An analysis of Factors Contributing to the Increase of Tobacco Consumption in Bangladesh despite Restrictive Anti-Smoking Policies

This paper examines an emerging issue rising up in a developing economy like Bangladesh “Indirect Marketing of Tobacco Productsâ€. This indirect marketing activity is currently moving under the radar of various government monitoring cells. As a result, there is an increase in the number of both underage and legal smokers in the country. The health risks due to the consumptions of the tobacco related products are now one of the widely discussed topics. Worldwide tobacco products are highly discouraged by both medical experts and governments. Governments in both developed and developing countries heavily regulated “Above the Line Marketing Activities†(ATL) utilized by the tobacco companies. Therefore, tobacco companies now employ “Below the Line Marketing Activities†to promote their products. Such activities include point of sale merchandizing, retailer advocacy and various discounting mechanisms. Tobacco companies in Bangladesh also employ such activities to advertise their brand portfolio. Although from a legal point of view, these marketing efforts are only employed to encourage the consumers to switch brands. However, the ripple effect of such marketing activities, growth of cigarette selling outlets (side effects of socio-economic condition of Bangladesh) and inefficiency in rigorous implementation of tobacco laws are encouraging underage/matured population of the country to become occasional smokers, who later on develop habitual smoking despite the restrictive anti-smoking laws. In this research, primary analysis is done through set questionnaires in the Sample Retail Universe (556 retailers randomly chosen from various parts of Bangladesh) along with “Retail Audit†data used to obtain the industry trend analysis. A strong positive correlation can be observed between the industry growth and the different parameters used in the study such as effects of Below the Line Marketing Activity, growth of cigarette selling retail universe and weak implementation anti-smoking policies by the government. The research gives us an insight into the true picture of tobacco industry’s surge with respect to the tobacco consumer behavior and the remedies needed to close the gap

Investigation of the Effect and Contribution of Process Parameters By Taguchi and ANOVA Analysis on the Morphological and Electrical Properties of RF Magnetron Sputtered SiO2 Over Si Substrate

In this work, we applied Taguchi Signal-to-noise (S/N) analysis to investigate the effect of varying three process parameters, namely — sputtering power, working pressure and Ar gas flow rate on the surface, morphological and electrical properties of the RF sputtered SiO2 over Si substrate. We also inspected the contribution of a particular process parameter on these properties by applying Analysis of Variance (ANOVA). SiO2 thin films were fabricated over Si substrate using RF magnetron sputtering system. Three sets of inputs for the three mentioned process parameters were chosen; for power, we chose 100W, 150W and 200W; 5mTorr, 10mTorr and 15mTorr were chosen for pressure and three Ar gas flow rate levels at 5, 10 and 15 sccm were selected. By performing Taguchi L9 orthogonal array, nine combinations of sputtering parameters were prepared for depositing SiO2/Si Thin films. The surface morphological and electrical properties (resistivity per unit area and capacitance per unit area) of the sputtered samples were therefore inspected by analyzing the Taguchi design of experiment. Signal-to-noise (S/R) analysis presents how the properties were affected by the variation of each process parameter. ANOVA analysis showed that sputtering power and working pressure are the two dominant process parameters contributing more to surface morphological and electrical properties. A regression model for surface roughness of the SiO2/Si thin film samples was also derived. The electrical properties of the SiO2/Si thin films, however, didn’t show linear properties

Optimum receiver performance of TH-PPM ultra wideband system in multiple user interference, Journal of Telecommunications and Information Technology, 2007, nr 4

This paper demonstrates optimum receiver performance in terms of bit error rate (BER) for time hopping pulse position modulation (TH-PPM) ultra wideband (UWB) system in multiple user interference environment for indoor radio communication. Equal gain combining and selective gain combining have been demonstrated in terms of ideal RAKE (ARAKE), selective RAKE (SRAKE) and partial RAKE (PRAKE) receiver performances. The recently accepted IEEE 802.15.3a model of the UWB channel has been used to describe UWB propagation in indoor environment. Two channel scenarios named CM-1 and CM-3 for IEEE 802.15.3a channel model have been investigated principally. Finally, this paper concludes with an approximation of equivalence of number of fingers in SRAKE and PRAKE receivers as well as an indication of SNR gains achievable as the RAKE finger number is increased, espe- cially with multiple user interference (MUI), for a 16.6 Mbit/s UWB system

On the Effects of Code Cardinality for TH-PPM Ultra Wideband Systems, Journal of Telecommunications and Information Technology, 2008, nr 4

This paper demonstrates the effects of code cardinality at transmitter section on bit error rate (BER) performance of time hopping pulse position modulation (TH-PPM) based ultra wideband (UWB) indoor radio communication. In the transmitter, different code cardinality values have been chosen and correspondingly the effects on BER of the system have been investigated. The recently accepted IEEE 802.15.3a model of the UWB channel has been used as the propaga- tion channel model in indoor environment. Results show that the system BER performance is significantly dependent on the code cardinality value of time hopping code. For such higher code cardinality values as in the range from 30 to 50, the BER performance degrades severely. Finally, code cardinality in the range from 10 to 15 has been recommended for TH-PPM system in UWB indoor communications providing better BER performance for the same system data rate requirement

Site-Specific Incidence Rate of \u3ci\u3eBlastocystis hominis\u3c/i\u3e and Its Association with Childhood Malnutrition: Findings from a Multi-Country Birth Cohort Study

In this study, we investigated the potential association between the burden of asymptomatic Blastocystis spp. (Blastocystis hominis) infection and nutritional status among children under 2 years of age using the data collected from 1,715 children from eight distinct geographic locations, including Bangladesh, Brazil, India, Peru, Tanzania, Pakistan, Nepal, and South Africa. Childhood stunting, wasting, and underweight were the outcome variables, and B. hominis infection was the exposure variable of this present study. The presence of B. hominis in nondiarrheal stools was evaluated by TaqMan Array Cards. Site-specific incidence rates were estimated using Poisson regression, and multiple generalized estimating equation was used to assess the association between the B. hominis infection and nutritional status. The site-specific incidence rates of asymptomatic B. hominis infections per 100 child-months were higher in Tanzania, Peru, and South Africa when compared with the other study sites. Moreover, in terms of site-specific association, childhood stunting was significantly associated with asymptomatic B. hominis infection in Bangladesh (odds ratio [OR]: 1.62; 95% CI: 1.26–2.08), India (OR: 1.78; 95% CI: 1.46–2.16), Nepal (OR: 2.26; 95% CI: 1.60–3.21), Peru (OR: 1.47; 95% CI: 1.26–1.71), South Africa (OR: 1.57; 95% CI: 1.35–1.83), and Tanzania (OR: 2.46; 95% CI: 2.18–2.79) sites. Wasting was associated with B. hominis in the Brazil site only (OR: 3.19; 95% CI: 1.31–7.77). On the other hand, underweight was associated in the Bangladesh (OR: 1.89; 95% CI: 1.48–2.42), Brazil (OR: 4.41; 95% CI: 1.57–12.4), Nepal (OR: 2.25; 95% CI: 1.52–3.35), and Tanzania (OR: 1.68; 95% CI: 1.42–1.99) sites. Our analysis further reveals that the presence of additional pathogens may play a pathogenic role in children who have B. hominis infection

Proof-of-concept study of the efficacy of a microbiota-directed complementary food formulation (MDCF) for treating moderate acute malnutrition

BACKGROUND: Childhood undernutrition remains a significant global health challenge accounting for over half of all under 5 child mortality. Moderate acute malnutrition (MAM), which leads to wasting [weight-for-length z-scores (WLZ) between - 2 and - 3], affects 33 million children under 5 globally and more than 2 million in Bangladesh alone. We have previously reported that acute malnutrition in this population is associated with gut microbiota immaturity, and in a small, 1-month pre-proof-of-concept (POC) study demonstrated that a microbiota-directed complementary food formulation (MDCF-2) was able to repair this immaturity, promote weight gain and increase plasma biomarkers and mediators of healthy growth. Here we describe the design controlled feeding study that tests whether MDCF-2 exhibits superior efficacy (ponderal growth, host biomarkers of a biological state) than a conventional Ready-to-use Supplementary Food (RUSF) in children with MAM over intervention period of 3 months. METHODS: Two separate cohorts of 12-18-month-old children will be enrolled: 124 with primary MAM, and 124 with MAM after having been treated for severe acute malnutrition (post-SAM MAM). We have established several field sites in an urban slum located in the Mirpur district of Dhaka, Bangladesh and at a rural site, Kurigram in the north of Bangladesh. The two groups of children receiving MDCF-2 and RUSF will be compared at baseline (pre-intervention), after 1 month, at the end of intervention (3 months), 1 month after cessation of intervention, and every 6 months thereafter for 4 years. DISCUSSION: This study will determine whether daily, controlled administration of MDCF-2 for 3 months provides superior improvements in weight gain, microbiota repair, and elevated levels of key plasma biomarkers/mediators of healthy growth compared to the control RUSF formulation. The pathogenesis of MAM is poorly defined and there are currently no WHO-approved treatments; results from the current study of children with primary MAM and post-SAM MAM will shed light on the effects of the gut microbiota on childhood growth/development and will provide a knowledge base that may help improve complementary feeding practices. TRIAL REGISTRATION: The primary MAM and post-SAM MAM trials are registered in Clintrials.gov (NCT04015999 and NCT04015986, registered on July 11, 2019, retrospectively registered)

Campylobacter infection and household factors are associated with childhood growth in urban Bangladesh : an analysis of the MAL-ED study

The dual burden of enteric infection and childhood malnutrition continues to be a global health concern and a leading cause of morbidity and death among children. Campylobacter infection, in particular, is highly prevalent in low- and middle-income countries, including Bangladesh. We examined longitudinal data to evaluate the trajectories of change in child growth, and to identify associations with Campylobacter infection and household factors. The study analyzed data from 265 children participating in the MAL-ED Study in Mirpur, Bangladesh. We applied latent growth curve modelling to evaluate the trajectories of change in children’s height, as measured by length-for-age z-score (LAZ), from age 0–24 months. Asymptomatic and symptomatic Campylobacter infections were included as 3- and 6-month lagged time-varying covariates, while household risk factors were included as time-invariant covariates. Maternal height and birth order were positively associated with LAZ at birth. An inverse association was found between increasing age and LAZ. Campylobacter infection prevalence increased with age, with over 70% of children 18–24 months of age testing positive for infection. In the final model, Campylobacter infection in the preceding 3-month interval was negatively associated with LAZ at 12, 15, and 18 months of age; similarly, infection in the preceding 6-month interval was negatively associated with LAZ at 15, 18, and 21 months of age. Duration of antibiotic use and access to treated drinking water were negatively associated with Campylobacter infection, with the strength of the latter effect increasing with children’s age. Campylobacter infection had a significant negative effect on child’s growth and this effect was most powerful between 12 and 21 months. The treatment of drinking water and increased antibiotic use have a positive indirect effect on linear child growth trajectory, acting via their association with Campylobacter infection

Site-Specific Analysis of the Incidence Rate of Enterotoxigenic \u3ci\u3eEscherichia coli\u3c/i\u3e Infection Elucidates an Association with Childhood Stunting, Wasting, and Being Underweight: A Secondary Analysis of the MAL-ED Birth Cohort

Asymptomatic infection by fecal enteropathogens is a major contributor to childhood malnutrition. Here, we investigated the incidence rate of asymptomatic infection by enterotoxigenic Escherichia coli (ETEC) and assessed its association with childhood stunting, wasting, and being underweight among children under 2 years of age. The Malnutrition and Enteric Disease birth cohort study included 1,715 children who were followed from birth to 24 months of age from eight distinct geographic locations including Bangladesh, Brazil, India, Peru, Tanzania, Pakistan, Nepal, and South Africa. The TaqMan array card assay was used to determine the presence of ETEC in the nondiarrheal stool samples collected from these children. Poisson regression was used to estimate the incidence rate, andmultiple generalized estimating equations with binomial family, logit link function, and exchangeable correlation were used to analyze the association between asymptomatic ETEC infection and anthropometric indicators such as stunting, wasting, and being underweight. The site-specific incidence rates of asymptomatic ETEC infections per 100 child-months were also higher at the study locations in Tanzania (54.81 [95% CI: 52.64, 57.07]) and Bangladesh (46.75 [95% CI: 44.75, 48.83]). In the Bangladesh, India, and Tanzania sites, the composite indicator of anthropometric failure was significantly associated with asymptomatic ETEC infection. Furthermore, a significant association between asymptomatic heat-stable toxin ETEC infections and childhood stunting, wasting, and being underweight was found in only the Bangladesh and Tanzania sites

Nutrition of Children and Women in Bangladesh: Trends and Directions for the Future

Although child and maternal malnutrition has been reduced in Bangladesh, the prevalence of underweight (weight-for-age z-score <-2) among children aged less than five years is still high (41%). Nearly one-third of women are undernourished with body mass index of <18.5 kg/m2. The prevalence of anaemia among young infants, adolescent girls, and pregnant women is still at unacceptable levels. Despite the successes in specific programmes, such as the Expanded Programme on Immunization and vitamin A supplementation, programmes for nutrition interventions are yet to be implemented at scale for reaching the entire population. Given the low annual rate of reduction in child undernutrition of 1.27 percentage points per year, it is unlikely that Bangladesh would be able to achieve the United Nations’ Millennium Development Goal to address undernutrition. This warrants that the policy-makers and programme managers think urgently about the ways to accelerate the progress. The Government, development partners, non-government organizations, and the academia have to work in concert to improve the coverage of basic and effective nutrition interventions, including exclusive breastfeeding, appropriate complementary feeding, supplementation of micronutrients to children, adolescent girls, pregnant and lactating women, management of severe acute malnutrition and deworming, and hygiene interventions, coupled with those that address more structural causes and indirectly improve nutrition. The entire health system needs to be revitalized to overcome the constraints that exist at the levels of policy, governance, and service-delivery, and also for the creation of demand for the services at the household level. In addition, management of nutrition in the aftermath of natural disasters and stabilization of prices of foods should also be prioritized