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Improved infant and young child feeding ( IYCF) practices have the potential to improve child health and development outcomes in poorly resourced communities. In Bangladesh, approximately 60% of rural girls become mothers before the age of 18, but most interventions to improve IYCF practices target older mothers. We investigated the knowledge, attitudes and perceptions regarding IYCF among adolescent girls and young women aged 15-23 years old in two rural regions in north-west Bangladesh and identified the main points of concordance with, or mismatch to, key international IYCF recommendations. We compared qualitative data collected during interviews and focus groups with participants who were unmarried, married without a child and married with at least one child, and stratified by region. Qualitative indicators of concordance with international recommendations suggest that IYCF knowledge of participants was limited, irrespective of marriage or maternity. Young mothers in our study were no more knowledgeable about feeding practices than their nulliparous peers. Some participants were well aware of an IYCF recommendation (e.g. to exclusively breastfeed for 6 months), but their interpretation of the recommendation deviated from the intended public health message. Notions of insufficient or 'spoiled' breast milk, gender-based biases in feeding intentions and understandings of infant needs, and generational shifts in feeding practices were commonly reported. Conclusions are that female adolescence is a window of opportunity for improving health outcomes among future children, and increased investment in early education of adolescent girls regarding safe IYCF may be an effective strategy to promote and support improved infant feeding practices. [ABSTRACT FROM AUTHOR]

This article draws links between the sense of smell, aesthetic choices concerning clothes, ideas about modernity and the aspirations of young British Bangladeshis. In doing so it highlights the preconscious and conscious factors that inform the identities that British Bangladeshis express. The article argues that despite its importance for our sense of belonging, the sense of smell has been neglected in accounts of identity. This discussion leads to a critique of Bourdieu’s notion of habitus and illustrates the ways in which the conscious elements of habitus draw upon the unconscious. Dispositions towards the smell of Bangladesh feed into ways in which British Bangladeshis express their identities through aesthetic choices and in turn reveal preferences for different discourses of modernity. [ABSTRACT FROM PUBLISHER]

Natural hazards lead to unexpected and often dire situations for people who have few resources and little control over the environment in which they live. Kutubdia, an island in the southeastern part of Bangladesh, experiences frequent natural hazards that impact the livelihoods of its people and put them in vulnerable situations. The research elaborated here is the result of 300 household surveys collected from persons in Kutubdia's fishing communities. The surveys investigated the perception and consequences of natural hazards on the fishing communities. The results indicated that the experience of natural hazards-cyclones, erosion, and flooding are examples-have increased over the years. Coastal erosion displaced seventy-two (24 percent) fishers, forcing them to relocate their houses several times and imposing multiple challenges on their lives. Literacy was not associated with perceptions of environmental changes or changes in fishing. However, young fishers-less than forty years of age-perceived that environmental changes had affected fish catch more than their older colleagues. [ABSTRACT FROM AUTHOR]

On 24th April, 2013, the people of Bangladesh experienced one of the world's most horrific industrial disasters involving the collapse of a nine-story building in Savar, known as the "Rana Plaza Tragedy". One thousand one hundred and twenty five people (1125) died and over 2000 were injured, many of whom were admitted to The Centre for the Rehabilitation of the Paralyzed (CRP)for rehabilitation. Occupational therapists (OTs) were engaged in the rehabilitation of people affected by the tragedy from the initial response through to their discharge and community reintegration. This study has discovered that the majority of persons affected suffered from Post-Traumatic Stress Disorder (PTSD) and the challenges of reintegrating back into the workforce. OTs provided assessments to establish patient's functional ability and investigated opportunities for reintegrating into local communities. To help them to recover from PTSD, OTs provided both physical intervention and psychological rehabilitation by engaging patients in a variety of purposeful and meaningful activities such as; self-care, leisure and vocational training and activities. [ABSTRACT FROM AUTHOR]

Using data from 165 participants in a survey experiment in six Bangladeshi villages, we explored the levels and correlates of women's indeterminate responses to a five-part attitudinal question on intimate partner violence (IPV) against women from the 2007 Bangladesh Demographic and Health Survey. Over 80 % had indeterminate responses to all five parts of the question. Indeterminate responses included silence or initial non-response (53-58 %), misunderstanding the question (30-37 %), and conditional opinions (7-13 %). The percentages of women who justified IPV were lower when indeterminate responses were permitted (7-12 %) than when they were not (37-57 %). Older women (≥26 years) with less schooling (≤2 grades) whose husbands were older (≥36 years), had less schooling (≤8 grades), and were at least 7 years older than the respondent often had higher odds of giving indeterminate responses. Husbands' attributes and spousal age gaps were most consistently associated with women's indeterminate responses. Latent power, or fears of expressing transgressive views, may underlie women's indeterminate responses to attitudinal questions about IPV against women. Recommendations for further research are discussed. [ABSTRACT FROM AUTHOR]

The violation of women's sexual rights is a crucial public health problem, which is often related to the way people view gender and sexuality in a society. This study explores married men's typical views on gender, family, and sexuality in a rural Bangladesh context. Using a qualitative methodological approach, 10 married men were purposively included from a northwest village. The study revealed that married men's views about gender and sexuality are heavily influenced by patriarchal norms. Men think that a wife is the property of her husband and that the wife should obey her husband by giving sex to her husband whenever he wants. Men also think that if women fail to obey their husbands or please them sexually, men are allowed to beat their wives. Interviews explored that the violation of women's sexual rights might be closely related to men's gendered views about women's rights. [ABSTRACT FROM AUTHOR]

Current knowledge about the nature and the degree of support for ecosystem restoration among residents is limited because of a lack of understanding of public attitudes and perceptions toward natural resources. Public perceptions are critical in designing and implementing any ecosystem restoration program. This study explores the relationship between public attitudes and ecosystem restoration, with a specific focus on identifying the role of place attachment in public attitudes. Using the Buriganga River of Dhaka City as a case study, the relationship between residents' attitude towards river ecosystem restoration and the effects of various domains of place attachment on their willingness to engage in its protection and restoration are examined. This study has found that residents' attitudes toward ecosystem restoration do vary with regard to particular measures of proximity to resources, their length of residence in the area and their depth of experience with the place. The findings of this study are useful for targeting education and awareness programs, setting priorities and in shaping policies for restoring degraded waterways. [ABSTRACT FROM AUTHOR]

The negotiation of prejudice among immigrant women has largely been unaddressed in the psychotherapy literature. In an increasingly pluralistic society, such as the United States, it is especially important to address needs of specific subgroups of women who experience racial and ethnic prejudice. Immigrant women are in a unique position to simultaneously encounter prejudice related to multiple aspects of social identity, such as gender, race, and ethnicity, contributing to feelings of marginalization. This article addresses the role of attachment related conflicts in immigrant women's negotiation of racial and ethnic stereotyping and discrimination, from a psychodynamic perspective. Implications of these conflicts for women's identity development are discussed. A clinical case vignette illustrates the complexity of addressing attachment and prejudice within and outside the therapeutic relationship. [ABSTRACT FROM AUTHOR]

People of Bangladeshi origin have the highest mortality ratio from coronary heart disease of any minority ethnic group in UK and their rate of kidney disease is three- to five-fold higher than that of the European UK population. However, there is little information regarding their dietary customs or knowledge, beliefs and attitudes towards health and nutrition. This multi-method qualitative study aimed to identify: (i) barriers and facilitators to dietary sodium restriction; (ii) traditional and current diet in the UK; and (iii) beliefs and attitudes towards development of hypertension, and the role of sodium. Methods included focus group discussions, vignettes and food diaries. Twenty female chronic kidney disease patients attended four focus group discussions and maintained food diaries; ten responded to vignettes during telephone interviews. Triangulation of the results obtained from the three methods identified categories and themes from qualitative thematic analysis. Identified barriers to sodium restriction were deeply-rooted dietary beliefs, attitudes and a culturally-established taste for salt. Facilitators of change included acceptable strategies for cooking with less salt without affecting palatability. Dietary practices were culturally determined but modified by participants' prosperity in the UK relative to their previous impoverished agrarian lifestyles in Bangladesh. Cultural background and orientation were strong determinants of the group's dietary practices and influenced their reception and response to health communication messages. Efforts to understand their cultural mores, interpret and convey health-promotion messages in culturally-appropriate ways met with a positive response. [ABSTRACT FROM AUTHOR]

The Macmillan head and neck nurse specialist in a large teaching trust spearheaded a mouth cancer awareness campaign in the north east of England. The campaign aimed to offer free oral health checks in a number of community settings. Display stands were set up in local shopping centres to target a wide cross-section of the population. Dentists were recruited to carry out oral checks, while the Macmillan nurse specialist and other healthcare professionals provided information to the general public about mouth cancer symptoms and risk factors. Written information was given out to the public. During the week, 357 people were examined resulting in 25 referrals. Feedback from the people who had the free checks was positive and informative, and the campaign was well evaluated. It is hoped that similar annual campaigns will take place in line with the annual national mouth cancer awareness week, which runs from November 14 to 20 this year. [ABSTRACT FROM AUTHOR]

Objective: To explore attitudes to quitting smoking and experience of smoking cessation among Bangladeshi and Pakistani ethnic minority communities. Design: Qualitative study using community participatory methods, purposeful sampling, interviews and focus groups, and a grounded approach to data generation and analysis. Setting: Newcastle upon Tyne, UK, 2000-2002. Participants: 53 men and 20 women aged 18-80 years, including smokers, former smokers, and smokers' relatives, from the Bangladeshi and Pakistani communities; and eight health professionals working with these communities. Results: Motivation to quit was high but most attempts had failed. "Willpower" was the most common approach to quitting. For some, the holy month of Ramadan was used as an incentive, however few had been successful in quitting. Perceived barriers to success included being tempted by others, everyday stresses, and withdrawal symptoms. Few participants had sought advice from health services, or received cessation aids, such as nicotine replacement therapy (NRT) or buproprion. Family doctors were not viewed as accessible sources of advice on quitting. Health professionals and community members identified common barriers to accessing effective smoking cessation, including: language, religion and culture; negative attitudes to services; and lack of time and resources for professionals to develop necessary skills. Conclusions: High levels of motivation do not seem to be matched by effective interventions or successful attempts to quit smoking among Bangladeshi and Pakistani adults in the UK. There is a need to adapt and test effective smoking cessation interventions to make them culturally acceptable to ethnic minority communities. UK tobacco control policies need to give special attention to the needs of ethnic minority groups. [ABSTRACT FROM AUTHOR]

It has sometimes been assumed that religiously based explanations for and attitudes to having a disabled child have led to the low uptake of health and social services by ethnic minority families in the UK. A series of semi-structured interviews were held between 1999 and 2001 with 19 Pakistani and Bangladeshi families with a disabled child as part of an evaluation of an advocacy service. The families’ understandings of the causes of their child's impairment, whether they felt shame and experienced stigma, and whether these factors influenced service uptake and their expectations of their child's future are reported. While religious beliefs did inform the ways in which some families conceptualised their experience, the families’ attitudes were complex and varied. There was little evidence that religious beliefs and associated attitudes rather than institutional racism had resulted in the low levels of service provision which the families experienced prior to the advocacy service. There was also no evidence that the families’ attitudes had been informed by the disability movement. The implications for service providers and the movement are considered. [ABSTRACT FROM AUTHOR]

Sexually transmitted disease (STD) in rural Bangladesh is currently a topic of great concern. To date, little information is available in the literature regarding its prevalence. It is now known, however, that the current level of STD awareness among the rural population with regard to modes of transmission and means of prevention is inadequate. In 1994, the MCH-FP Extension Project (Rural) of ICDDR, B surveyed 8674 married women of reproductive age (MWRA) in 4 rural thanas to examine their awareness of STDs. The association between socio-demographic and programmatic factors (variables which affect STD information availability) and awareness of STDs was examined by both bivariate and multivariate analyses. Seven focus group discussions were conducted among groups of government health and family planning workers and paramedics to assess their knowledge of STDs and attitudes about their prevention. Only 12% of the original group had even a basic understanding about STDs and how to protect themselves from them. Twenty-five per cent of the women surveyed had ever heard of either syphilis or gonorrhoea. Of these women, less than half could mention specific mechanisms involved in the transmission of these diseases. Seven per cent reported that syphilis and gonorrhoea are transmitted through sexual intercourse. Thirteen per cent reported that the infections are transmitted from spouses to their partners. Four per cent reported that STDs can be spread by having multiple sexual partners. The results of logistic regression analysis indicate that awareness of STDs was higher among relatively older women than among younger women. Awareness of STDs was most strongly and positively associated with the education of both the women and their husbands. Awareness of STDs was also found to be higher among women who were more socially mobile (e.g. those who frequent cinemas or mothers' clubs). The findings of focus group discussions indicate that family planning and health care service providers have a moderate level of STD awareness. Modes of transmission and means of prevention, however, were areas of weakness. It will, therefore, be necessary, whether to prevent a potential STD epidemic or to combat current STD prevalence, to implement culturally acceptable and affordable means of disseminating knowledge in rural areas of Bangladesh. Training of health care providers will be an essential first step. [ABSTRACT FROM AUTHOR]

Family planning knowledge, attitude and practice surveys typically assess respondents' reproductive attitudes and intentions to use contraception. Longitudinal observation of individual respondents nevertheless shows that such questions are not strongly predictive of subsequent behaviour. This study examines 3 years' data which show that a set of such responses to questions are nevertheless substantially superior in predicting behaviour than any single indicator. Thus statistical techniques which bring into account the apparent multidimensionality of contraceptive motivation can greatly improve upon the estimation of future practice of family planning in a population. [ABSTRACT FROM PUBLISHER]

Despite worldwide initiatives, the exclusive breastfeeding (EBF) rate is low. The study aims to investigate the role of fathers' knowledge, attitude and support in formulating mothers' practice of breastfeeding taking Bangladeshi parental cases as a sample. The study uses a standard survey instrument following the theory of planned behavior (TPB). Responses from 332 couples are accepted following a standard criteria and used for analysis. The sample is divided into sub-groups based on delivery mode—vaginal (n = 211, 64%) and cesarean section (n = 121, 36%). Based on the sub-groups, a multi-group structural equation modelling (SEM) is applied to analyze the phenomena. The study finds that a father's knowledge in EBF can, in one way, significantly enhance mother's knowledge by sharing and, in another way, can enhance his own attitude to offer different support to his partner/wife which induces the chances of EBF practices by mothers. The enhanced EBF knowledge of a mother raises her attitude to practice EBF, which is also positively affected by the father's attitude. Thus, fathers' support, coupled with mothers' positive attitude, the mother's intention to practice EBF as per standard guidelines. [ABSTRACT FROM AUTHOR]

The use of antibiotics in animals for both therapeutic and non-therapeutic purposes is a major driver of the emergence and spread of antimicrobial resistance (AMR). While several studies have investigated prescription and consumption patterns in humans, little attention has been paid to the veterinary sector. A cross-sectional study was conducted in 3002 veterinary students (VS) and non-medical students (NMS) from 12 universities in Bangladesh to explore their knowledge, attitudes and practices (KAP) about antibiotics and AMR using a self-administered questionnaire, and assess the influence of the veterinary curriculum. KAP regarding antibiotic use and AMR was significantly higher in veterinary than non-medical students, and in first-year than final-year students. However, gaps in knowledge and practices were highlighted, suggesting deficiencies in training. Moreover, final-year veterinary students were found to be more likely than first-year students to use antibiotics without instructions, which could indicate deficiencies in their curriculum. Although the study suggested a positive impact of the veterinary curriculum on KAP about antibiotics and AMR in Bangladesh, critical gaps remain that are likely to contribute to inadequate use in their future practice. Therefore, there is scope for improving educational programs on AMR in professional curricula. [ABSTRACT FROM AUTHOR]

Background: The pharmaceutical market in Bangladesh is highly concentrated (top ten control around 70 % of the market). Due to high competition aggressive marketing strategies are adopted for greater market share, which sometimes cross limit. There is lack of data on this aspect in Bangladesh. This exploratory study aimed to fill this gap by investigating current promotional practices of the pharmaceutical companies including the role of their medical representatives (MR).Methods: This qualitative study was conducted as part of a larger study to explore the status of governance in health sector in 2009. Data were collected from Dhaka, Chittagong and Bogra districts through in-depth interview (healthcare providers and MRs), observation (physician-MR interaction), and round table discussion (chief executives and top management of the pharmaceutical companies).Results: Findings reveal a highly structured system geared to generate prescriptions and ensure market share instituted by the pharmaceuticals. A comprehensive training curriculum for the MRs prepares the newly recruited science graduates for generating enough prescriptions by catering to the identified needs and demands of the physicians expressed or otherwise, and thus grab higher market-share for the companies they represent. Approaches such as inducements, persuasion, emotional blackmail, serving family members, etc. are used. The type, quantity and quality of inducements offered to the physicians depend upon his/her capacity to produce prescriptions. The popular physicians are cultivated meticulously by the MRs to establish brand loyalty and fulfill individual and company targets. The physicians, willingly or unwillingly, become part of the system with few exceptions. Neither the regulatory authority nor the professional or consumer rights bodies has any role to control or ractify the process.Conclusions: The aggressive marketing of the pharmaceutical companies compel their MRs, programmed to maximize market share, to adopt unethical means if and when necessary. When medicines are prescribed and dispensed more for financial interests than for needs of the patients, it reflects system's failed ability to hold individuals and entities accountable for adhering to basic professional ethics, code of conduct, and statutory laws. [ABSTRACT FROM AUTHOR]