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Background: Telehealth services are essential to expand healthcare coverage for all in the era of modern technology. Knowledge, willingness, and involvement with the service are also significantly important in the utilization of the service. This study investigated factors associated with knowledge, perceived benefits, perceived concerns, and predisposition to use telehealth services in Bangladesh. This web-based survey was conducted among 1266 adults in Bangladesh. Respondents were enrolled by following a convenience sampling technique. Results: Demographic, telehealth service, and perceived health related information were significantly associated with respondents' knowledge, perceived benefits, perceived concerns, and predispositions. The knowledge was significantly positively correlated with the perceived benefit (p <0.05) and predisposition of telehealth (p <0.05). Albeit, knowledge was significantly negatively correlated with perceived concerns of telehealth (p <0.05). Conclusion: The findings of the study may assist policymakers in implementing telehealth services by addressing the associated factors of knowledge, perceived benefits, perceived concerns, and predispositions. [ABSTRACT FROM AUTHOR]

Switching from traditional to online learning during the COVID-19 pandemic bore the associated opportunities and challenges. The study presents the clout of Perception, Emotion, Attitude, Teacher-Student, and Peer interaction on Learner Satisfaction (LS) partially mediated by motivation among business management students of Russia, India, and Bangladesh. The psychological framework used in the study, followed by Structural Equation Modelling, displayed a significant association between all exogenous and endogenous variables. The responses from the 1008 students during the pandemic corroborate two critical learning theories, i.e. Social Constructivism and Media Richness Theory, by confirming a significant and positive relationship between attitude and motivation. The learners' perception of the content and administration is pivotal for LS. Whereas peer learning was an important aspect in Russia and India, assisted learning was preferred by the students of Bangladesh. [ABSTRACT FROM AUTHOR]

Solar irrigation pumps (SIPs) are emerging as a popular technology to address water, energy, and climate change challenges in South Asia while enhancing livelihoods and food security. SIPs are deemed to be a women-friendly renewable energy technology (RET) due to their design, operating system, and safety. While the gender dimensions of natural resources are well documented, the extent to which the water, energy, and food (WEF) policies--including policies to promote SIP technologies in the countries of South Asia--conceptualize and operationalize gender equality and social inclusion (GESI) is not well understood. Therefore, in this study, we reviewed 39 WEF sectoral policies of Bangladesh and Nepal by adopting a gender-transformative analysis approach to rank the policies on a continuum ranging from a scale of 0-3 (denoting gender-unaware, gender-aware, gender-responsive, and gendertransformative). We found that the governments in both countries commit to gender equality and women's advancement in their WEF sector policies, institutions, and decision-making by ensuring gender and justice principles in their constitutions and national development frameworks. However, these higher-level aspirational principles are not always operationalized in the WEF sector policies. We found that the WEF policies are aware of the need to include GESI and social equity in sectoral programming, yet operational rules for their implementation often fail to challenge structural barriers. Such barriers hinder women and marginalized groups from participating in and benefiting from WEF policies, including the deployment of SIP technologies. This calls for a transformation not only in project implementation but also in the policymaking processes of WEF sectors in the South Asian region. [ABSTRACT FROM AUTHOR]

The increasing population and plateaued capture fishery landings have led to increasing demand for aquaculture products. However, environmental challenges are critical barriers to the sustainable development of aquaculture in developing countries. This review critically evaluates the environmental barriers facing aquaculture development in Bangladesh while laying out a roadmap for future development and spatial planning. An increase in the area used for aquaculture most often results in increasing pressure on natural resources such as land, water, energy, and the sources used for feed. Some of the negative externalities that this review focuses on are effluent discharge, the spread of diseases, and conflicts over land use with other ecosystem users. A way forward is to internalize these negative externalities and their costs into production decisions by farmers. Formulation of incentive-based pragmatic regulations can pave a forward path to increased environmental sustainability. [ABSTRACT FROM AUTHOR]

The Intergovernmental Panel on Climate Change (IPCC) 6th Assessment Report (AR6) forecasts a sea level rise (SLR) of up to 2 m by 2100, which poses significant risks to regional geomorphology. As a country with a rapidly developing economy and substantial population, Bangladesh confronts unique challenges due to its extensive floodplains and 720 km-long Bay of Bengal coastline. This study uses nighttime light data to investigate the demographic repercussions and potential disruptions to economic clusters arising from land inundation attributable to SLR in the Bay of Bengal. By using geographical information system (GIS)-based bathtub modeling, this research scrutinizes potential risk zones under three selected shared socioeconomic pathway (SSP) scenarios. The analysis anticipates that between 0.8 and 2.8 thousand km2 of land may be inundated according to the present elevation profile, affecting 0.5–2.8 million people in Bangladesh by 2150. Moreover, artificial neural network (ANN)-based cellular automata modeling is used to determine economic clusters at risk from SLR impacts. These findings emphasize the urgency for land planners to incorporate modeling and sea inundation projections to tackle the inherent uncertainty in SLR estimations and devise effective coastal flooding mitigation strategies. This study provides valuable insights for policy development and long-term planning in coastal regions, especially for areas with a limited availability of relevant data. [ABSTRACT FROM AUTHOR]

Unrestrained utilization of plastic has reached an intemperate state, menacing environment and human lives. The preliminary focus of this research was to investigate and divulge the contemporary status of microplastics (MPs) in commercialized and open pan salts from Cox's Bazar and Maheshkhali channels. A total of 27 samples were obtained. The samples were analyzed for the prevalence of MPs by FTIR and Raman spectroscopy (RS); the prevailing amount, color, size, and shapes were analyzed by stereomicroscope and SEM. The abundance of high‐density polyethylene, polyethylene terephthalate (PET), and low‐density polyethylene (LDPE) were detected by FTIR, meanwhile exuberance of cellulose acetate, polypropylene, PET, LDPE, and Nylon 6 were identified by RS. The average quantifications of MPs in Cox's Bazar, Maheshkhali, and packaged salts were found to be 6851.11 ± 538.18, 5638.89 ± 1001.18, and 3405.56 ± 638.57 per kg, respectively. ANOVA resulted in highly significant association between MPs and sampling sites (p =.001*). Post hoc Tukey's test revealed prominent link between commercialized and open pan salts based on the amount of MPs (p =.001*). The most prevalent colors were purple (28%) and blue (27%). The most frequent shapes were fibrous (79%) and fragmented (19.9%) MPs. The smallest MP was detected in commercial salt (1.55 μm), nearly identical and closer to the size of nanoplastics. [ABSTRACT FROM AUTHOR]

This study investigates the effects of COVID‐19 on fish consumption and nutrition intake based on a random survey of 247 fish consumers in Bangladesh. The Propensity Score Matching technique is used to compare fish consumption and fish‐sourced nutrition intake between two groups of consumers before and during COVID‐19. The result shows that 38% overall reduction in fish consumption for the low‐income group compared to lower‐middle, upper‐middle‐ and high‐income groups. Furthermore, per capita consumption of culture and capture fish species decreased significantly for low‐income, lower‐middle‐income, and upper‐middle‐income groups of consumers. It indicates that nutrition and mineral intake have reduced sharply as well Higher energy and K reduction are observed for Pangasius hypophthalmus among different culture fish species while energy and Ca reduction were higher for Wallago attu and Mystus vittatus respectively. Therefore, the government might place a greater emphasis on excluding the food supply chain from lockdown restrictions during a COVID‐19‐like pandemic. [ABSTRACT FROM AUTHOR]

Background: Considering the high frequency of respiratory infections among children in low- and middle-income countries (LMICs), the World Health Organization (WHO) developed a pragmatic guideline for managing pneumonia in low-resource settings. The guideline's low specificity leads to many false-positive pneumonia cases receiving antibiotic treatment. Integrating diagnostic technology to incorporate lung sounds into WHO guidelines could improve childhood pneumonia diagnosis and management. This qualitative study aimed to explore the acceptability of a prototype digital stethoscope device among potential end-users in Bangladesh. Methods: We conducted four focus group discussions (FGDs) with beneficiaries and service providers who used a 2018 digital stethoscope prototype. The data collection was conducted in November 2020. The study was carried out at Zakiganj Upazila (sub-district) of Sylhet district of Bangladesh. A total of 34 respondents, including parents of under-5 children, Community Health Care Providers (CHCPs), and community leaders were enrolled. Two researchers (TJ and a research assistant (not a co-author of this manuscript) conducted the FGDs. Verbatim transcripts were prepared, and translations were completed. Coding was executed in Microsoft Excel, and relevant quotes were extracted to ascertain the emerging themes. To ensure validity, two researchers coded the dataset independently and inconsistencies were resolved through discussion. Findings: Mothers were more aware of the digital stethoscope than fathers. Except for the female community leaders, male leaders were unaware of the stethoscopes. Most CHCPs had positive perceptions of the digital stethoscope. They appreciated stethoscope training as they learned about new technology and diagnostic approaches. The users mentioned several technical shortcomings of the prototype device. A few stakeholders expressed dissatisfaction with the level of community involvement and information sharing from the study. The use of the device plummeted during the COVID-19 pandemic for fear of infection, to counteract which the CHCPs cleaned the device with chlorhexidine after every application as a precaution. Conclusion: Overall, device use was supported by stakeholders despite perceptions that the prototype had some technological limitations, community engagement was suboptimal, and the COVID-19 pandemic caused disruptions. Stronger community engagement, addressing technological issues, and further research on its health systems application would improve the acceptability and effective use of the digital stethoscope. [ABSTRACT FROM AUTHOR]

Optimal infant and young child feeding (IYCF) and nurturing care during the first years of children's lives are crucial for ensuring their growth and development. The IYCF and nurturing practices are associated with a multifaceted interplay of context‐specific factors where fathers' involvement is necessary. The aim of this study is to explore the current scenario of fathers' involvement in IYCF practices in the urban slums of Bangladesh. A cross‐sectional survey among the residents of the Sat Tola slum in Dhaka, the capital of Bangladesh was conducted. To avoid social desirability bias, 361 mothers of children aged <24 months were interviewed regarding fathers' involvement. An operational definition of father's involvement was developed based on 11 criteria and then scoring was applied to classify 'Good Involvement' and associated factors were identified using multivariable logistic regression. Fathers' mean age was around 31 (SD ± 6.09) years and the majority of them (44.32%) completed primary education. Fathers had diversified occupations such as day laborer (32.41%), garment worker (22.71%), and business (14.96%). Factors that were significantly associated with the father's involvement in IYCF practices include educational status (aOR = 3.98, 95% CI = 1.91, 8.26, p <.00) and theiroccupational status (aOR = 0.34, 95% CI = 0.16, 0.70, p =.00). Fathers were more active for their first child (aOR: 1.99, 95% CI = 1.04, 3.79, p =.03). Having child in the age group of 14–20 months (aOR = 2.73, 95% CI = 1.32, 5.64, p = <.01) and wife in the age group of 21–30 years (aOR = 2.34, 95% CI = 1.20, 4.58, p =.01) were significantly associated. The study finding explored that fathers' education and occupation as well as mothers' age and education were significantly associated factors for fathers' involvement in the IYCF practices. Further longitudinal studies are recommended to establish the causal relationship between fathers' involvement with IYCF and their impact on child growth and development. [ABSTRACT FROM AUTHOR]

Intensive pond aquaculture production is increasing and playing a major role in global aquaculture production, especially in developing countries. Empirical evidence shows that the access to and exchange of fresh water in tilapia pond aquaculture is important for making pond production ecologically more sound, efficient and productive. This study investigates productivity and efficiency differences between farms with access to open water resources and farms without access using data obtained from 311 interviews with tilapia farmers in Bangladesh. Propensity Score Matching (PSM) and meta-frontier DEA have been employed to estimate productivity and efficiency differences between the groups. Results show that farms located in areas with access to open water resources are significantly more efficient, but a bit surprisingly less productive than farms located in areas with deficit access to water resources. Furthermore, output could be increased by 29% and 40% without increasing input in areas with good access and limited access to water, respectively. Thus, promoting intensive aquaculture pond production in areas with access to water resources should focus on how to increase productivity, while areas with limited access should focus on optimal use of input in order to improve water quality and efficiency. [ABSTRACT FROM AUTHOR]

A 32‐year‐old male case with short stature presented to us with audio‐visual impairment, obesity, impaired glucose tolerance, dyslipidemia, and hypogonadism. The single‐gene genetic analysis revealed an ALMS1 gene mutation. A diagnosis of ALMS was reached for meeting one major and four minor criteria. [ABSTRACT FROM AUTHOR]

The consequence of good diabetic treatment depends on the patient's commitment to a large degree. Noncompliance leads to inadequacy of metabolic control, which strengthens the advancement and speeds up diabetic complications. The study's main goal was to assess the treatment noncompliance level among patients with type-2 diabetes mellitus (T2DM) in Bangladesh. This descriptive cross-sectional study was conducted at Medical Center Hospital, Chattogram, Bangladesh. The study included two hundred and fifty-nine patients with T2DM. Data regarding sociodemographic factors, patient's characteristics, medication factors, physician-related factors, and noncompliance were collected using a pretested and structured questionnaire. Treatment adherence was assessed by Morisky Medication Adherence Scales (MMAS-8). Data analyses were conducted on SPSS v23.0 Software. The majority of the participants (56%) were in the 40–45 years of age group, followed by 32% in the older age group (≥60 years), and 62.5% of them were male. One hundred and sixty-eight (64.86%) patients were considered low adherent as per the response of the MMAS-8 scale (score <6), followed by 57 (22.0%) patients were regarded as high adherent (score 8) and 34 (13.13%) patients were considered medium adherent (score 6–7) to treatment. Observing the frequency distribution for noncompliance, financial concerns (32.3%), forgetfulness (27.7%), a busy daily schedule (17.7%), and fear of antihyperglycemic drug side effects were all identified as significant explanations. On multivariate analysis, participants aged 60 years or more, monthly family incomes of <30,000BDT or 30,000–50,000 BDT, smoking, and uncontrolled glycemic status showed higher chances of noncompliance than their counterparts. Patient counseling and awareness programs may enhance treatment adherence among people with T2DM. Our findings will help physicians and public health workers to develop targeted strategies to increase awareness of the same among their patients. [ABSTRACT FROM AUTHOR]

Introduction: Each year, antibiotics save hundreds of thousands of lives; nonetheless, antibiotic self-administration is a major concern all over the world. This study aimed to investigate the prevalence of antibiotic self-administration among two-month adult antibiotic users as well as the factors contributing to this prevalence. Method and Participants: This cross-sectional study was conducted among 295 Bangladeshi adults between May 22nd and June 15th, 2021, during the COVID-19 pandemic. Descriptive statistics included frequency distribution, while inferential statistics included the Pearson chi-square test. For data analysis, the statistical software STATA-16 was used. Results: In this study, the prevalence of antibiotic self-administration was 17.97%. Antibiotic self-administration was found to be significantly more prevalent among those who were unable to take antibiotic on time, incomplete doses, did not know over prescriptions may cause antibiotic resistance, and could not correctly recognize amoxicillin and azithromycin are antibiotics. Conclusion: Due to the increased rate of antibiotic self-administration among adults in Bangladesh, the responsible authority should give more attention towards the factors responsible for antibiotic self-administration and revise their current policy to ensure the safe and effective use of antibiotics. [ABSTRACT FROM AUTHOR]

The impact of climate change on crop production is a cause for concern worldwide. Indigenous knowledge and adaptation approaches can help the farmers and relevant stakeholders cope with the devastating effects of climate change. Hence, this study reviews the crop farmers' discernments of climate change and recognizes key adaptation options, factors that impact their decisions and various barriers they face, through interviews with crop farmers in northwest Bangladesh. The study found that the main indigenous coping strategies recognized were toggling the different crops, shifting application of fertilizer and insecticide, and changing the pattern of the irrigation process. Inadequate accessibility to information on the climate parameters, poor knowledge of proper coping options, and inadequate value of crop production were the foremost barriers. The study recommends intensification of research on agricultural diversification and conservatory services to the crop farmers, together with training, information dissemination, and proper supply of seeds and fertilizers, to formulate effective indigenous and sustainable adaptation strategies to climate change. [ABSTRACT FROM AUTHOR]

This study examines the impact of land tenure systems on aquaculture farm productivity, efficiency, and profitability based on information obtained from interviews with 517 randomly selected aquaculture farms across Bangladesh. Propensity score matching (PSM) is used to estimate productivity variation, and the stochastic frontier production function (SFPF) is employed to analyze efficiency variation depending on aquaculture farms' land ownership. The results reveal that the productivity and efficiency of cash tenant farms are significantly higher than those of self-owned farms, but that the land-owner extracts most of the associated profits through the rent. Furthermore, the efficiency of self-owned farms decreases with farm size, while the opposite is true for cash tenant farms. [ABSTRACT FROM AUTHOR]

Background Infant and young child feeding (IYCF) practices directly impact the health of <2-y-old children. Minimum dietary diversity (MDD) is an IYCF indicator to assess feeding practices of children aged 6–23 mo. The definition of MDD has recently been updated by the WHO and UNICEF, substituting "≥4 out of 7 food groups" (MDD-7FG) with "≥5 out of 8 food groups" (MDD-8FG). Objectives The goals of this study were to estimate the prevalence of IYCF indicators and identify the implications of the change in the prevalence of MDD at the national and regional levels of Bangladesh. Methods This study used data from the National Food Security and Nutrition Surveillance 2018–2019 round. A total of 1992 children aged 0–23 mo were included in this analysis. IYCF indicators and MDD were calculated according to the WHO-UNICEF guidelines. The difference between the prevalence of MDD-7FG and MDD-8FG is presented as percentage points. Results The prevalence of early initiation of breastfeeding was 43.8%, and exclusive breastfeeding was 56.2%. Approximately 55% of children maintained MDD (MDD-7FG), 48% received minimum meal frequency, and 28% received a minimum acceptable diet. Compared with MDD-7FG, the prevalence of MDD-8FG was lower among 6–23-mo-old children. The difference between MDD prevalence (MDD-8FG vs. MDD-7FG) was high for boys (44.0% vs. 53.2%), children aged 12–23 mo (53.4% vs. 63.4%), in urban areas (30.2% vs. 42.4%), in the Dhaka administrative division (42.0% vs. 56.3%), among uneducated mothers (37.1% vs. 47.1%), in households with ≤4 members (44.3% vs. 55%), and for middle-class households (40.3% vs. 57.6%). Conclusions The new method led to a decrease in the prevalence of MDD in Bangladesh. As the country prepares to implement the new indicator, it is critical to disseminate the new knowledge and its positive implication for improved child feeding and nutrition. [ABSTRACT FROM AUTHOR]

Over the last three decades, aquaculture production and technologies for culture system upgradation have become a revolutionary development in Bangladesh, especially in the coastal areas. The study was conducted to assess aquaculture development along with sustainable value chain for aquaculture business purposes in the southern coast of Bangladesh. The authors found that small-scale aquaculture and inland fisheries sector in the study areas is facing some environmental, technological and socioeconomic challenges that may lead to production failures and make it unstable in the near future. Additionally, farmraised fish quality and their safety for human consumption are becoming a serious concern to local and international food markets. These challenges could have severe impacts on earnings and the rural economy of the southern coast of Bangladesh. To overcome the challenges, sustainable and environment-friendly aquaculture practices are required to be taken up to maximize environmental and economic sustainability and reduce the likelihood of outbreak of diseases in the aquaculture farms. However, adopting Good Aquaculture Practices (GAPs) requires a combination of strategies and policies. A top-down and bottomup holistic approach to aquaculture planning and management may help to sustain this sector. [ABSTRACT FROM AUTHOR]

Background. Eyelid tumours are common in our ophthalmic practice. Malignancy cases account only for one-fourth of all eyelid tumours. The most aggressive eyelid malignancy is sebaceous gland carcinoma, but its occurrences are rare in western countries. We found sebaceous gland carcinoma is as common as basal cell carcinoma in our clinical practices. Hence, it is essential to build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Aim. To assess the relative frequency of eyelid malignancies in the Bangladesh population, state their clinical features and outcome of management strategies and build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Methods. This was a retrospective case series study of 332 patients in Bangladesh. This study analyzed all the recorded data of the histologically proven primary eyelid malignancies and followed them up for at least six months from 2014 to 2019 (6 years). All patients were managed by surgical excision with tumor-free margins verified on histopathology, either the frozen section or excision biopsy with 2–3 mm microscopic view of normal tissue followed by eyelid reconstruction. Computer-based statistical software SPSS was used for the analysis, and an appropriate test of significance (chi-square) was used for the statistical analysis. Results. Sebaceous gland carcinoma (SGC) was the highest in occurrence, at 42%, followed by 38% basal cell carcinoma (BCC), 18% squamous cell carcinoma (SqCC), and 02% malignant melanoma (MM). The mean age at presentation of SGC, BCC, SqCC, and MM were 57.41 years, 62.56 years, 64.73 years, and 59.28 years, respectively. Female (59%) was slightly more preponderance over the male (41%) for SGC than other malignancies. Pigmentation was associated with malignant melanoma (100%) and BCC (81%). Statistically, a significant difference was found between eyelid malignancies, including location, size, pigmentation, recurrence, and invasiveness. The recurrence rate was low lower in the patients who underwent frozen section biopsy (3%) for margin clearance than those who underwent excision biopsy (21.5%) in the follow-up time. Conjunctival map biopsy (8%) was performed as an essential tool for excluding the pagetoid spread of SGC. A new reconstruction method named triangular-shaped musculocutaneous tail flap was performed in 33 (11%) patients to reconstruct the moderate eyelid defect following local resection. Conclusion. Sebaceous gland carcinoma (SGC) was the highest occurrence found to be the highest occurrence among all eyelid malignancies in Bangladesh. SGC is more aggressive and the recurrence rate was higher than BCC and SqCC. [ABSTRACT FROM AUTHOR]

Background: Mucormycosis, a severe fungal infection, is an emerging public health concern during the COVID-19 pandemic. This study aimed to investigate the perception of mucormycosis among Bangladeshi healthcare workers. Results: An exploratory cross-sectional study was carried out among the Bangladeshi healthcare workers from May 25, 2021, to June 5, 2021. The study found 422 responses from the healthcare workers of Bangladesh. Among the respondents, nearly half of them (45.26%) were doctors (n = 191). This study explored that the healthcare workers' mucormycosis perception scores were significantly associated with their age, gender, profession, monthly income, marital status, job type, and death of friends and family members due to COVID-19. Conclusions: This study emphasized the healthcare workers' mucormycosis perception along with other associated factors. The findings could help policymakers to mitigate mucormycosis and related infectious diseases emergencies in the post-COVID-19 situation. [ABSTRACT FROM AUTHOR]

Low-income countries (LICs) and lower-middle-income countries (LMICs) are still deprived of the optimum doses of coronavirus disease 2019 (COVID-19) vaccines for their population, equal access and distribution, as well as mass immunization roadmaps to be implemented for achieving herd immunity and protection from the ongoing pandemic. In this short report, we are interacting with the world public health experts, as well as national and global leaders for warranting the mass vaccination drive to be more progressive against COVID-19 with equitable access of vaccines to LICs or LMICs to save the lives of the poorest country people and refugees. From several scientific databases, such as Google Scholar, PubMed, as well as national and international news websites, the data were collected data by utilizing appropriate keywords regarding the topic. Bangladesh might be exemplified in this brief communication as the representative of LMIC. As of October 14, 2021, 48% of the world's people have received at least one dose of the COVID-19 vaccine. In contrast, only 2.5% of people from LICs have come in under COVID-19 vaccination for at least a single shot. Both LICs and LMICs need far more vision and ambition, including political, administrative, and diplomatic progress along with enhancing the vaccination drive for their population to be immunized through simultaneous mass vaccination progress of other countries with implementing public health safety measures against the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the earnings management practices of the listed manufacturing firms in Bangladesh and assess the impact of corporate governance mechanisms on such earnings management behavior. Design/methodology/approach: The study applies the real earnings management (REM) model developed by Dechow et al. (1998) and implemented by Roychowdhury (2006) and modified Jones model (1991) for the proxy of accrual-based earnings management (AEM). It uses a pooled ordinary least square regression model corrected with robust standard errors for empirical analysis. Findings: The study finds that firms with small positive earnings per share are engaged in AEM to avoid losses. Also, firm managers craft discretionary expenses to manage real earnings. For governance factors, the institutional shareholders tend to play a significant role in limiting both REM and AEM embedded in generally accepted accounting principles or International Financial Reporting Standards. Also, factors such as foreign ownership and board size significantly restrict REM, whereas director ownership encourages the same. The paper does not reveal any significant monitoring role for other governance factors in curbing either REM or AEM practices by Bangladeshi firms. Research limitations/implications: The paper studies the monitoring role of governance mechanisms on listed manufacturing firms' earnings management. A study of separating the listed firms into family and non-family ones could be interesting for future research. Practical implications: The paper unveils earning management techniques used by firms in Bangladesh and provides critical policy implications to the corporate governance mechanisms that effectively limit earnings management practice. Social implications: The social significance is to aware constituents of financial reporting about the earnings management behavior by firms in emerging economies. Originality/value: The study adds to evidence that the manufacturing firms in Bangladesh adopt both REM and AEM techniques to avoid losses. Simultaneously, the paper highlights some critical governance factors that can restrict misleading earnings management behavior by firms in an emerging economy to assist in policymaking. [ABSTRACT FROM AUTHOR]

Background: E-learning is a relatively trending system of education that has been placed over conventional campus-based learning worldwide, especially since the emergence of the COVID-19 pandemic. This study aimed to assess e-learning readiness among university students of a developing country like Bangladesh and identify the independent predictors of e-learning readiness. Methods: From 26 December 2020 to 11 January 2021, a total of 1162 university students who had enrolled for e-learning completed a semi-structured questionnaire. Data were collected online via "Google Form" following the principles of snowball sampling through available social media platforms in Bangladesh. A multivariable linear regression model was fitted to investigate the association of e-learning readiness with perceived e-learning stress and other independent predictor variables. Results: A total of 1162 university students participated in this study. The results indicated that with the increase of students' perceived e-learning stress score, the average e-learning readiness score was significantly decreased (β = -0.43, 95% CI: -0.66, -0.20). The students did not seem ready, and none of the e-learning readiness scale items reached the highest mean score (5.0). The age, gender, divisional residence, preference of students and their parents, devices used, and having any eye problems were significantly associated with the students' e-learning readiness. Conclusion: During the prolonged period of the COVID-19 pandemic, e-learning implication strategies are needed to be assessed systematically with the level of readiness and its' impacts among students for the continuation of sound e-learning systems. The study findings recommend evaluating the e-learning readiness of university students and the mental health outcomes during the COVID-19 catastrophe in Bangladesh. [ABSTRACT FROM AUTHOR]

Amid growing debate between scientists and policymakers on the trade-off between public safety and reviving economy during the COVID-19 pandemic, the government of Bangladesh decided to relax the countrywide lockdown restrictions from the beginning of June 2020. Instead, the Ministry of Public Affairs officials have declared some parts of the capital city and a few other districts as red zones or high-risk areas based on the number of people infected in the late June 2020. Nonetheless, the COVID-19 infection rate had been increasing in almost every other part of the country. Ironically, rather than ensuring rapid tests and isolation of COVID-19 patients, from the beginning of July 2020, the Directorate General of Health Services restrained the maximum number of tests per laboratory. Thus, the health experts have raised the question of whether the government is heading toward achieving herd immunity instead of containing the COVID-19 pandemic. In this paper, the dynamics of the pandemic due to SARS-CoV-2 in Bangladesh is analyzed with integrated the Unscented Kalman Filter (UKF) in the SIRD model. We demonstrate that the herd immunity threshold can be reduced to 31% than that of 60% by considering age group cluster analysis resulting in a total of 53.0 million susceptible populations. With the data of COVID-19 cases till January, 2021, the time-varying reproduction numbers are used to explain the nature of the pandemic. Based on the estimations of active, severe and critical cases, we discuss a set of policy recommendations to improve the current pandemic control methods in Bangladesh. [ABSTRACT FROM AUTHOR]

Financial institutions can make a significant contribution to sustainable economic development. Characterized as "green banking," banks can foster environmentally friendly practices as well as socially responsible business practices. This study explores the adoption pattern of various green banking activities by different types of banks in Bangladesh between 2014 and 2019, and the extent of banks' contribution to achieving sustainable development in the country. The secondary data used in the study reveals that many commercial banks (private and foreign) have been practicing green banking since 2014 and have instituted green financing policies that are environmentally friendly and sustainable. However, the state-owned commercial and specialized development banks have been more reluctant to adopt green banking practices. The study proposes a framework for adopting green banking practices that will contribute to attaining the Sustainable Development Goals (SDGs), along with policy changes to align banking operations with the SDGs. [ABSTRACT FROM AUTHOR]

Background: Neuropsychiatric systemic lupus erythematosus (NPSLE) is well known for its varying presentations and poor outcomes, but little is evident about its distribution and characteristics among the Bangladeshi population. This study aimed to assess the pattern and prevalence of neuropsychiatric symptoms in female systemic lupus erythematosus (SLE) patients of Bangladesh. A retrospective study was conducted at a tertiary care hospital in Dhaka, Bangladesh, between January and December 2018. One hundred female SLE patients were included in the study purposively. Data were collected on sociodemographic and clinical characteristics of diagnosed SLE cases visiting the SLE clinic and indoor medicine department. Neuropsychiatric (NP) syndromes were defined according to the widely accepted American College of Rheumatology (ACR) nomenclature and case definitions. Results: A total of 244 NP events were identified in fifty-five patients. Headache was the most frequent symptom (55%), followed by cognitive dysfunction (50%), anxiety (49%), psychosis (43%), seizure (23%), depression (17%), and cerebrovascular disease (ischemic type, 7%). The NP manifestations were more prevalent among urban residents (58.2%), younger patients (41.8%), and patients with graduate-level education (34.5%). Besides, young age at diagnosis (p = 0.038), Raynaud's phenomenon (p = 0.015), other organ involvement (p < 0.001), and time of NPSLE development (p < 0.001) were found to be significantly associated with the development of these manifestations. Conclusion: NP damage is prevalent among Bangladeshi female SLE patients (55%) with headache and cognitive dysfunction being the most common symptoms. Routine screening for neuropsychiatric symptoms among suspected SLE cases and further evaluation with a larger population are warranted. [ABSTRACT FROM AUTHOR]

This study elucidated the effects of biogas technology adoption on income and livelihood in rural areas of Bangladesh using Propensity Score Matching (PSM) techniques and the Logit Regression Model respectively. A total of 80 biogas adopters and non-adopters were selected from Bangladesh using Simple Random Sampling technique. The results exposed that the income of biogas adopters is noticeably higher than that of biogas non-adopters. The availability of customers and time saving for other activities exerted positively significant influences on the biogas adopters' livelihood. The rise in number of cattle and fuel costs are positively related to biogas plant adoption. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) has recently developed a non-laboratory based cardiovascular disease (CVD) risk chart considering the parameters age, sex, current smoking status, systolic blood pressure, and body mass index. Using the chart, we estimated the 10-years CVD risk among the Bangladeshi population aged 40–74 years. We analyzed data from a nationally representative survey conducted in 2018–19. The survey enrolled participants from 82 clusters (57 rural, 15 non-slum urban, and 10 slums) selected by multistage cluster sampling. Using the non-laboratory-based CVD risk chart of the World Health Organization (WHO), we categorized the participants into 5 risk groups: very low (<5%), low (5% to <10%), moderate (10% to <20%), high (20% to <30%) and very high (> = 30%) risk. We performed descriptive analyses to report the distribution of CVD risk and carried out univariable and multivariable logistic regression to identify factors associated with elevated CVD risk (> = 10% CVD risk). Of the 7,381 participants, 46.0% were female. The median age (IQR) was 59.0 (48.0–64.7) years. Overall, the prevalence of very low, low, moderate, high, and very high CVD risk was 34.7%, 37.8%, 25.9%, 1.6%, and 0.1%, respectively. Elevated CVD risk (> = 10%) was associated with poor education, currently unmarried, insufficient physical inactivity, smokeless tobacco use, and self-reported diabetes in both sexes, higher household income, and higher sedentary time among males, and slum-dwelling and non-Muslim religions among females. One in every four Bangladeshi adults had elevated levels of CVD risk, and males are at higher risk of occurring CVD events. Non-laboratory-based risk prediction charts can be effectively used in low resource settings. The government of Bangladesh and other developing countries should train the primary health care workers on the use of WHO non-laboratory-based CVD risk charts, especially in settings where laboratory tests are not available. [ABSTRACT FROM AUTHOR]

Background Puerperal sepsis (PP sepsis) is a leading cause of maternal mortality globally. The majority of maternal sepsis cases and deaths occur at home and remain undiagnosed and under-reported. In this paper, we present findings from a nested case-control study in Bangladesh and Pakistan which sought to assess the validity of community health worker (CHW) identification of PP sepsis using a clinical diagnostic algorithm with physician assessment and classification used as the gold standard. Methods Up to 300 postpartum women were enrolled in each of the 3 sites 1) Sylhet, Bangladesh (n = 278), 2) Karachi, Pakistan (n = 278) and 3) Matiari, Pakistan (n = 300). Index cases were women with suspected PP Sepsis as diagnosed by CHWs clinical assessment of one or more of the following signs and symptoms: temperature (recorded fever ≥38.1°C, reported history of fever, lower abdominal or pelvic pain, and abnormal or foul-smelling discharge. Each case was matched with 3 control women who were diagnosed by CHWs to have no infection. Cases and controls were assessed by trained physicians using the same algorithm implemented by the CHWs. Using physician assessment as the gold standard, Kappa statistics for reliability and diagnostic validity (sensitivity and specificity) are presented with 95% CI. Sensitivity and specificity were adjusted for verification bias. Results The adjusted sensitivity and specificity of CHW identification of PP sepsis across all sites was 82% (Karachi: 78%, Matiari: 78%, Sylhet: 95%) and 90% (Karachi: 95%, Matiari: 85%, Sylhet: 90%) respectively. CHW-Physician agreement was highest for moderate and high fever (range across sites: K=0.84-0.97) and lowest for lower abdominal pain (K=0.30-0.34). The clinical signs and symptoms for other conditions were reported infrequently, however, the CHW-physician agreement was high for all symptoms except severe headache/ blurred vision (K = 0.13-0.38) and reported "lower abdominal pain without fever" (K = 0.39-0.57). Conclusion In all sites, CHWs with limited training were able to identify signs and symptoms and to classify cases of PP sepsis with high validity. Integrating postpartum infection screening into existing community-based platforms and post-natal visits is a promising strategy to monitor women for PP sepsis - improving delivery of cohesive maternal and child health care in low resource settings. [ABSTRACT FROM AUTHOR]

An extensive study has been made to identify, document, and investigate the ethnomedicinal plants used by Rakhine ethnic minorities in Patuakhali and Barguna District of southern Bangladesh for the term of April 2018 to June 2019. In this article, we have focused on the Rakhine population trends, management concerns, and some actions for conserving the Rakhine population diversity in the study area. In this study, we have identified the locations where Rakhine population lives in Patuakhali and Barguna districts. A total of 86 plant species belonging to 71 genera and 43 families were reported to be used for treating more than 57 various physical ailments under 14 illness categories from the study area. For each of the species, the botanic name, common name, Rakhine name, family, habit, parts used and traditional medicinal uses of the plant species have been presented. The maximum numbers of ethnomedicinal plant species were utilized to treat gastrointestinal complaints (43) taken after by the treatment of dermatological issues (36). The highly cited (75.60%) plant species were found to be Ananas comosus and Aegle marmelos used for gastro-intestinal (Stomach pain, indigestion, and dysentery) digestive disorders and subsequently followed by Colocasia esculenta (70.73%) used for cut, bleeding and wound healing. The results of this study have shown that Rakhine indigenous communities still depend on conventional plant-based medication to remedy various diseases and therapeutic purposes in the study area. Our findings have also shown that despite there have adequate phytodiversity in the natural habitat of the study area but the number of Rakhine population has been declining significantly day-by-day. As an ultimate result, we have lost the plant-based traditional medicinal knowledge of Rakhine indigenous communities in Bangladesh. As a rich source of traditional knowledge and cultural diversity, it calls for urgent initiatives to conserve the cultural heritage of the Rakhine community as well as the diversity of Rakhine ethnic group. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence of noncommunicable disease (NCD) risk factors and the factors associated with the coexistence of multiple risk factors (= 2 risk factors) among adolescent boys and girls in Bangladesh. Methods: Data on selected NCD risk factors collected from face to face interviews of 4,907 boys and 4,865 girls in the national Nutrition Surveillance round 2018-2019, was used. Descriptive analysis and multivariable logistic regression were performed. Results: The prevalence of insufficient fruit and vegetable intake, inadequate physical activity, tobacco use, and being overweight/obese was 90.72%, 29.03%, 4.57%, and 6.04%, respectively among boys; and 94.32%, 50.33%, 0.43%, and 8.03%, respectively among girls. Multiple risk factors were present among 34.87% of boys and 51.74% of girls. Younger age (p < 0.001), non-slum urban (p < 0.001) and slum residence (p < 0.001), higher paternal education (p = 0.001), and depression (p < 0.001) were associated with the coexistence of multiple risk factors in both boys and girls. Additionally, higher maternal education (p < 0.001) and richest wealth quintile (p = 0.023) were associated with the coexistence of multiple risk factors in girls. Conclusion: The government should integrate specific services into the existing health and non-health programs which are aimed at reducing the burden of NCD risk factors. [ABSTRACT FROM AUTHOR]

Objective: There is dearth of information on the timeliness of antenatal care (ANC) uptake. This study aimed to determine the timely ANC uptake by a medically trained provider (MTP) as per the World Health Organization (WHO) recommendations and the country guideline. Methods: Cross-sectional survey was done with 2,731 women having livebirth outcome in last one year in Dinajpur, Nilphamari and Rajshahi districts, Bangladesh from August-November,2016. Results: About 82%(2,232) women received at least one ANC from a MTP. Overall, 78%(2,142) women received 4 or more ANCs by any provider and 43%(1168) from a MTP. Only 14%(378) women received their first ANC at the 1st trimester by a MTP. As per 4 schedule visits by the WHO FANC model and the country guideline 8%(203) and 20%(543) women respectively received the first 2 timely ANC by a MTP; where only 1%(32) and 3%(72) received the first 3 visits timely and 0.6%(17) and 1%(29) received all the four timely visits. Factors significantly associated with the first two timely visits are: 10 or above years of schooling of women [adj. OR 2.13 (CI: 1.05, 4.30)] and their husbands [adj. OR 2.40 (CI: 1.31, 4.38)], women's employment [adj. OR 2.32 (CI: 1.43, 3.76)], urban residential status [adj. OR 3.49 (CI: 2.46, 4.95)] and exposure to mass media [adj. OR 1.58 (CI: 1.07, 2.34)] at 95% confidence interval. According to the 2016 WHO ANC model, only 1.5%(40) women could comply with the first two ANC contacts timely by a MTP and no one could comply with all the timely 8 contacts. Conclusion: Despite high coverage of ANC utilization, timely ANC visit is low as per both the WHO recommendations and the country guideline. For better understanding, further studies on the timeliness of ANC coverage are required to design feasible intervention for improving maternal and child health. [ABSTRACT FROM AUTHOR]

This study examines how production environment characteristics affect total factor productivity (TFP) and technical efficiency (TE) in aquaculture farms. Enhancing productivity is important for increasing resource use efficiency, especially in developing countries where improvements in the aquaculture sector can enhance food security for low‐ and middle‐income people and improve farmer livelihood. In the present study, 580 aquaculture farms from different areas of Bangladesh were sampled using stratified random sampling techniques. A Fisher quantity index and data envelopment analysis were used to analyze TFP and TE, respectively. In addition, a rank‐sum test was used to investigate how production environment characteristics affect TFP and TE. The results show that farmers could significantly reduce input while maintaining the same level of output. Furthermore, they demonstrate that the TFP and TE of a farm are significantly affected by environmental characteristics, varying with geographical variation in water availability, color, and plants; feed types; and culture systems. Dissemination of the results through training programs and extension services provided by public or private stakeholders could help extensive pond farmers in developing countries improve productivity and efficiency and thereby help provide food and improve livelihood conditions in developing countries. [ABSTRACT FROM AUTHOR]

Little is known of the usual food intakes of rural adolescents in South Asia. This study describes dietary patterns, based on >91,000 7‐day food frequencies among 30,702 girls and boys, aged 9–15 years in rural northwest Bangladesh. Three intake assessments per child, taken across a calendar year, were averaged to represent individual annual intake patterns for 22 food groups. Latent class analysis was used to assign individuals to dietary patterns based on class membership probabilities. The following five dietary patterns (class membership probabilities) were identified: (1) "least diverse" (0.20); (2) "traditional" (0.28); (3) "low vegetable/low fish" (0.23), (4) "moderately high meat" (0.20); and (5) "most diverse" (0.09). The least diverse pattern had the lowest median consumption of most foods and traditional had a relatively higher intake of most vegetables and fish. The most diverse pattern consumed both healthy and processed foods much more often than other patterns. The two most diverse patterns (4 and 5) were associated with higher socioeconomic status, body mass index, height‐for‐age Z‐score, and male gender, and the least diverse pattern showed inverse associations with these characteristics. The most diverse pattern may represent an early wave of the nutrition transition in rural Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Neonatal infections remain a leading cause of newborn deaths globally. In 2015, WHO issued guidelines for managing possible serious bacterial infection (PSBI) in young infants (0–59 days) using simplified antibiotic regimens when compliance with hospital referral is not feasible. Bangladesh was one of the first countries to adopt WHO's guidelines for implementation. We report results of an implementation research study that assessed facility readiness and provider performance in three rural sub-districts of Bangladesh during August 2015-August 2016. Methods: This study took place in 19 primary health centers. Facility readiness was assessed using checklists completed by study staff at three time points. To assess provider performance, we extracted data for all infection cases from facility registers and compared providers' diagnosis and treatment against the guidelines. We plotted classification and dosage errors across the study period and superimposed a locally weighted smoothed (LOWESS) curve to analyze changes in performance over time. Focus group discussions (N = 2) and in-depth interviews (N = 28) with providers were conducted to identify barriers and facilitators for facility readiness and provider performance. Results: At baseline, none of the facilities had adequate supply of antibiotics. During the 10-month period, 606 sick infants with signs of infection presented at the study facilities. Classification errors were identified in 14.9% (N = 90/606) of records. For infants receiving the first dose(s) of antibiotic treatment (N = 551), dosage errors were identified in 22.9% (N = 126/551) of the records. Distribution of errors varied by facility (35.7% [IQR: 24.7–57.4%]) and infection severity. Errors were highest at the beginning of the study period and decreased over time. Qualitative data suggest errors in early implementation were due to changes in providers' assessment and treatment practices, including confusion about classifying an infant with multiple signs of infection, and some providers' concerns about the efficacy of simplified antibiotic regimens. Conclusions: Strategies to monitor early performance and targeted supports are important for enhancing implementation fidelity when introducing complex guidelines in new settings. Future research should examine providers' assessment of effectiveness of simplified treatment and address misconceptions about superiority of broader spectrum antibiotics for treating community-acquired neonatal infections in this context. [ABSTRACT FROM AUTHOR]

Introduction: Many infants with possible serious bacterial infections (PSBI) do not receive inpatient treatment because hospital care may not be affordable, accessible, or acceptable for families. In 2015, WHO issued guidelines for managing PSBI in young infants (0–59 days) with simpler antibiotic regimens when hospital care is not feasible. Bangladesh adopted WHO's guidelines for implementation in outpatient primary health centers. We report results of an implementation research study that assessed caregiver acceptability of the guidelines in three rural sub-districts of Bangladesh during early implementation (October 2015-August 2016). Methods: We included 19 outpatient primary health centers involved in the initial rollout of the infection management guidelines. We extracted data for all PSBI cases (N = 192) from facility registers to identify gaps in referral feasibility, simplified antibiotic treatment, and follow-up. Focus group discussions (FGD) and in-depth interviews (IDI) were conducted with both caregivers (6 FGDs; 23 IDIs) and providers (2 FGDs; 28 IDIs) to assess caregiver acceptability of the guidelines. Results: Referral to the hospital was not feasible for many families (83.3%; N = 160/192) and acceptance varied by infection severity. Barriers to referral feasibility included economic and household factors, and previous experiences with poor quality of care at the sub-district hospital. Conversely, providers and caregivers indicated high acceptability of simplified antibiotic treatment. 80% (N = 96/120) of infants with clinical severe infection for whom referral was not feasible returned to the facility for the second antibiotic injection. Some providers reported developing local solutions—including engaging informal providers in treatment of the infant—to address organizational barriers and promote treatment compliance. Follow-up of young infants receiving simplified treatment is critical, but only 67.4% (N = 87/129) of infants received fourth day follow-up. Some providers' reported deviations from the guidelines that shifted responsibility of follow-up to the caregiver, which may have contributed to lapses. Conclusion: Caregivers' perception of trust and communication with providers were influential in caregiver acceptability of care. Few caregivers accepted referral to the sub-district hospital, suggesting low acceptability of this option. When referral was not feasible, many caregivers reported satisfaction with simplified antibiotic treatment. Local solutions described by providers require further examination in this context to assess the safety and potential value of these strategies in outpatient treatment. Our findings suggest strengthening providers' interpersonal skills could improve caregiver acceptability of the guidelines. [ABSTRACT FROM AUTHOR]

Background: Bangladesh introduced the 10-valent pneumococcal conjugate vaccine (PCV-10) in 2015. We measured population-based incidence of invasive pneumococcal disease (IPD) prior to introduction of PCV-10 to provide a benchmark against which the impact of PCV-10 can be assessed. Methods: We conducted population, facility and laboratory-based surveillance in children 0–59 months of age in three rural sub-districts of Sylhet district of Bangladesh from January 2014 to June 2015. All children received two-monthly home visits with one week recall for morbidity and care seeking. Children attending the three Upazilla Health Complexes (UHC, sub-district hospitals) in the surveillance area were screened for suspected IPD. Blood samples were collected from suspected IPD cases for culture and additionally, cerebrospinal fluid (CSF) was collected from suspected meningitis cases for culture and molecular testing. Pneumococcal isolates were serotyped by Quellung. Serotyping of cases detected by molecular testing was done by sequential multiplex polymerase chain reaction. Results: Children under surveillance contributed to 126,657 child years of observations. Sixty-three thousand three hundred eighty-four illness episodes were assessed in the UHCs. Blood specimens were collected from 8,668 suspected IPD cases and CSF from 177 suspected meningitis cases. Streptococcus pneumoniae was isolated from 46 cases; 32 (70%) were vaccine serotype. The population-based incidence of IPD was 36.3/100,000 child years of observations. About 80% of the cases occurred in children below two years of age. Discussion: IPD was common in rural Bangladesh suggesting the potential benefit of an effective vaccine. Measurement of the burden of IPD requires multiple surveillance modalities. [ABSTRACT FROM AUTHOR]

The aquaculture sector is a capital intensive production process where access to credit is helpful in order to develop and manage farms in developing countries. Nevertheless, a supply of credit is often not readily available, which is creating credit constraint situations. This study investigates how credit constraints affect the productivity of aquaculture farmers in Bangladesh. An endogenous switching regression model is used to estimate the effects of credit constraints on productivity. The results show that productivity is significantly higher for farmers who are not exposed to credit constraints. This result reveals significant production-enhancing effects when using modern inputs for both constrained and unconstrained farmers. However, the effects are larger for the credit-unconstrained farmers because they have the opportunity to buy higher quality inputs and use them in a better input mix. [ABSTRACT FROM AUTHOR]

Purpose: Tomato production in the world has increased tremendously within last few decades. Nevertheless, tomato farmers are facing production, market, price and fi nancial uncertainty. Management of these risks is greatly influenced by their attitudes towards risk. So, the objective of this study is to determine the risk attitude and profitability of tomato farmers in Bangladesh. Research Method: Sixty sample respondents of tomato farmers were selected from Mymensingh district. The Safety-First principle was used to estimate risk attitude coefficient while obit regression model was utilized to estimate the factors aff ecting risk attitudes of tomato farmers. In addition, fi nancial profitability was analyzed from diff erent points of view. Findings: Most of the tomato farmers were risk averse. Results fi nd that only 18% of farmers were risk preferring while 42% of farmers were risk averse. Risk preferences of farmers increase with training and education while risk preference decrease with age and experience. Training and education help to understand the importance of receiving newly introduced technology, timely application of seed, irrigation and fertilizer. Education assists to earn from diversified sources that make them risk preferred. The benefit cost ratio (BCR) of tomato farming was 2.31 indicating that tomato farming is profitable. Research Limitation: A small sample size was used for this study. Therefore, policy makers should be cautious to generalize the results to a wide context of tomato farmers in developing countries. Originality/Value: Productivity and profitability of tomato farmers can be improved if farmers can manage diff erent risks and uncertainty associated with production practices. [ABSTRACT FROM AUTHOR]

Background: Antenatal multiple micronutrient (MM) supplementation improves birth outcomes relative to iron-folic acid (IFA) in developing countries, but limited data exist on its impact on pregnancy micronutrient status.Objective: We assessed the efficacy of a daily MM (15 nutrients) compared with IFA supplement, each providing approximately 1 RDA of nutrients and given beginning at pregnancy ascertainment, on late pregnancy micronutrient status of women in rural Bangladesh. Secondarily, we explored other contributors to pregnancy micronutrient status.Methods: Within a double-masked trial (JiVitA-3) among 44,500 pregnant women, micronutrient status indicators were assessed in n = 1526 women, allocated by cluster to receive daily MM (n = 749) or IFA (n = 777), at 10 wk (baseline: before supplementation) and 32 wk (during supplementation) gestation. Efficacy of MM supplementation on micronutrient status indicators at 32 wk was assessed, controlling for baseline status and other covariates (e.g., inflammation and season), in regression models.Results: Baseline status was comparable by intervention. Prevalence of deficiency among all participants was as follows: anemia, 20.6%; iron by ferritin, 4.0%; iron by transferrin receptor, 4.7%; folate, 2.5%; vitamin B-12, 35.4%; vitamin A, 6.7%; vitamin E, 57.7%; vitamin D, 64.0%; zinc, 13.4%; and iodine, 2.6%. At 32 wk gestation, vitamin B-12, A, and D and zinc status indicators were 3.7-13.7% higher, and ferritin, γ-tocopherol, and thyroglobulin indicators were 8.7-16.6% lower, for the MM group compared with the IFA group, with a 15-38% lower prevalence of deficiencies of vitamins B-12, A, and D and zinc (all P < 0.05). However, indicators typically suggested worsening status during pregnancy, even with supplementation, and baseline status or other covariates were more strongly associated with late pregnancy indicators than was MM supplementation.Conclusions: Rural Bangladeshi women commonly entered pregnancy deficient in micronutrients other than iron and folic acid. Supplementation with MM improved micronutrient status, although deficiencies persisted. Preconception supplementation or higher nutrient doses may be warranted to support nutritional demands of pregnancy in undernourished populations. This trial was registered at clinicaltrials.gov as NCT00860470. [ABSTRACT FROM AUTHOR]

Introduction: The role of screening and treatment for abnormal vaginal flora (AVF) on adverse pregnancy outcomes remains unclear. Using data from women who participated in a population-based cluster randomized trial who were screened and treated for AVF, we report risk factors for AVF and association of persistent AVF with adverse perinatal outcomes.Material and Methods: Pregnant women (n = 4221) <19 weeks of gestation provided self-administered mid-vaginal swabs; smears were Nugent-scored. AVF was treated with oral clindamycin; if AVF was present 3 weeks after treatment, persistent AVF was re-treated. We examined risk factors for AVF and the association of persistent AVF with adverse pregnancy outcomes.Results: The prevalence of AVF was 16.5%: 9.8% of women had bacterial vaginosis and 6.8% had intermediate flora. Lower economic and educational status of women were associated with increased risk of AVF. One-third of women with AVF had persistent abnormal flora; these women had a higher risk of a composite measure of adverse pregnancy outcomes from 20 to <37 weeks (preterm live birth, preterm still birth, late miscarriage) (relative risk [RR] 1.33, 95% confidence interval [CI] 1.07-1.65) and of late miscarriage alone (RR 4.15, 95% CI 2.12-8.12) compared to women without AVF.Conclusions: In this study in Sylhet District, Bangladesh, rates of AVF and persistent AVF were high and persistent AVF was associated with adverse pregnancy outcomes, with an especially high associated risk for late miscarriage. Further characterization of the microbiome and relative bacterial species density associated with persistent AVF is needed. [ABSTRACT FROM AUTHOR]

Bangladesh is currently going through a nutritional transition with rapid increase in overnutrition while undernutrition is still remaining prevalent. Nevertheless, population-based data on demographic, socio-economic and lifestyle factors associated with underweight and overweight among adult population is scarce. Employing a nationwide cross-sectional survey, we collected anthropometric, demographic, socio-economic, lifestyle and dietary information from 12,180 adults aged ≥35 years. Body Mass Index (BMI) was calculated using standard formula and categorized into underweight (<18.50), normal weight (18.50– 22.99), and overweight (≥23.00). Multivariable multinomial logistic regression was performed to identify factors associated with underweight and overweight. Overall, prevalence of underweight and overweight was 18.1% (95% CI: 17.5–18.8) and 33.7% (95% CI: 32.9–34.6), respectively. All the demographic, socio-economic, dietary and lifestyle factors showed significant association with nutritional status in bivariate analysis. In adjusted analysis, factors showing significant positive association with underweight included female gender (ARRR-1.38, 95% CI: 1.11–1.71), older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 2.32 (1.89–2.86), for 60–69 years is 1.62 (1.36–1.93), for 50–59 years 1.34 (1.13–1.58) and for 40–49 years 1.05 (0.87–1.15)] and smoking habit (ARRR-1.32, 95% CI: 1.14–1.52) while factors showing significant inverse association with underweight included higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 0.68 (0.55–0.84), for second highest quintile 0.77 (0.65–0.91), for middle quintile 0.81 (0.69–0.94) and for second lowest quintile 0.89 (0.77–1.03)], urban residence (ARRR-0.66, 95% CI: 0.66–0.90), and more frequent meat/fish and fruits consumption (ARRR-0.76, 95% CI: 0.65–0.90). On the other hand, factors significantly associated with increased risk of overweight included female gender (ARRR-1.35, 95% CI: 1.12–1.63), higher household wealth [compared to lowest wealth quintile, ARRR (95% CI) for highest quintile is 2.27 (1.93–2.68), for second highest quintile 1.67 (1.44–1.94), for middle quintile 1.26 (1.10–1.46) and for second lowest quintile 1.07 (0.93–1.24), excess food availability [compared to food shortage, ARRR (95% CI) for excess food in the household is 1.29 (1.12–1.47) and for no shortage/no excess is 1.23 (1.09–1.38) and more frequent fruits consumption [compared to no fruits, ARRR (95% CI) for 5–7 days per week consumption is 1.61 (1.41–1.83) and for 3–4 days per week is 1.28 (1.16–1.41) and factors significantly associated with decreased risk of overweight included older age [compared to 35–39 years age group, ARRR (95% CI) for ≥ 70 years is 0.77 (0.64–0.93), for 60–69 years is 0.82 (0.71–0.94), for 50–59 years 0.91 (0.80–1.04) and for 40–49 years 1.01 (0.89–1.15)] and smoking (ARRR-0.76, 95% CI: 0.68–0.86). Both underweight and overweight are prevalent in Bangladeshi adult population. Several demographic, socio-economic, dietary and lifestyle factors are associated with underweight and overweight in Bangladesh. Population level impact of these factors should be examined to design suitable public health and nutrition interventions to address this dual challenge. [ABSTRACT FROM AUTHOR]

Salinity has caused significant negative effects on agricultural production. This research is focused on the vulnerabilities of soil and water salinities on crop, fish, and livestock production across the Kalapara coastal belt of Bangladesh. Several parameters were measured as indicators of salinity. The electrical conductivity of water was found to be significant with TDS, F-, Cl-, SO4 2-, Na+, K+, Ca2+, Mg2+, NO2 -, and PO4 3-. Chloride was found to be identical with SO4 2-, Na+, K+, Ca2+, Mg2+, Br-, and PO4 3-. Electrical conductivity, F-, Cl-, SO4 2-, Na+, K+, andMg2+ were all found to be higher than the recommended values. Similarly, soil conductivity was found significant with TDS, Cl-, SO4 2-, Na+, F-, NO2 -, NO3 -, and PO4 3-. Chloride in soil samples was found statistically identical with SO4 2-, Na+, NO3 -, and PO4 3-. About 200 ha fodder crops areas are affected each year due to salinity. Ninety-two percent of the areas were found to be salinity affected in the 36 current cropping patterns. Twelve percent of marine fish and 25 percent of shrimp species have disappeared as a result of salinity. The negative impact of soil and water salinity on crops, fish, and livestock has been increasing in this coastal belt. [ABSTRACT FROM AUTHOR]

DNA barcoding, based on the sequencing of a short, standardized region of the cytochrome c oxidase subunit 1 (COI) gene has the potential to be a practical method for fish species identification in raw or processed fish products. The aim of this study was to identify the level of fraudulence in fish marketing particularly in super shops of Bangladesh. Different species of fish as whole or in fillet were collected from different supermarkets and local markets of Dhaka metropolis for examination. COI gene sequence was amplified using random primers (Fish F1, Fish F2, Fish R1 and Fish R2) and then compared with reference sequences from GenBank and BOLD (Barcode of Life Data Systems). The database was able to provide species matches of >85% sequence similarity for ten samples tested. The overall fraudulence was detected 80% but specifically for whole fish it was 85.71% and fraudulence for fish fillet was 66.67%. These naming discrepancies and ambiguities demonstrate that DNA barcoding can be a reliable tool for the detection of fish products mislabeling in Bangladesh. Therefore, it can be a useful tool for fraudulence control, law enforcement and guiding consumers to get rid of fish product fraudulence. [ABSTRACT FROM AUTHOR]

Background: The burden of maternal complications during antepartum and intrapartum periods is high and care seeking from a trained provider is low, particularly in low middle income countries of sub-Saharan Africa and South Asia. Identification of barriers to access to trained care and development of strategies to address them will contribute to improvements in maternal health. Using data from a community-based cohort of pregnant women, this study identified the prevalence of antepartum and intrapartum complications and determinants of care-seeking for these complications in rural Bangladesh. Methods: The study was conducted in 24,274 pregnant women between June 2011 and December 2013 in rural Sylhet district of Bangladesh. Women were interviewed during pregnancy to collect data on demographic and socioeconomic characteristics; prior miscarriages, stillbirths, live births, and neonatal deaths; as well as data on their ability to make decision to go to health center alone. They were interviewed within the first 7 days of child birth to collect data on self-reported antepartum and intrapartum complications and care seeking for those complications. Bivariate analysis was conducted to explore association between predisposing (socio-demographic), enabling (economic), perceived need, and service related factors with care-seeking for self-reported antepartum and intrapartum complications. Multivariable multinomial logistic regression was performed to examine the association of selected factors with care-seeking for self-reported antepartum and intrapartum complications adjusting for co-variates. Results: Self-reported antepartum and intrapartum complications among women were 14.8% and 20.9% respectively. Among women with any antepartum complication, 58.9% sought care and of these 46.5% received care from a trained provider. Of the women with intrapartum complications, 61.4% sought care and of them 46.5% did so from a trained provider. Care-seeking for both antepartum and intrapartum complications from a trained provider was significantly higher for women with higher household wealth status, higher literacy level of both women and their husbands, and for those living close to a health facility (<10 km). Women’s decision making ability to go to health centre alone was associated with untrained care only for antepartum complications, but was associated with both trained and untrained care for intrapartum complications. Conclusions: Nearly 40.0% of the women who experienced either an antepartum or intrapartum complications did not seek care from any provider and 11.5% -14.9% received care from untrained providers, primarily because of economic and geographic barriers to access. Development and evaluation of context specific, cost-effective, and sustainable strategies that will address these barriers to access to care for the maternal complications will enhance care seeking from trained health care providers and improve maternal health. [ABSTRACT FROM AUTHOR]

Objective To estimate neonatal mortality, particularly within 24 hours of birth, in six low- and lower-middle-income countries. Methods We analysed epidemiological data on a total of 149 570 live births collected between 2007 and 2013 in six prospective randomized trials and a cohort study from predominantly rural areas of Bangladesh, Ghana, India, Pakistan, the United Republic of Tanzania and Zambia. The neonatal mortality rate and mortality within 24 hours of birth were estimated for all countries and mortality within 6 hours was estimated for four countries with available data. The findings were compared with published model-based estimates of neonatal mortality. Findings Overall, the neonatal mortality rate observed at study sites in the six countries was 30.5 per 1000 live births (range: 13.6 in Zambia to 47.4 in Pakistan). Mortality within 24 hours was 14.1 per 1000 live births overall (range: 5.1 in Zambia to 20.1 in India) and 46.3% of all neonatal deaths occurred within 24 hours (range: 36.2% in Pakistan to 65.5% in the United Republic of Tanzania). Mortality in the first 6 hours was 8.3 per 1000 live births, i.e. 31.9% of neonatal mortality. Conclusion Neonatal mortality within 24 hours of birth in predominantly rural areas of six low- and lower-middle-income countries was higher than model-based estimates for these countries. A little under half of all neonatal deaths occurred within 24 hours of birth and around one third occurred within 6 hours. Implementation of high-quality, effective obstetric and early newborn care should be a priority in these settings [ABSTRACT FROM AUTHOR]

Little appears to be known about the capitalization of transportation accessibility in South Asian housing markets, which typically differ from those of industrialized countries. This study starts addressing this gap by providing empirical evidence about the nature and the magnitude of the value of accessibility as reflected by residential rents in Rajshahi City, Bangladesh. Results of our SARAR spatial hedonic model estimated on 526 observations from a random sample collected via in-person interviews indicate that the rent of a multi-unit dwelling decreases by 0.0239% for every 1% increase in network access distance to the nearest major road. Moreover, proximity (within 400 m) to a primary school and to a healthcare facility commands rent premiums of respectively 93.55 BDT ($1.40) and 109.45 BDT ($1.64). Surprisingly, whether access roads are paved or not does not statistically impact rents, probably because of the dominance of walking, rickshaws use, and biking, combined with the rarity of personal cars. Likewise, proximity to bus stops and to train stations is not reflected in rents of multi-family dwellings, likely because buses and trains in Rajshahi City only provide regional and national service. Differences in estimates of our spatial models between maximum likelihood (ML) and generalized spatial two-stage-least-squares illustrate the danger of relying on ML in the presence of heteroskedasticity. These results should be useful for planning transportation infrastructure funding measures in least developed country cities like Rajshahi City. [ABSTRACT FROM AUTHOR]