Tropical quasi-biennial oscillation of the 10mb wind and Indian monsoon rainfall - implications for forecasting.

The fluctuations in the zonal wind anomalies in January at 10mb appear to be highly related to the monsoon rainfall, with rainfall tending to be less (more) than normal during E (W) anomaly, suggesting some predictive value for the Indian monsoon rainfall. The zonal wind anomalies at 10mb lead those at 30mb by 6 months. This lead time is consistent with the well-known downward phase propagation with a speed of 1km/month in the QBO of tropical stratospheric wind. Large-scale flood never occurred during E wind anomalies, and drought almost never during W anomalies in January at 10mb. This suggests that useful probability forecasts of droughts or floods could be prepared

Care-seeking patterns for fatal non-communicable diseases among women of reproductive age in rural northwest Bangladesh

<p>Abstract</p> <p>Background</p> <p>Though non-communicable diseases contribute to an increasing share of the disease burden in South Asia, health systems in most rural communities are ill-equipped to deal with chronic illness. This analysis seeks to describe care-seeking behavior among women of reproductive age who died from fatal non-communicable diseases as recorded in northwest rural Bangladesh between 2001 and 2007.</p> <p>Methods</p> <p>This analysis utilized data from a large population-based cohort trial in northwest rural Bangladesh. To conduct verbal autopsies of women who died while under study surveillance, physicians interviewed family members to elicit the biomedical symptoms that the women experienced as well as a narrative of the events leading to deaths. We performed qualitative textual analysis of verbal autopsy narratives for 250 women of reproductive age who died from non-communicable diseases between 2001 and 2007.</p> <p>Results</p> <p>The majority of women (94%) sought at least one provider for their illnesses. Approximately 71% of women first visited non-certified providers such as village doctors and traditional healers, while 23% first sought care from medically certified providers. After the first point of care, women appeared to switch to medically certified practitioners when treatment from non-certified providers failed to resolve their illness.</p> <p>Conclusions</p> <p>This study suggests that treatment seeking patterns for non-communicable diseases are affected by many of the sociocultural factors that influence care seeking for pregnancy-related illnesses. Families in northwest rural Bangladesh typically delayed seeking treatment from medically certified providers for NCDs due to the cost of services, distance to facilities, established relationships with non-certified providers, and lack of recognition of the severity of illnesses. Most women did not realize initially that they were suffering from a chronic illness. Since women typically reached medically certified providers in advanced stages of disease, they were usually told that treatment was not possible or were referred to higher-level facilities that they could not afford to visit. Women suffering from non-communicable disease in these rural communities need feasible and practical treatment options. Further research and investment in adequate, appropriate care seeking and referral is needed for women of reproductive age suffering from fatal non-communicable diseases in resource-poor settings.</p