Augmented reality system for rehabilitation : new approach based on human interaction and biofeedback

University of Technology Sydney. Faculty of Engineering and Information Technology.Rehabilitation is the process of training for someone in order to recover or improve their lost functions caused by neurological deficits. The upper limb rehabilitation system provides relearning of motor skills that are lost due to any neurological injuries via motor rehabilitation training. The process of motor rehabilitation is a form of motor learning via practice or experience. It requires thorough understanding and examination of neural processes involved in producing movement and learning as well as the medical aspects that may affect the central nervous system (CNS) or peripheral nervous system (PNS) in order to develop an effective treatment system. Although there are numerous rehabilitation systems which have been proposed in literatures, a low cost upper limb rehabilitation system that maximizes the functional recovery by stimulating the neural plasticity is not widely available. This is due to lack of motivation during rehabilitation training, lack of real time biofeedback information with complete database, the requirement of one to one attention between physiotherapist and patient, the technique to stimulate human neural plasticity. Therefore, the main objective of this thesis is to develop a novel low cost rehabilitation system that helps recovery not only from loss of physical functions, but also from loss of cognitive functions to fulfill the aforementioned gaps via multimodal technologies such as augmented reality (AR), computer vision and signal processing. In order to fulfill such ambitious objectives, the following contributions have been implemented. Firstly, since improvements in physical functions are targeted, the Rehabilitation system with Biofeedback simulation (RehaBio) is developed. The system enhances user’s motivation via game based therapeutic exercises and biofeedback. For this, AR based therapeutic games are developed to provide eye-hand coordination with inspiration in motivation via immediate audio and visual feedback. All the exercises in RehaBio are developed in a safe training environment for paralyzed patients. In addition to that, real-time biofeedback simulation is developed and integrated to serve in two ways: (1) from the patient’s point of view, the biofeedback simulation motivates the user to execute the movements since it will animate the different muscles in different colors, and (2) from the therapist’s point of view, the muscle simulations and EMG threshold level can be evaluated as patient’s muscle performance throughout the rehabilitation process. Secondly, a new technique that stimulates the human neural plasticity is proposed. This is a virtual human arm (VHA) model that driven by proposed continuous joint angle prediction in real time based on human biological signal, Electromyogram (EMG). The VHA model simulation aims to create the illusion environment in Augmented Reality-based Illusion System (ARIS). Finally, a complete novel upper limb rehabilitation system, Augmented Reality-based Illusion System (ARIS) is developed. The system incorporates some of the developments in RehaBio and real time VHA model to develop the illusion environment. By conducting the rehabilitation training with ARIS, user’s neural plasticity will be stimulated to re-establish the neural pathways and synapses that are able to control mobility. This is achieved via an illusion concept where an illusion scene is created in AR environment to remove the impaired real arm virtually and replace it with VHA model to be perceived as part of the user’s own body. The job of the VHA model in ARIS is when the real arm cannot perform the required task, it will take over the job of the real one and will let the user perceive the sense that the user is still able to perform the reaching movement by their own effort to the destination point. Integration with AR based therapeutic exercises and motivated immediate intrinsic and extrinsic feedback in ARIS leads to serve as a novel upper limb rehabilitation system in a clinical setting. The usability tests and verification process of the proposed systems are conducted and provided with very encouraging results. Furthermore, the developments have been demonstrated to the clinical experts in the rehabilitation field at Port Kembla Hospital. The feedback from the professionals is very positive for both the RehaBio and ARIS systems and they have been recommended to be used in the clinical setting for paralyzed patients

An economic analysis of fish demand and livelihood outcomes of small-scale aquaculture in Myanmar

Given that capture fishery production has either remained stagnant or declined globally, aquaculture has been responsible for the massive growth in the supply of fish to fulfill increasing demand and has also improved livelihoods. The development of the fishery sector, particularly aquaculture, has the potential to contribute to the Sustainable Development Goals (SDGs). New technologies and effective fishery management policies play critical roles in achieving this sectors contribution to the SDGs. Although aquaculture in Myanmar is dominated by large-scale fish farming, a larger number of small-scale aquaculture (SSA) households exist either legally or illegally because profitability and employment opportunities have enticed them to enter the sector. However, the potential of SSA farmers and their challenges are still overlooked. Even though Myanmar is one of the major consumers of fish and producers of aquaculture fish worldwide, to date, a holistic approach that considers the demand and supply side of Myanmars aquaculture sector is rare. The thesis focuses on two main topics. One topic is an analysis of the disaggregated fish demand system. Empirical evidence on whether the aquaculture sector can meet household demand through adequate availability of and accessibility to fish is vital to ensure household food and nutrition security and understand the future of the fish demand. The second main topic focuses on the two aspects of production based on SSA farms; production efficiency and impacts on welfare outcomes from the adoption of sustainable aquaculture (SA) technologies. To fulfill fish demand by increasing the supply of fish from farms, production efficiency of the farmers needs to improve to generate profitable in the face of lower fish prices that will accompany an increase in supply. In addition, traditional aquaculture production practices are risky and are not a long-term option for SSA farmers. Therefore, renewing or modifying productive resources and implementing new technologies may play critical roles in the development of a sustainable SSA sector. The study on the fish demand analysis in Chapter 2 relies on nationally representative data from the "Myanmar Poverty and Living Conditions survey (MPLCS) in 2015,". For the production side analysis in Chapters 3 and 4, primary survey data originate from 440 SSA households collected in three townships in Phyapon District, Ayeyarwady Delta region, Myanmar. Chapter 2 estimates the demand parameters differentiated by fish supply sources (aquaculture, freshwater capture, marine capture, and dried fish) and household groups (wealth group and household location) in Myanmar using a three-stage budgeting framework, combined with a Quadratic Almost Ideal Demand System (QUAIDS). The results reveal that fish demand from all sources of fish and household groups increases with income because fish is the second most crucial food commodity after rice in Myanmar. A substantial share of the increasing demand for all sources of fish is likely to come from poor and rural households with growing incomes due to their higher-income elasticity for all sources of fish. Moreover, less elastic price elasticity of demand in most cases for poor and rural households indicates that those households have less animal protein substitutes for fish available and accessible because fish is the cheapest form of an animal protein source in Myanmar. Due to the income responsiveness of aquaculture fish, its demand will grow faster than that of other fish sources. This study confirms that the rapidly growing aquaculture sector can compensate for the concurrent stagnation of capture fisheries production to fulfill the increase in the fish demand. The studys findings suggest that effective management policies and new technologies are essential to sustain the fish supply from capture fisheries and aquaculture. Intervention programs that sustainably increase aquaculture production will generate the most effective and significant effects on securing households food and nutrition security in the long-run. Chapter 3 analyzes the current technical efficiency level of SSA farms and the link between womens level of participation in decision-making (WPDM) activities and the technical efficiency of fish farming using the two-stage double bootstrap data envelopment analysis (DEA) method. The results show that most SSA farming households are not technically efficient, performing in a range of 45%-60% below the production frontier. All the inputs used contain slacks, such that all of them are over-utilized in inappropriate ratios. This study reveals that while some of the households socio-economic and production characteristics are significant shifters to enhance efficiency of fish farming, decision-making power of women at the household-level is found to significantly improve the level of technical efficiency through its effects on the ability of household members to allocate and organize resources optimally. This study highlights the vital need to promote intervention programs targeted at improving the technical efficiency of SSA farming households. Policies and intervention programs aimed at increasing productivity in the aquaculture sector would benefit by including women empowerment programs to reduce gender inequality and promote equity. Chapter 4 evaluates the determinants and the impacts of SA technologies adoption on SSA households welfare outcomes using the endogenous switching regression (ESR) model. The significant value of the correlation coefficients between the error terms of the adoption decision and the outcome equations, as well as heterogeneity in the outcome variables between adopters and non-adopters, confirm that the ESR model is more appropriate than data pooling in a regression model. The models actual and counterfactual results highlight that the adoption of SA technologies increases the SSA households welfare outcomes, measured by fish yield per ha, Household Dietary Diversity Score (HDDS), and Total Food Consumption Score (TFCS). However, the actual adopters would benefit the most in terms of fish yield per ha and TFCS from adopting SA technologies because the average treatment effects of adoption on adopters are larger than that of non-adopters for these variables. The results highlight that household knowledge about aquaculture production and information sources are main drivers for the adoption decision and improving welfare outcomes. Therefore, appropriate policies targeting SSA development should emphasize the promotion of farmers awareness and adoption of SA technologies by providing improved extension services. This thesis findings contribute to the current debate that the development of the aquaculture sector can help achieve some of the SDGs. In particular, aquaculture can help end hunger through increased food security by making fish more widely available and accessible by increasing the supply of fish. Moreover, aquaculture can improve gender equality and womens empowerment through creating employment opportunities linked to the aquaculture sector. Given the lower technical efficiency level and positive welfare impacts of SA technologies, it is recommended that the government and other development organizations disseminate information on the improved aquaculture practices and suitable input use through improved extension services to SSA farmers. Due to the dominance of a single fish species in the aquaculture sector, the government needs to support research and development programs in the hatchery sector for a new generation of species. Another recommendation is to reformulate the current "Farmland Law 2012" because it puts restrictions on converting agricultural land to fish ponds, which is preventing farmers entering the aquaculture sector legally. The above policy recommendations are crucial to achieve growth in the SSA sector and increase womens intra-household decision-making power, thereby opening the door to improve livelihoods.Während die Fangfischerei weltweit entweder stagniert oder zurück geht, ist es mittels Fischproduktion in Aquakulturen gelungen, die wachsende Nachfrage durch massive Steigerung des Fischangebots zu decken und eine Verbesserung der Lebensbedingungen zu ermöglichen. Die Entwicklung des Fischereisektors, insbesondere der Aquakultur, kann maßgeblich zur Erreichung der Sustainable Development Goals (SDGs, englisch für nachhaltige Entwicklungsziele) beitragen. Wie hoch dieser Beitrag ausfällt, wird von neuen Technologien und Fischereimanagementpolitiken abhängen. In Myanmar sind große Fischfarmen die vorherrschende Form von Aquakultur, doch gibt es auch eine wachsende Anzahl an Haushalten, die wegen der hohen Rentabilität und der Arbeitsplatzsituation sowohl legal als auch illegal Aquakultur in kleinem Maßstab (SSA, englische Abkürzung für small scale aquaculture) betreiben. Potenziale sowie Herausforderungen der SSA-Kleinbauern werden jedoch oft verkannt. Obwohl Myanmar einer der größten Fischkonsumenten und Produzenten von Aquakulturfischen weltweit ist, fehlt ein ganzheitlicher Ansatz, der sowohl die Nachfrage- als auch die Angebotsseite des Aquakultursektors berücksichtigt. Die Arbeit konzentriert sich auf zwei Hauptthemen. Zuerst steht die Analyse des Fischnachfragesystems, disaggregiert nach verschiedenen Kriterien, im Fokus. Empirische Erkenntnisse darüber, ob der Aquakultursektor die Nachfrage der Haushalte durch eine angemessene Verfügbarkeit und Zugänglichkeit von Fisch befriedigen kann, sind entscheidend, um die Ernährungssicherheit der Haushalte zu gewährleisten und die Zukunft der Fischnachfrage zu verstehen. Das zweite Hauptthema konzentriert sich auf zwei Aspekte der Produktion von Fisch in kleinen Aquakulturen: Produktionseffizienz und Wohlfahrtseffekte durch die Einführung von nachhaltigen Aquakulturtechnologien. Um die Fischnachfrage durch ein höheres Angebot von Fisch aus Aquakultur zu befriedigen, muss die Produktionseffizienz von SSA verbessert werden. Nur so können die SSA-Kleinbauern trotz der niedrigeren Fischpreise, die mit einer Erhöhung des Angebots einhergehen, profitabel bleiben. Darüber hinaus sind die traditionellen Produktionsmethoden risikoreich und daher langfristig keine rentable Option für die SSA-Kleinbauern. Deswegen können Erneuerungen oder Modifizierungen von aktuellen Produktionsmitteln sowie die Einführung neuer Technologien eine entscheidende Rolle bei der Entwicklung eines nachhaltigen Aquakultursektors mit SSA-Kleinbauern spielen. Die Studie zur Analyse der Nachfrage nach Fisch in Kapitel 2 stützt sich auf national repräsentative Daten aus der "Myanmar Poverty and Living Conditions survey (MPLCS) in 2015". Für die produktionsseitige Analyse in den Kapiteln 3 und 4 wurden Primärdaten erhoben mittels einer Befragung von 440 Haushalten, die Aquakultur in kleinem Maßstab in drei Gemeinden im Phyapon-Distrikt (Ayeyarwady-Delta-Region, Myanmar) betreiben. Kapitel 2 schätzt die Nachfrageparameter aufgeteilt nach Fischversorgungsquellen (Aquakultur, Süßwasserfang, Meeresfang und Trockenfisch) und Haushaltsgruppen (Wohlstandsgruppe und Haushaltsstandort) in Myanmar unter Verwendung eines dreistufigen Budgeting Frameworks, kombiniert mit einem quadratischen fast idealen Nachfragesystem (QUAIDS, englische Abkürzung für quadratic almost ideal demand system). Die Ergebnisse zeigen, dass die Nachfrage nach Fisch aus allen Fischquellen und Haushaltsgruppen mit dem Einkommen steigt, da Fisch in Myanmar nach Reis das zweitwichtigste Nahrungsmittel ist. Ein wesentlicher Anteil der steigenden Nachfrage nach allen Fischquellen wird wahrscheinlich von armen und ländlichen Haushalten mit steigendem Einkommen kommen. Grund dafür ist deren höhere Einkommenselastizität für Fisch aus allen Produktionsformen. Außerdem deutet die geringere Preiselastizität der Nachfrage in den meisten Fällen für arme und ländliche Haushalte darauf hin, dass diesen Haushalten weniger tierische Eiweißsubstitute für Fisch zur Verfügung stehen, da Fisch die kostengünstigste Form einer tierischen Eiweißquelle in Myanmar ist. Durch diese starke Einkommensabhängigkeit wird erwartet, dass die Nachfrage nach Fisch aus Aquakultur deutlich schneller wachsen wird als die nach anderweitig produziertem Fisch. Diese Studie bestätigt, dass der schnell wachsende Aquakultursektor die gleichzeitige Stagnation des Fischfangs kompensieren und damit die gestiegene Nachfrage decken kann. Die Ergebnisse legen außerdem nahe, dass eine effektive Managementpolitik und neue Technologien notwendig sind, um das Fischangebot aus Fangfischerei und Aquakultur aufrechtzuerhalten. Besonders weitreichende Auswirkungen auf die langfristige Ernährungssicherung werden von Interventionsprogrammen erwartet, die die Aquakulturproduktion nachhaltig steigern. Im dritten Kapitel wird das aktuelle technische Effizienzniveau der SSA-Kleinbauern und der Zusammenhang zwischen demselben und der Beteiligung von Frauen an Entscheidungsprozessen mit Hilfe einer zweistufigen Double-Bootstrap-Data-Envelopment-Analyse Methode analysiert. Die Ergebnisse zeigen, dass die meisten landwirtschaftlichen Haushalte, die kleinere Aquakulturen unterhalten, technisch nicht effizient sind und zwischen 45 % und 60 % unterhalb der Produktionsgrenze arbeiten. Zudem wird deutlich, dass einige der sozioökonomischen und produktionstechnischen Merkmale der Haushalte die Effizienz der Fischzucht signifikant beeinflussen. Auch das Mitspracherecht der Frauen auf Haushaltsebene verbessert signifikant das Niveau der technischen Effizienz, indem Ressourcen optimal verteilt und organisiert werden. Diese Studie unterstreicht die dringende Notwendigkeit, Interventionsprogrammen zu fördern, die auf die Verbesserung der technischen Effizienz von SSA-Kleinbauern abzielen. Strategien und Interventionsprogrammen mit dem Ziel die Produktivität in der Aquakultur zu steigern würden davon profitieren, wenn sie auch die Stärkung der Frauen zum Ziel machen und damit Ungleichheiten zwischen den Geschlechtern verringern. Im vierten Kapitel werden die Determinanten und die Wohlfahrtseffekte auf Haushaltsebene der Einführung von nachhaltigen Aquakulturtechnologien mit Hilfe des endogenen Switching-Regressionsmodells (ESR) bewertet. Dass das ESR-Modell besser geeignet ist als eine gepoolte Regression, wird durch die folgenden zwei Aspekte deutlich; zum einen durch den signifikanten Korrelationskoeffizienten zwischen den Fehlertermen der Entscheidung, die neuen Technologien einzusetzen, und den Ergebnisgleichungen und zum anderen durch die Heterogenität in den Ergebnisvariablen zwischen Haushalten, die die Technologien einsetzen und denen die sich dagegen entscheiden. Die tatsächlichen und kontrafaktischen Ergebnisse des Modells zeigen, dass die Annahme von nachhaltigen Aquakulturtechnologien zu positiven Wohlfahrtseffekten auf alle SSA-Haushalte führt, gemessen am Fischertrag pro ha, dem Household Dietary Diversity Score (englisch für Score für die Ernährungsdiversität eines Haushalts) und dem Total Food Consumption Score (englisch für Score für den gesamten Lebensmittelkonsum eines Haushalts). Die Studie stellt auch heraus, dass das Wissen der Haushalte über Aquakulturproduktion und auch die Informationsquellen einen starken Einfluss auf die Entscheidung für oder wider die neue Technologie haben und auch für die Wohlfahrtseffekte entscheidend sind. Folglich sollten die Förderung des Bewusstseins der SSA-Kleinbauern und die Bereitstellung verbesserter Beratungsdienste fester Bestandteil von Politikstrategien sein, die auf die Entwicklung von Aquakulturen in kleinerem Maßstab abzielen. Die Ergebnisse dieser Arbeit leisten einen Beitrag zur Debatte um die Frage, wie die Entwicklung des Aquakultursektors darauf hinwirken kann, einige der SDGs zu erreichen. Insbesondere kann die Aquakultur die Ernährungssicherung verbessern, indem sie durch erhöhtes Angebot Fisch in größerem Umfang verfügbar und zugänglich macht. Darüber hinaus kann die Aquakultur Geschlechtergleichstellung und die Rolle der Frau durch Schaffung von Beschäftigungsmöglichkeiten, die mit dem Aquakultursektor zusammenhängen, stärken. Akteuren wie der Regierung und Entwicklungsorganisationen wird empfohlen über optimale, angepasste Aquakulturpraktiken und den geeigneten Einsatz von Produktionsmitteln mittels verbesserter Beratungsdienste zu informieren. Da der Aquakultursektor bisher von nur einer Fischart dominiert wird, wird zudem geraten, Forschungs- und Entwicklungsprogramme zum Brüten und Züchten anderer, geeigneter Arten zu unterstützen. Eine weitere Empfehlung ist das aktuelle "Farmland Law 2012" neu zu formulieren, da es aktuell Einschränkungen für die Umwandlung von landwirtschaftlichen Flächen in Fischteiche vorsieht. Das hindert Landwirte daran, legal in den Aquakultursektor einzusteigen. Diese politischen Empfehlungen sind essentiell, um ein Wachstum im SSA-Sektor zu erreichen und das Mitspracherecht von Frauen innerhalb des Haushalts zu erhöhen und damit die Tür zu höheren Lebensstandards zu öffnen

Tobacco smoking among school adolescents in Northern Sabah

Tobacco smoking in adolescent age group has become a major public health concern as it is one of the major risk factors for non-communicable diseases leading to burden of adverse health effects in their later life. Those who start smoking tobacco at an early age are more likely to develop nicotine addiction and continue smoking throughout their adulthood. The general objective of the study was to determine the prevalence of tobacco smoking, their initiation and perception towards tobacco smoking among school adolescents in Kudat District, Sabah State, Malaysia. It was a school based cross sectional descriptive study which employed a two-staged stratified random sampling method and used self-administered structured questionnaire for data collection. A total of 257 students aged between 15 to 19 years old from two upper secondary schools participated in the study. This study revealed that (26.6%) were ever smokers and (8.6%) were current smokers. The earliest age of started smoking was 7 years old and 9 years old among male and female ever smokers respectively. Majority of the respondents perceived that smoking was a bad habit which would cause environmental pollution and harmful effects on health. The most common reasons to start smoking among ever smokers were peer pressures, curiosity and experimenting and to relieve the feeling of pressured and stress. Among the current smokers, 86.4%had ever attempted to quit smoking but they failed to stop smoking because they thought smoking could give feeling pleasure (50%), relieve their anxiety or craving (27.3%) and because of peer pressures (22.7%). The findings suggested that although tobacco smoking prevalence among school adolescents in Kudat was comparatively lower than that of national prevalence reported by GYTS, there is still need for early interventions with holistic approach to prevent them from initiation and to help them for cessation of tobacco smoking

Assessment of Value Chain Management of Sesame in Pwint Phyu Township, Magway Region, Myanmar

Sesame is economically important for producing edible oil and export crops in Myanmar. Empirical research on the sesame value chain is becoming necessary. This study investigated the market performance of 100 sesame stakeholders along the value chain in Myanmar. Interviews with 100 sesame stakeholders along the chain were performed. The results indicated that most of the farmers grew the black sesame (Sahmon Nat) variety because of the higher price and the higher market demand from stakeholders, which increase the marketing margin. Most sesame products flowed to wholesalers and Chinese commission agents in Mandalay, who traded them directly to cross-border exporters to China. Exporters in Yangon traded raw products to Japan and Taiwan and roasted sesame powder to Korea via the Yangon port as normal trade. However, the sesame value chain was very weak in Myanmar because of the unequal marking margin among actors, which was caused by the farmers’ lack of negotiation power with other actors along the chain. Among the discovered constraints, the low quality of product and the lack of advanced facilities and technologies were ranked as the major constraints. Therefore, public and private investments should be raised in this sector not only to overcome the major constraints but also to produce international standard-quality seed. Keywords: key words, Value Chain, sesame, cost, profit and margin, constraints DOI: 10.7176/JESD/10-12-13 Publication date:June 30th 201

An Empirical Study on the Development of Global Mindset Through Learning

This study aims to examine the development of global mindset, which is rarely addressed in a Korean international business journal. We investigate whether the global mindset is a static state that is difficult to change or a dynamically changeable competence. Based on the global mindset literature, we categorize the global mindset into three dimensions - cognition, skills and attitudes - and analyze the nature (static or dynamic) of each dimension. We collect survey questions from 269 undergraduate students. We use paired sample t-tests to analyze whether the undergraduates have changed their global mindsets in terms of cognition, skills and attitudes after taking the international business class during a semester. Results reveal that the levels of cognition and skills have increased after the class, but the attitude level shows no significant difference before and after the class. The results also show that overall global mindsets after the class become higher than before the class. We also find the positive moderating effects of global motivation and international experience on the relationship between the international business class and the global mindset. It means that the effectiveness of international business class on the global mindset is strengthened with the high levels of global motivation and international experience. After the conclusion, we suggest future research topics related to the global mindset which have been rarely addressed in the field of the Korean international business academy

Perceived Barriers to Regular Class Attendance of BCommH Students in University of Community Health, Magway

Education is essential not only for every citizen to survive in dignity but also for nation building. In any education settings, students’ regular class attendance plays a vital role for obtaining good academic achievements. A cross-sectional analytic study was conducted among BCommH students (n=410) of University of Community Health, Magway from October to December 2017 using a mixed method with objectives of exploring their perceived barriers of regular class attendance and possible solutions. Data collected by pretested semi-structured questionnaires were entered into computers and analysed by SPSS software version 18.0 with a significant level of 0.05. Qualitative data were assessed by content analysis. Significant findings related to irregular class attendance were level of previous class [OR = 3.08 (95% CI: 1.6 – 5.91) (p < 0.005)], monthly financial aid from family of MMK 100,000 or more [OR = 2.24 (95% CI: 1.29 – 3.86) (p = 0.003)], travelling pattern to and from campus by other means [OR = 7.76 (95% CI: 2.13 – 28.21) (p < 0.005)] and lunch taking pattern in week days [OR = 1.91 (95% CI: 1.13 – 3.23) (p < 0.025)]. Among the perceived barriers most of students (82.2%) stated illness as a barrier followed by being busy with preparation for examinations (46.4%), getting up late from bed in the morning (41.1%) and lecture room with high indoor temperature (40.5%). In in-depth interviews, students mentioned the reasons of missing classes as weakness in teaching system, their socio-behavioral factors and poor class room conditions. In conclusion the present study unearthed the various perceived barriers and these barriers should be removed by appropriate means including intensive oversight of faculty and staff on the students, reinforced with introduction of time management concepts into curriculum and making teaching learning environment more friendly to and happy for students, leading to more regular attendance among the students finally to achieve their high academic grades

Burden of Stroke in Myanmar

Myanmar is home to over 51 million people. The age- and sex-standardized mortality rate due to stroke is 165.4/100,000, while the rate of age- and sex-standardized disability-adjusted life years lost due to stroke is 2971.3/100,000. The prevalence of stroke among adults aged 40–99 years is 1.5%. Stroke is the leading cause of morbidity and mortality and comprises 20% of the neurological workload. There are only 10 stroke units in the whole country. Doctors are aware of the importance of hypertension in stroke prevention and the need for physiotherapy after stroke, but, until recently and in rural areas, they also tend to use steroids and neuroprotectants, and lower blood pressure aggressively acutely after stroke; antiplatelets are not widely used. Thrombolysis service is available at some tertiary centers but mechanical thrombectomy is not yet available

Future scenarios of fish supply and demand for food and nutrition security in Bangladesh: An analysis with the AsiaFish model

Bangladesh has made significant progress in social and economic development in recent years, but micronutrient deficiencies and poor dietary diversity remain a significant challenge. This paper developed five scenarios to explore futures of fish supply-demand in Bangladesh using the AsiaFish model, with special emphasis on the role of fish in macronutrient and micronutrient supply to address the nation's malnutrition and nutrition security challenges. A business-as-usual (BAU) scenario followed historical trends for exogenous variables used in the model. The four alternative scenarios explored: the implications of increase productivity of farmed tilapia, pangasius and rohu carp (AS1); improvements in the quality of feeds (AS2); disease outbreak in farmed shrimps and prawns (AS3); and climate change impacts (AS4). The BAU scenario indicates that aquaculture growth will be a prominent contribution to increasing total fish supply and demand and fish exports to 2040. Apart from the scenarios that are favourable to aquaculture sector development, other alternative scenarios highlighted the lower growth rate of capture fisheries and aquaculture compared to BAU, resulting in declining in per capita fish consumption, fish exports and nutrient supply from fish as a consequence. Increased availability of aquaculture fish can slightly compensate for the lower growth of capture fisheries in term of their nutrition quality and dietary diversity, particularly for poor consumers. Policies towards sustaining fisheries and a nutrition-sensitive approach to aquaculture is recommended as both capture fisheries and aquaculture are essential for sustaining healthy and nutritious diets in Bangladesh