The provision of long-term capital for large-scale industry in Pakistan

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Evaluation of a Cluster-Randomized Controlled Trial of a Package of Community-Based Maternal and Newborn Interventions in Mirzapur, Bangladesh

To evaluate a delivery strategy for newborn interventions in rural Bangladesh.A cluster-randomized controlled trial was conducted in Mirzapur, Bangladesh. Twelve unions were randomized to intervention or comparison arm. All women of reproductive age were eligible to participate. In the intervention arm, community health workers identified pregnant women; made two antenatal home visits to promote birth and newborn care preparedness; made four postnatal home visits to negotiate preventive care practices and to assess newborns for illness; and referred sick neonates to a hospital and facilitated compliance. Primary outcome measures were antenatal and immediate newborn care behaviours, knowledge of danger signs, care seeking for neonatal complications, and neonatal mortality.A total of 4616 and 5241 live births were recorded from 9987 and 11153 participants in the intervention and comparison arm, respectively. High coverage of antenatal (91% visited twice) and postnatal (69% visited on days 0 or 1) home visitations was achieved. Indicators of care practices and knowledge of maternal and neonatal danger signs improved. Adjusted mortality hazard ratio in the intervention arm, compared to the comparison arm, was 1.02 (95% CI: 0.80-1.30) at baseline and 0.87 (95% CI: 0.68-1.12) at endline. Primary causes of death were birth asphyxia (49%) and prematurity (26%). No adverse events associated with interventions were reported.Lack of evidence for mortality impact despite high program coverage and quality assurance of implementation, and improvements in targeted newborn care practices suggests the intervention did not adequately address risk factors for mortality. The level and cause-structure of neonatal mortality in the local population must be considered in developing interventions. Programs must ensure skilled care during childbirth, including management of birth asphyxia and prematurity, and curative postnatal care during the first two days of life, in addition to essential newborn care and infection prevention and management.Clinicaltrials.gov NCT00198627

Highly dense and chemically stable proton conducting electrolyte sintered at 1200 °C

The authors S. Hossain and A. M. Abdalla are grateful to the graduate studies office of Universiti Brunei Darussalam for graduate research scholarship (GRS) for funding this research. The authors are thankful to Professor John T. S. Irvine for managing a visiting scholarship for SH and AMA at Center for Advanced Materials at School of Chemistry in University of St Andrews, UK for the research works done.The BaCe0.7Zr0.1Y0.2−xZnxO3−δ (x = 0.05, 0.10, 0.15, 0.20) has been synthesized by the conventional solid state reaction method for application in protonic solid oxide fuel cell. The phase purity and lattice parameters of the materials have been studied by the room temperature X-ray diffraction (XRD). Scanning electron microscopy (SEM) has been done for check the morphology and grain growth of the samples. The chemical and mechanical stabilities have been done using thermogravimetric analysis (TGA) in pure CO2 environment and thermomechanical analysis (TMA) in Argon atmosphere. The XRD of the materials show the orthorhombic crystal symmetry with Pbnm space group. The SEM images of the pellets show that the samples sintered at 1200 °C are highly dense. The XRD after TGA in CO2 and thermal expansion measurements confirm the stability. The particles of the samples are in micrometer ranges and increasing Zn content decreases the size. The conductivity measurements have been done in 5% H2 with Ar in dry and wet atmospheres. All the materials show high proton conductivity in the intermediate temperature range (400–700 °C). The maximum proton conductivity was found to be 1.0 × 10−2 S cm−1 at 700 °C in wet atmosphere for x = 0.10. From our study, 10 wt % of Zn seems to be optimum at the B-site of the perovskite structure. All the properties studied here suggest it can be a promising candidate of electrolyte for IT-SOFCs.PostprintPeer reviewe

Factors affecting recruitment and retention of community health workers in a newborn care intervention in Bangladesh

<p>Abstract</p> <p>Background</p> <p>Well-trained and highly motivated community health workers (CHWs) are critical for delivery of many community-based newborn care interventions. High rates of CHW attrition undermine programme effectiveness and potential for implementation at scale. We investigated reasons for high rates of CHW attrition in Sylhet District in north-eastern Bangladesh.</p> <p>Methods</p> <p>Sixty-nine semi-structured questionnaires were administered to CHWs currently working with the project, as well as to those who had left. Process documentation was also carried out to identify project strengths and weaknesses, which included in-depth interviews, focus group discussions, review of project records (i.e. recruitment and resignation), and informal discussion with key project personnel.</p> <p>Results</p> <p>Motivation for becoming a CHW appeared to stem primarily from the desire for self-development, to improve community health, and for utilization of free time. The most common factors cited for continuing as a CHW were financial incentive, feeling needed by the community, and the value of the CHW position in securing future career advancement. Factors contributing to attrition included heavy workload, night visits, working outside of one's home area, familial opposition and dissatisfaction with pay.</p> <p>Conclusions</p> <p>The framework presented illustrates the decision making process women go through when deciding to become, or continue as, a CHW. Factors such as job satisfaction, community valuation of CHW work, and fulfilment of pre-hire expectations all need to be addressed systematically by programs to reduce rates of CHW attrition.</p

Rickettsial illnesses as important causes of febrile illness in Chittagong, Bangladesh

We conducted a yearlong prospective study of febrile patients admitted to a tertiary referral hospital in Chittagong, Bangladesh, to assess the proportion of patients with rickettsial illnesses and identify the causative pathogens, strain genotypes, and associated seasonality patterns. We diagnosed scrub typhus in 16.8% (70/416) and murine typhus in 5.8% (24/416) of patients; 2 patients had infections attributable to undifferentiated Rickettsia spp. and 2 had DNA sequence-confirmed R. felis infection. Orientia tsutsugamushi genotypes included Karp, Gilliam, Kato, and TA763-like strains, with a prominence of Karp-like strains. Scrub typhus admissions peaked in a biphasic pattern before and after the rainy season, whereas murine typhus more frequently occurred before the rainy season. Death occurred in 4% (18/416) of cases; case-fatality rates were 4% each for scrub typhus (3/70) and murine typhus (1/28). Overall, 23.1% (96/416) of patients had evidence of treatable rickettsial illnesses, providing important evidence toward optimizing empirical treatment strategies

Highly dense and chemically stable proton conducting electrolyte sintered at 1200 \ub0C

The BaCe 0.7 Zr 0.1 Y 0.2−x Zn x O 3−δ (x = 0.05, 0.10, 0.15, 0.20) has been synthesized by the conventional solid state reaction method for application in protonic solid oxide fuel cell. The phase purity and lattice parameters of the materials have been studied by the room temperature X-ray diffraction (XRD). Scanning electron microscopy (SEM) has been done for check the morphology and grain growth of the samples. The chemical and mechanical stabilities have been done using thermogravimetric analysis (TGA) in pure CO 2 environment and thermomechanical analysis (TMA) in Argon atmosphere. The XRD of the materials show the orthorhombic crystal symmetry with Pbnm space group. The SEM images of the pellets show that the samples sintered at 1200 \ub0C are highly dense. The XRD after TGA in CO 2 and thermal expansion measurements confirm the stability. The particles of the samples are in micrometer ranges and increasing Zn content decreases the size. The conductivity measurements have been done in 5% H 2 with Ar in dry and wet atmospheres. All the materials show high proton conductivity in the intermediate temperature range (400–700 \ub0C). The maximum proton conductivity was found to be 1.0 7 10 −2 S cm −1 at 700 \ub0C in wet atmosphere for x = 0.10. From our study, 10 wt % of Zn seems to be optimum at the B-site of the perovskite structure. All the properties studied here suggest it can be a promising candidate of electrolyte for IT-SOFCs

Highly dense and chemically stable proton conducting electrolyte sintered at 1200 °C

The BaCe0.7Zr0.1Y0.2−xZnxO3−δ (x = 0.05, 0.10, 0.15, 0.20) has been synthesized by the conventional solid state reaction method for application in protonic solid oxide fuel cell. The phase purity and lattice parameters of the materials have been studied by the room temperature X-ray diffraction (XRD). Scanning electron microscopy (SEM) has been done for check the morphology and grain growth of the samples. The chemical and mechanical stabilities have been done using thermogravimetric analysis (TGA) in pure CO2 environment and thermomechanical analysis (TMA) in Argon atmosphere. The XRD of the materials show the orthorhombic crystal symmetry with Pbnm space group. The SEM images of the pellets show that the samples sintered at 1200 °C are highly dense. The XRD after TGA in CO2 and thermal expansion measurements confirm the stability. The particles of the samples are in micrometer ranges and increasing Zn content decreases the size. The conductivity measurements have been done in 5% H2 with Ar in dry and wet atmospheres. All the materials show high proton conductivity in the intermediate temperature range (400–700 °C). The maximum proton conductivity was found to be 1.0 × 10−2 S cm−1 at 700 °C in wet atmosphere for x = 0.10. From our study, 10 wt % of Zn seems to be optimum at the B-site of the perovskite structure. All the properties studied here suggest it can be a promising candidate of electrolyte for IT-SOFCs