Improving and sustaining quality of child health care through IMCI training and supervision: experience from rural Bangladesh

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Prevalence and risk factors of gestational diabetes mellitus in Bangladesh: Findings from demographic health survey 2017–2018

Gestational diabetes mellitus (GDM) has serious consequences for both maternal and neonatal health. The growing number of noncommunicable diseases and related risk factors as well as the introduction of new World Health Organization (WHO) diagnostic criteria for GDM are likely to impact the GDM prevalence in Bangladesh. Our study aimed to assess the national prevalence and identify the risk factors using the most recent WHO criteria. We used the secondary data of 272 pregnant women (weighted for sampling strategy) from the Bangladesh Demographic and Health Survey 2017–2018. Multivariate logistic regression was performed to determine the risk factors of GDM. The overall prevalence of GDM in Bangladesh was 35% (95/272). Increased odds of GDM were observed among women living in the urban areas (adjusted odds ratio (aOR) 2.74, 95% confidence interval (CI) 1.43–5.27) compared to rural areas and those aged ≥25 years (aOR 2.03, 95% CI 1.13–3.65). GDM rates were less prevalent in the later weeks of pregnancy compared to early weeks. Our study demonstrates that the national prevalence of GDM in Bangladesh is very high, which warrants immediate attention of policy makers, health practitioners, public health researchers, and the community. Context-specific and properly tailored interventions are needed for the prevention and early diagnosis of GDM

Modelling the Impact of Perceived Connectivity on the Intention to Use Social Media: Discovering Mediating Effects and Unobserved Heterogeneity

Early research examined the direct effect of perceived connectivity (PC) on intention to adopt information systems. In this study, we extend that research stream by examining the mediating effects of perceived enjoyment (PE) and perceived playfulness (PP) on the relationship between PC and the intention to use social media within the workplace. To test our proposed model, we collected data from 2,556 social media users from Australia, Canada, India, the UK, and the US. We applied the REBUS-PLS algorithm, a response-based method for detecting unit segments in PLS path modelling and assessing the unobserved heterogeneity in the data sample. Based on the strength of effects, the algorithm automatically detected two groups of users sharing the same intentions to use social media. A post hoc analysis of each group was done using contextual and demographic variables including geographic location, country, age, education and gender. Implications for practice and research are discussed

'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study

Objective: To explore the role of a community-based intervention in reducing delays in accessing emergency obstetric care (EmOC) in rural Bangladesh, and the factors associated with delayed decision making, reaching the health facility and receiving treatment. Study design: Quasi-experimental study. Methods: Multistage random sampling was used to select 540 villages, from which 1200 women who reported obstetric complications in March–April 2010 were interviewed. Results: The median time taken to make the decisions to access health care was significantly lower in the intervention areas compared with the control areas (80 vs 90 min). In addition, the median time taken to reach the health facility was significantly lower in intervention areas compared with the control areas (110 vs 135 min). However, no difference was found in the median time taken to receive treatment. Multiple linear regressions demonstrated that community intervention significantly reduced decision making and time taken to reach the health facility when accessing EmOC in rural Bangladesh. However, for women experiencing haemorrhage, the delays were longer in the intervention areas. Protective factors against delayed decision making included access to television, previous medical exposure, knowledge, life-threatening complications during childbirth and use of primary health facility. Financial constraints and traditional perceptions were associated with delayed decision making. Complications during labour, use of a motorized vehicle and use of a primary health facility were associated with faster access to EmOC and poverty, distance, transportation difficulties and decision making by male guardian were associated with slower access to EmOC. Conclusions: The intervention appeared to reduce the time taken to make the decision to access health care and time taken to reach the health facility when accessing EmOC. This study provides support for a focus on emergency preparedness for timely referral from the community

Fortaleza: The emergence of a network hub

Digitalisation, accelerated by the pandemic, has brought the opportunity for companies to expand their businesses beyond their geographic location and has considerably affected networks around the world. Cloud services have a better acceptance nowadays, and it is foreseen that this industry will grow exponentially in the following years. With more distributed networks that need to support customers in different locations, the model of one-single server in big financial centres has become outdated and companies tend to look for alternatives that will meet their needs, and this seems to be the case with Fortaleza, in Brazil. With several submarine cables connections available, the city has stood out as a possible hub to different regions, and this is what this paper explores. Making use of real traffic data through looking glasses, we established a latency classification that ranges from exceptionally low to high and analysed 800 latencies from Roubaix, Fortaleza and Sao Paulo to Miami, Mexico City, Frankfurt, Paris, Milan, Prague, Sao Paulo, Santiago, Buenos Aires and Luanda. We found that non-developed countries have a big dependence on the United States to route Internet traffic. Despite this, Fortaleza proves to be an alternative for serving different regions with relatively low latencies

Digital Bangladesh: Using Formative Research to Develop Phone Messages for the Prevention and Control of Diabetes in Rural Bangladesh

mHealth, Behaviour Change, Bangladesh, Diabetes Mellitus, Formative researc

Visual Participatory Analysis: A qualitative method for engaging participants in interpreting the results of randomized controlled trials of health interventions

This article contributes to the field of mixed methods by introducing a new method for eliciting participant perspectives of the quantitative results of randomized controlled trials. Participants are rarely asked to interpret trial results, obscuring potentially valuable information about why a trial either succeeds or fails. We introduce a unique method called visual participatory analysis and discuss the insights gained in its use as part of a trial to prevent risk and reduce the prevalence of diabetes in Bangladesh. Findings highlight benefits such as elucidating contextualized explanations for null results and identifying causal mechanisms, as well as challenges around communicating randomized controlled trial methodologies to lay audiences. We conclude that visual participatory analysis is a valuable method to use after a trial

Presentation of invasive cervical cancer in Bangladesh

Background: Cervical cancer is a disease of significant worldwide morbidity and mortality. More than 85% of the disease occurs in developing countries. Bangladesh, like other developing countries faces a burden of the disease. ObJec­tive: To find out the different way of presentation of invasive cervical cancer patients. Methods: This cross-sectional study was carried out in the Gynaecologic Oncology wing of the Department of Obstetrics and Gynaecology of Bang­abandhu Sheikh Mujib Medical University (BSMMU) during 1st January 2007 to 30th April 2008. One hundred and four patients with invasive cervical cancer admitted in hospital were enrolled in the study by purposive sampling. All the infor­mation were collected in a pre-designed structured questionnaire. Data were analyzed using statistical program SPSS version: 17.0. Frequency distributions were used to present the characteristics of the patients. Chi-square test was calcu­lated and the significant level was set at P<0.05. Results: Maximum patients (60.6%) were in stage II. Majority of the patients (61.5%) presented with abnormal bleeding. Exophytic growth was found in the majority of the patients (71.2%). Squamous cell carcinoma was more (92.3%) in the majority of patients and adenocarcinoma was more in younger age group. Conclusion: The status of the patients irJ this study reflects advanced stage of the disease at presentation and the peak incidence was observed in 36-45 years age group

Enzyme-Accelerated Acid Hydrolysis of Untanned Proteinaceous Wastes from Tanning Industry

Traditionally, tanning industry has been producing considerable amounts of solid wastes, which raises serious concerns on account of their environmental impact. Out of these, untanned raw trimmings account for about 5-7% of the total quantity of raw materials processed. This waste could be a value-added cheap source of collagen, which has numerous industrial applications if properly and scientifically utilized. This research work deals with the utilization of raw trimmings of solid waste from tanneries in the process of enzymatic hydrolysis, performed by using acetic acid and protease, in order to obtain protein hydrolysate. The hydrolysis was carried out with varying acid concentrations, acid solutions, temperatures and times. The maximum obtained protein hydrolysate was about 88% at 1.5 M acid concentration, 4% enzyme ratio, and 60 °

Negative Effects of the Urban River Pollution on the Environment and Human Health in Bangladesh

Based on research findings, Bangladesh’s river water, crucial for domestic, agricultural, and industrial use, has long been in a terrible situation. There have been numerous instances of significant contamination in the waterways surrounding Dhaka city, including the Buriganga River, and in Chattogram city, including the Karnaphuli River, over the past 40 years. The existing data demonstrate that other urban rivers, particularly Karatoa, Teesta, Rupsa, Pasur, and Padma, are also in severe condition due to the disposition of huge pollutants. Contaminants flowing with the water have severely polluted the downstream areas of the rivers. High metal concentrations are frequently observed in river water during the dry season. In the Buriganga River and at certain locations in the Turag, Balu, Sitalakhya, and Karnaphuli Rivers, the presence of dissolvable oxygen (DO) is nearly zero. NO3, NO2, and PO4-3 pollution has also occurred in many rivers. Most rivers have Cr, Zn, Fe, Pb, Cu, Cd, Mn, As, and Ni concentrations beyond the legal limit for drinking water. In contrast, some rivers have metal concentrations above the legal irrigation water limit. The majority of the rivers, particularly the peri-urban rivers in Dhaka city, Teesta, Korotoa, Rupsha, Karnaphuli, and Meghna Rivers, have significantly higher metal concentrations, according to sediment data. Metal concentrations in sediment are generally higher than USEPA standards in most rivers. Metal concentrations in fish and crops demonstrate metal bioaccumulation. The trend in metal concentration follows the order of water, fish, and sediment. It has been shown that crops irrigated with tainted water contain dangerous metals. The analysis of daily intake data on carcinogenic and noncarcinogenic substances reveals that consuming contaminated food can seriously impact human health