these areas in spite of government initiatives. According to the Ministry of Rural Development of India, rural development implies both the economic betterment of people as well as greater social transformation. So, it can be said that there is a need to create awareness among rural people of India to socially transform India. Motivation needs to be spread among the people of rural villages to use proper sanitisation system, which is lacking in the present scenario. As the existing awareness programme arranged by the government is not effective in these villages a new model of awareness programme needs to be designed. The design model must be more communicative as well as interactive with the rural people of India.

To improve the rural living environment and build beautiful and livable countryside is an important task of implementing Rural Revitalization Strategy, which is related to building all-round well-off society, the basic well-being of farmers, and the rural social civilization and harmony. This paper sorts the problems existing in the four major aspects of the current rural human settlements environment, including environment health condition, installation of rural environment infrastructure, capital investment status and construction of comprehensive renovation project of rural environment. In combination with the main attack direction of “Three-year plan of Action for the rehabilitation of the rural human settlements environment”, this paper proposes six specific countermeasures: promoting the disposal of rural domestic waste, promoting rural toilet revolution, treatment of rural domestic sewage, promoting the appearance of village, strengthening the management of village planning and perfecting construction and manage-protect mechanism. Responding actively to the human settlements environment policy and Rural Revitalization Strategy policy, it is of great practical significance to effectively improve the rural human settlement environment in China.

To establish climate resilience indigenous communities in rural and remote areas of Fiji, a pilot freshwater biomonitoring project was conducted in six villages of the Vanua Levu island using an innovative, user, age, education and gender friendly community-based river health assessment tool—‘Traffic Light Bioindicator Guide’ (TLBG). This project was aimed at developing local community practitioners for conducting bioassessment and implementing riverine ecosystem-based conservation. To achieve this, a workshop and riverine field training were conducted to educate the villagers on the riverine biophysical structure, river health bioindicator taxa identification, TLBG use and river mapping for identification of catchment threats. Site-specific rapid bioassessment results are discussed. The social empowerment gained through field assessments and workshops resulted in (a) indigenous community-based plans for water source safeguarding (b) establishment of a village specific river monitoring committee (c) establishment of banana circle bio-filter for wastewater treatment (d) local community rubbish pit construction (e) proper toilet construction and (f) the development of a modified TLBG post-pilot field trial. The annual freshwater biomonitoring results complementing the implementation of community-initiated mitigation measures (a–e) were published as a proof of the successful trial of the TLBG in the Fiji RiverCare Toolkit.

The collective behaviour of individuals and households may be changed in the desired direction by appropriate intervention. This may be changed by strategies that are likely to nudge behaviour rather than through command-and-control policy. Nudging behaviour is like libertarian paternalism, whereby communities may be encouraged to change behaviour through appropriate communication. The development management policies for changes in customs (rational behaviour irrespective of others) may involve developing infrastructures or facilities. Home-based employment for women may be generated for women who have to attend to household chores throughout the day for household welfare. Better sanitation infrastructure may be developed to change sanitation behaviour if people do not use toilet due to quality issues in the first place.

Public toilets are being established in India to make it an open-defecation free country. These amenities are assigned workers to monitor its cleaning. Due to negligence, improper usage, and lack of timely maintenance, majority of them are in bad condition. There is a critical requirement of an Internet of Things (IoT)-based smart application to automate the monitoring of these public toilets and provide services. This work proposes an Adaptive Neuro-Fuzzy Inference System (ANFIS)-based IoT application for smart monitoring of large-scale public amenities. Determining a toilet state is fuzzy as the condition of toilet is affected by multiple factors such as environmental conditions, day and hour of usage, rate of usage and type of use. ANFIS is used as an information fusion model to predict the amenity state and determine an action accurately. Dampster–Shafer theory is implemented to reduce the data uncertainty in the input feature set of the ANFIS model. A real prototype-based experiment confirmed the effectiveness of the proposed information fusion model.

This chapter examines whether Indian society encourages or discourages open defecation and whether open defecation is a social norm or custom. This empirical analysis has been conducted on the basis of surveys conducted in four villages in Gujarat and West Bengal, the two states located in the western and eastern parts of the country. The Respondent Driven Sampling (RDS) approach of the social network analysis method has been used to select sample households for the analysis. The analysis shows that the reference network of sample households has profound implications on access and attitude towards toilet use. Privacy and convenience are the main reasons for toilet construction. Personal normative beliefs about the use of toilets are higher in Gujarat than in West Bengal.

Water is the gifted resource which is needed by each and every living kind on this Earth. It is the part and parcel of all functions we do. The first most used resource is finding its shortage since the Industrial Revolution has been started. Water is used for many purposes where it is not required to maintain its drinking water standards for all activities. For example, toilet flushing, car washing, gardening and irrigation do not require exactly the potable standards. Relaxation on water demand and wastage can be given going for recycling. Grey water is used, and water collected from washbasin, kitchen sink and laundry activities constitutes about 33.33%. Thus, grey water collected from a residential area has given a simple treatment to make it fit to use for toilet flushing. Due to European toilet system, users even started wasting the potable water. Decentralized system confined to specific colony, i.e. individual colony is responsible for the treatment. It helps in reducing load on STP. This study concentrated on enhancing grey water aesthetic appearance by providing treatment units like aeration, two-stage filtration and disinfection.

Sit-to-stand (STS) transfer is one of the most common difficulties faced by the elderly. The present paper aims at identifying the STS transfer difficulty among Indian elderly and also focuses on the need for an appropriate STS transfer aid. The study was undertaken in 2018 on 200 elderly respondents having difficulty in STS movement. Self-structured questionnaire and other scales, viz. Mini-Mental State Examination (MMSE) and Timed Up and Go (TUG), were applied to assess the needs and problems of Indian elderly in STS tasks. The results show that among all the respondents a large number of females in the age group of 60–70 years had STS transfer difficulty. High body mass index (63.5%), osteoarthritis (69%), and vegetarian diet (58%) were noted among respondents. The impaired ability of sit-stand transfer affected their capacity in carrying out important activities of daily living. The elderly also faced trouble in STS movement particularly in western toilet (WT) and Indian toilets (IT). Walking stick users also found difficulty in STS tasks at many places. Thus, a need was identified to develop an assistive aid to help the elderly in STS transfer particularly in WT and IT, along with a modified walking stick, which could serve the dual purpose of mobility and STS transfer.

The Swachh Bharat Mission was started by the Prime Minister of India with a vision of clean India and to ensure hygiene, waste management and sanitation across the nation. Since its inception in 2014, its progress has been praise worthy. More than 91.65 million toilets have been built across the nation and 0.54 million villages, 585 districts and 27 States/UTs have been declared open defecation free. In the past one year, the pace of toilet construction has been exponential in States like Uttar Pradesh, Bihar and Odisha. However, many agencies have noted that the districts with ODF status and 100% toilet construction on government Web sites have a high fall back rate and a substantial amount of people not using toilets even now. A similar trend was noticed in the district of Ghaziabad in Uttar Pradesh through a survey conducted in the town. The purpose of this paper is to find whether the district of Ghaziabad is in fact, truly ODF, and if not, the reasons for the same so that a general understanding of most cities of India and their performance in the mission could be understood.

Globally, ‘One in Seven’ people have ‘NO’ choice but to defecate in the open, and about 2.3 billion people still live without improved sanitation (WHO/UNICEF in Progress on drinking water, sanitation and hygiene update and SDG baselines 2017, 2017). Although, India has made big progress since 2014 after the launch of Swachh Bharat Mission, still about 40% of the population lacks any kind of proper sanitation facility (Source: WaterAid’s Report in Out of order the state of World’s Toilets 2017, 2017). The poor and lack of sanitation facility would lead to various associated health diseases and is the main reason for the 99.8% deaths due to ‘Diarrhoea’, which occurs in developing countries of which 90% are children’s. Thus, there is a great need for developing the proper sanitation facility in the ‘Rural’ as well as ‘Urban’ areas, and more importantly keeping it clean and hygienic, in order to enhance its usability. CSIR-NEERI have developed sanitation technologies ‘NEERFLUSH’ and ‘NEERSWACHH’, which offers low cost and affordable solution for improving sanitation facility, and overcomes limitations/drawbacks of the existing technologies. The user perception questionnaire study conducted for the installed unit’s shows 98% of the regular users were highly satisfied with the overall performance of the ‘NEERFLUSH’ with reference to improvement in cleanliness, hygiene, and smell problem.

Current demographic trends, the rise of chronic diseases, the accessibility of inexpensive generic treatments, and the emergence of “lifestyle” drugs have been the key to increased pharmaceutical medicine use throughout the world. These pharmaceuticals are now the group of emerging contaminants with rising concern in the scientific world due to their presence in surface water, such as lake and river, groundwater, soil, and even drinking water and their associated impact on invertebrates, vertebrates, and ecosystem structure and function. The two main routes of such contaminations are (1) when such drugs taken are excreted in faces and urine and (2) when unused drugs are thrown down. Research undertaken has found that 60–80% of these pharmaceutical medicines are flushed down the toilet or dumped as regular household waste that ends up in sewage treatment plants, which are generally not designed to remove such pollutants from wastewater. Bioremediation is a process where degradation of contamination is done with the help of different microorganisms, which is one of the cost-effective methods that has been used until now. Though there are some interesting reports on the bioremediation of pharmaceuticals from water, further research is crucial for the systematic development of novel technologies to deal with such emerging contaminants. This chapter, therefore, is focused on summarizing and consolidating findings from the current state of the art in the area of pharmaceutical bioremediation.

This is a second survey, following an earlier study of rural facilities that found that the toilet was the most significant influencing factor affecting farmers’ satisfaction. The quality of rural sanitary latrines in China has been low, and the health of rural residents and the environmental sanitation in rural areas has not been effectively guaranteed. Factor analysis and logistic regression models are used to study the current situation of rural household latrines, rural residents’ satisfaction and its influencing indicators within Sichuan. This research led to three key findings: (1) the present situation of rural household latrine construction in Sichuan is less than ideal; (2) rural residents are relatively satisfied with rural household latrines; (3) rural residents’ satisfaction is affected mainly by village committee performance, response time, the quality of latrine construction, transparency of village affairs, sources and subsidies of funds, construction participants and construction methods. Results of this study lay a foundation for further research regarding rural household latrines, and provide a theoretical basis for the construction and reform of rural household latrines in Sichuan.

Technology is recognized as a vital measure to promote the transformation and the upgrading of medical industry when health management has entered the intelligent era. Smart toilets, considered to have great potential for monitoring health information at home, emerge in our daily life. This paper is conducted to ameliorate the key interactions between human and smart toilet and based on peak-end rule, effectively improving user experience. A new design approach is applied to finds the peak and end moments in using process, and finally identifies four key interactions through the method combining user interview and Kano model. This paper details how the application of the new approach improves the interactions between human and smart toilet, contributing to a smoother product operation process which creates a better user experience.

Background: Faecal sludge management is the process of safe collection, conveyance, treatment and disposal of sludge from on-site sanitation system. The goal of the proposed study was to undertake an in-depth assessment of the on-site sanitation system and practice with focus on faecal sludge and septage management in Puri town. Methods: All households, institutions and commercial establishments were surveyed and geo-tagged (100%). On-site sanitation systems and practices of 44,739 households, 529 institutions, 1215 commercial establishments and 158 mixed establishments; reasons for not connecting their latrine/toilets to the existing sewerage system information were collected using computer based structured tool. Findings: Out of 44,739 households; 39,218 households have toilets/latrines and remaining 5,521 households did not have toilets/latrines. Out of 39,218 households, only 16,530 household toilets are connected to septic tanks; 15,036 households have pit latrines; 3098 households did not construct any containment system for faecal matter and connected their toilets direct to drain; 4515 households connected their toilets to sewer network and the remaining 39 households have toilets but did not have containment system and discharge in open space or surrounding environment. The survey revealed that out of 5,521 households who did not have their own toilet, 4406 were practising open defecation and the remaining used community/public/shared toilets. About 61% of the septic tanks/pit latrines were never cleaned. Only 2862 households (6.4%) used cesspool vehicle for cleaning and 9327 households (20.8%) cleaned their septic tank/pit latrines in non-mechanised method. Primarily, location of the toilets with respect to the sewer lines—about 60% septic tanks/pits are located at the backside while sewer lines are in the front of the properties. Road accessibility of the cesspool vehicles to septic tanks/pits are the major challenges for faecal sludge management. About one-fifth of the city roads are narrow—less than 2.5 m, which creates hindrance for the accessibility to the cesspool trucks to the septic tanks/pits. Despite, more than 90% of the households were aware about sewer system in the town and the availability of an incentive of INR 6,667 from the Government for sewer connection, the rate of sewer connection did not increasing due to inconvenience of digging/cutting of roads and making physical connection and excavation within the house premises and repair to the floor of the houses. Conclusion: Integration between the sewerage system and the on-site sanitation system shall be a critical step along with mainstreaming the sanitary workers and empowering them with appropriate mechanised tools for cleaning and transportation of faecal sludge and septage.

Domestic water consumption can be affected by many factors. Household routines that involve the use of water appliances such as number of time the occupants of a household took bath, flushing toilet, washing clothes and others ultimately regulate the amount of residential household’s monthly water consumption. Accurately estimating the amount of domestic water consumption is a very challenging task as these household routines differs from one another with one routine may be more influential than the others. This paper therefore proposes the employment of Genetic Algorithm (GA) in order to optimize the coefficient of micro-components of water consumption (coMC) to determine which micro-component of water consumption (household routines) is more influential than the others. This is accomplished by encoding the chromosome data in GA to incorporate the coMC values to minimize the domestic water consumption estimation error and subsequently enabling increased accuracy towards estimating the amount of monthly water consumption. Using household’s characteristics data and monthly water consumption from 80 residential households, it is discovered that there exist micro-components that are more influential towards the water consumption than the others.

This article summarizes the existing problems of toilet systems in the high-end public toilets based on field research and design psychology, and then uses ergonomics theory to analyze the operation scene and main man–machine engineering factors. Based on the analysis, related body size data and related experimental data, we follow the ergonomic design principles and the principle of universal design to determine three different man–machine dimensions of the toilet system for ordinary adults, disabled people, and children. In the end, we design a new toilet machine which integrates mirror, sensor water, sensor of hand sanitizer, and sensor drying, combining with a semi-embedded washbasin to form a set of toilet system.

Mahatma Gandhi once said, ‘Sanitation is more important than independence’ [1]. First Sanitation Programme in India was launched by the Government of India in 1986 which was restructured in 1999 and 2012. But it could not lead to substantial increase in the coverage of rural households with sanitation facilities. After 64 years of independence, Census 2011 revealed that 67.30% rural households had no access to the toilet in India. The present Government which was formed in 2014 put sanitation in its top priorities and launched Swachh Bharat Mission (SBM) on 2 October 2014. One of the objectives of this Mission is to achieve open defecation free (ODF) status by 2 October 2019 as a tribute to ‘Mahatma Gandhi’ on his 150th birth anniversary. The problem of open defecation is not equally distributed among the States of India. This paper tries to evaluate the impact of the Mission considering the increase in coverage of households with sanitation facilities in six States, namely Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan, Odisha and West Bengal by 31 March 2017 which had 675.02 lakh rural households without access to toilets accounting for 60.75% of total uncovered households with the individual household toilet in India as per the Baseline Survey conducted by Ministry of Drinking Water and Sanitation in 2012–13.

The necessity of a healthy environment is a major aspect in this modern age. Several trials have been made by multidisciplinary researchers for the development of a healthy environment. However, it is important to facilitate most of the modern healthcare resources to the unhealthy people for their betterment. Some extent of technology has an important role to support it. In this paper, a case study of water supply in healthcare system is analyzed. The paper has three aspects; first, the use of PI control for measuring the water level in a tank, second, the water distribution to several resources using PD control. The use of both the controls is further explained through an example of water distribution in a smart toilet. Lastly, the tuning of the PID controller using a fuzzy-based controller which makes the overall system robust. The simulation results confirm the advantages and demonstrate better dynamic behavior. For low energy consumption, either the input energy is decreased or the efficiency of mechanical transmission is increased. Performance of the controller is judged upon the simulation results obtained from MATLAB.

In this ultramodern era, there is an increase in demand of smart systems. It is quite observable that the bedridden patients face problems in defecating and urinating. Taking the problems into account, we have taken an approach to design the user-friendly toilet to support the hospitals and the patients. Based on the cognitive science, fuzzy-based smart toilet is designed so that maximum ICU patients can be benefited. The toilet is fixed with the bed and can be used by the patients with a simple switch. The FL-based PID controller is designed to slide the pan cover as well as water supply to the toilet. It can clean the body part of the patient along with the toilet. Rule based fuzzy is applied to design the system and defuzzification is done using COG method. According to a performed survey, the proposed idea is a type of big data analysis and can be widely used for the betterment of hospitals and old-age homes.

We aim to develop a new in-home assistance system to aid in the standing-up motion from toilet seats in assisted bathrooms. The underlying design concept for accessible toilet facilities is to use a novel compact actuation device—a metal hydride actuator with several unique properties such as softness, noiselessness, and being lightweight—for tilting a toilet seat when required, thus helping elderly or frail people to stand-up after excretion. This ergonomic study evaluates the easiness of the standing-up motion using both objective and subjective data from healthy participants, as a prior step before developing the envisaged toilet seat tilting system. In the experiment, the participants were monitored to obtain simultaneous objective data concerning muscle activity, 3D body motion, center of pressure, and seat pressure distribution. Additionally, all participants were requested to provide subjective data (comfort scores) while standing up from a toilet seat under four different conditions—four different forward-tilting angles (0°, 5°, 10°, and 15°). All participants repeated the motion 25 times for each tilting angle, and provided feedback regarding their standing-up experience and feelings under each condition. According to the collected subjective data, a toilet seat tilt angle of approximately 10° increased the easiness and comfort of the standing-up motion. However, according to the measured objective data, the standing-up motion has individual variations in the electromyogram magnitude, center of pressure excursion, and seat pressure pattern, implying that to analyze the standing-up motion both the measured objective data and the perceived subjective data must be considered.

As the number of inhabitants in the nation is expanding day by day, it gets to be distinctly hard to deal with the cleanliness of the urban areas. One vital reason for this issue is some time for individuals it is hard to find the public toilet and even if one finds it then there may be an issue of cleanliness with the one found. With help of the recent technology known as IOT, we are proposing a solution for this issue. Sensors will be conveyed in different public toilets which will accumulate the cleanliness parameters and this acquired information will be uploaded to the database. This information can likewise be utilized by maintenance office for further activities. Utilizing this information, one can without much of a stretch get the exact location and the cleanliness level of the toilet utilizing our android application on his smart cell/tablets.

The discussion so far has focussed on household welfare based on money metric variables such as prices and expenditure. In this chapter and the next, the volume widens the discussion to include a household’s inability to enjoy some of the basic necessities of life such as drinking water, Fuel, electricity, toilet and medical care. Notwithstanding significant improvement in levels of living, many parts of the world still experience lack of access to several of these dimensions. Poverty measures and, more broadly, an exclusive reliance on variables that can be quantified in money terms, often fail to capture the true extent of human misery both globally and in pockets inside countries. The motivation of this chapter and the next is to provide evidence from studies that compare between and within countries taking a multidimensional view of deprivation.

Constipation is a common problem in childhood with a prevalence of about 3–4%. Constipation can be defined as delay or difficulty in passing stools, which is present for more than 2 weeks. The most widely accepted definition is as per Rome III definitions in which a child with presence of two of more of the following symptoms is considered to have constipation: Two or less defecations per week At least one episode of incontinence per week History of excessive stool retention or retentive posturing History of painful or hard bowel movements Large fecal mass in the rectum History of large-diameter stools that may obstruct the toilet

Like many low- and middle income countries, out-of-pocket payment (OOPP) is the most common healthcare financing mechanism in Bangladesh. Higher and unpredictable health payments can expose households to substantial financial risk along with, at their most extreme, can result in economic impoverishment. Health policy-makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. This study intends to examine the factors that are mostly influencing out-of-pocket payments healthcare in Bangladesh. A total of 10,705 populations who spent for receiving any type of healthcare services were analyzed from Bangladesh Household Income and Expenditure Survey data, 2010. We used a multiple regression model for the determinants of OOPP using Ordinary Least Square (OLS) considering socio-economic, demographic, social financial security as well as health-related indicators. Adjusted findings showed that, household characteristics like unsafe water, unhygienic toilet and household belonging to urban community were significantly associated with OOP payments. The other significant factors were household income, age, sex, informal healthcare. Finding can help for the decision-makers by stating OOPP determinants, discussing the mechanism causing them and thus making them into account to adapt OOP relevant regulations which highlights the emphasis to develop financial protection mechanisms in Bangladesh. Government should consider enhancing resources of healthcare policy. Parallel to government, spending other prudent and sustainable risk-pooling mechanism can help reducing intensity of OOP payments.

Many treatment strategies either need modification or are not appropriate for patients with dementia. Treatment options will often depend on the setting of care and the availability of carers and need to be individualized. Much of the assessment may need to be discussed with carers, and it is important to recognize that family members may feel uncomfortable discussing and being involved in this intimate area of care with their loved ones and vice versa. Continence aids are often a mainstay of treatment. Options of modifying the environment to improve access and reduce the risk of falls and incontinence include decluttering, ensuring adequate lighting and highlighting the toilet. Ensuring bowels are regular has a greater emphasis in dementia patients to avoid incontinence both of bowel and bladder. Patients with Alzheimer’s disease may be managed with cholinesterase inhibitors that can cause or exacerbate urinary frequency and incontinence. Medications used for urge incontinence should not be completely dismissed in patients with dementia despite their potential side effects.

This chapter discusses the effect of two technical barriers to trade (TBT) adopted by Ecuador in November 2013 on the import flows of perfumes and toilet waters. The study considers two TBTs: Resolution 116 and Resolution 093. In order to obtain an unbiased estimate, the study uses a synthetic control method combined with a difference-in-difference estimation. To the best of the authors’ knowledge, this is the first study that uses the synthetic control method to estimate the causal effect of a particular barrier to trade. In that sense, the contribution of this chapter is mainly methodological.

Cytotoxic and radioactive wastes from hospitals are of major concern in the various types of urban wastes, and in developed countries they are managed by proper regulated methods. Nuclear medicine services are in the increase in many developing countries. Therefore to implement existing regulatory policies and guidelines in terms of handling of radioactive materials used in the treatment of patients and management of wastes arising out of hospitals need a good model. The commonly used radioisotopes in hospitals are: for diagnostic investigations 99mTechnetium (99mTc), 99Molybdenum (parent for 99mTc), 67Gallium, 201Thallium, 131I-MIBG, and 131I (Capsules of activity 555MBq, 3.7,7.4 GBq(15,100,200mCi)) for therapeutic applications. Positron Emission radiopharmaceuticals do not pose much problem because of their short half lives. National regulatory authorities monitor the issues relating to organized safe use of radiopharmaceuticals in medical applications and give clearance for their use in hospitals. The sequences of protocols insisted are (1) Maintain inventory of receipts and safe custody of received radioisotopes, (2) Constant surveillance in terms of their safe applications during routine use (3) Safe methods of disposal of the radioactive wastes generated from human use of these radioisotopes and chemical formulations. Permissible concentrations of the radioactive waste disposals must take into account the community safety, and the expected degree of dilution is achieved at the discharge point of the institution into the sewage system. The hazard to the general population is insignificant in case the sludge containing radioactive waste material being used as fertilizer material. Depending on the type of radioactive waste from nuclear medicine procedures indicate to simply store the wastes till radioactive decay reduces the activity to a safe level or possibly by disposal of low-activity waste into the sewage system to achieve sufficient dilution. Disposal with permission from the regulatory authority and appropriate monitoring is known as a controlled disposal. Solid wastes (Diagnostic): Syringes, sharps, gloves kept in yellow plastic containers, allowed minimum 2 months decay, monitored by GM survey instrument and released. They bear dates written on them. They go for incineration. General department wastes are sent only after 24 h elapsed, because most of them contain 99m Tc cotton swabs etc., with half-life 6 h. Liquid wastes (Diagnostic): No laboratory work with open isotopes except for some labeling studies in the department. Diagnostic waiting patients’ toilet urine wastes go to delay tank for increase in volume for I-131 patient’s urine storage. Total about 2–4 months decay is ensured. 131I Therapy Isotope is received in capsule form, and directly administered to patients orally. No liquid operations are carried out these days in the departments. I-131 (therapeutic) patients’ linen, collected in an adjacent room in therapy ward, allowed to decay for varying periods 2–4 months; released to laundry after monitoring the count-rate, by an end-window type GM monitor. Half-life of 131I is 8.05d, and therefore about 8–10 half lives will reduce the waste activity burden. 131I therapeutic Solid wastes (nonactive black bags) (active yellow bags) all are monitored, and sent to ‘Decay Waste Box’ kept in the backyard of the hospital, which is innovation by the author based on long experience in the hospital. Whenever the box becomes filled up (about 2–3 months), individual bags are re-monitored to ascertain residual radioactivity. If they reach background count rates, they are released. Waste release with BIN number, informed to regulatory authority for records. A special waste storage trolley help to keep the I-131 solid wastes from wards to allow decay, before these are released to waste treatment plant of the city. Some countries follow, centralized waste collection system which are commercial firms dealing with this operation throughout city, for many busy hospitals. Our local set up has a pair of delay tanks with individual volume total volume 36 M3. The urine toilet releases are collected for about 2 months, kept closed for achieving a delay time of 2 months before releasing into the sewage treatment plant (STP) of the hospital. Six releases at 2 monthly intervals take place annually. At the time of releasing the contents of the delay tank, 50 mL samples are collected, and these sample are counted to document released activity of I-131 to confirm whether they are much below recommended levels of bi-monthly release. The released activity calculated showed good statistical correlation with measured values. The safe procedures followed for radioactive waste disposal is enumerated.

The importance of communication in human daily lives is undeniable as it is a mean of expressing ideas, thoughts and most importantly the basic needs. Unfortunately, there are elderly patients with speech disabilities, commonly caused by aphasia. Aphasic patients can lose their ability to obtain basic needs and healthcare services as they are unable to communicate. There is no electronic communication device or Voice Output Communication Aid (VOCA) that is made locally to help local stroke patients to communicate. Imported VOCA is extremely expensive and do not work in multi languages and dialects which usually are the native languages for local patients. Hence, there is a demand for such device to be designed. The design criteria and features of the device are decided based on literature review and surveys done. The device consists of 6 basic needs buttons, output voice messages such as eat, and drink, toilet, thank you, yes and no. It costs less than RM400, can be operated with minimum technical and reading skills and is portable. Additional features for this device included the option for any 3 languages, optional recordings of user’s family voice as the voice messages and a built in alarm for urgent use. The circuit of the device was tested to prevent over current, burn and reduce power consumption. The overall design of the prototype is good according to the healthcare professionals and patients’ evaluations. Minor improvements can be done in the future to bring the device into the market. Finally, approaches to commercialise the device and the business model are briefly explained.