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As the world moves towards renewable and sustainable energy sources, the need for systems that can quickly and safely store this energy is also rising. Supercapacitors (SCs) are among the most promising alternatives to conventional lithium-ion batteries. SCs are more stable, have higher-power densities, and can be charged much faster. However, SCs have their issues, and three of the main drawbacks of current SCs are 1) lower energy densities, 2) high cost of production, and 3) safety concerns in wearable devices. In this review, we discuss recent progress made in supramolecule-based SCs (SSCs). In supramolecular systems, molecules are held stable using non-covalent-type bonds. This allows for a flexible system in which the molecular interaction sites can easily break and reform at low energy, allowing for exposure of highly active sites and self-healing. When heterometal atoms are introduced into these supramolecular systems, this allows for further activation of the metal sites through the metal-metal interaction along with the metal-ligand interactions. This review discusses different types of SSCs (carbon-based and metal-incorporated) that have been utilized in recent years depending on their synthesis process. The working principle of SSCs and the utilization of different supramolecular elements that enhance the performance of SCs have also been discussed.
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BACKGROUND: The growing urban population imposes additional challenges for health systems in low- and middle-income countries (LMICs). We explored the economic burden and inequities in healthcare utilisation across slum, non-slum and levels of wealth among urban residents in LMICs. METHODS: This scoping review presents a narrative synthesis and descriptive analysis of studies conducted in urban areas of LMICs. We categorised studies as conducted only in slums, city-wide studies with measures of wealth and conducted in both slums and non-slums settlements. We estimated the mean costs of accessing healthcare, the incidence of catastrophic health expenditures (CHE) and the progressiveness and equity of health expenditures. The definitions of slums used in the studies were mapped against the 2018 UN-Habitat definition. We developed an evidence map to identify research gaps on the economics of healthcare access in LMICs. RESULTS: We identified 64 studies for inclusion, the majority of which were from South-East Asia (59%) and classified as city-wide (58%). We found severe economic burden across health conditions, wealth quintiles and study types. Compared with city-wide studies, slum studies reported higher direct costs of accessing health care for acute conditions and lower costs for chronic and unspecified health conditions. Healthcare expenditures for chronic conditions were highest amongst the richest wealth quintiles for slum studies and more equally distributed across all wealth quintiles for city-wide studies. The incidence of CHE was similar across all wealth quintiles in slum studies and concentrated among the poorest residents in city-wide studies. None of the definitions of slums used covered all characteristics proposed by UN-Habitat. The evidence map showed that city-wide studies, studies conducted in India and studies on unspecified health conditions dominated the current evidence on the economics of healthcare access. Most of the evidence was classified as poor quality. CONCLUSIONS: Our findings indicated that city-wide and slums residents have different expenditure patterns when accessing healthcare. Financial protection schemes must consider the complexity of healthcare provision in the urban context. Further research is needed to understand the causes of inequities in healthcare expenditure in rapidly expanding and evolving cities in LMICs.
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Países em Desenvolvimento , Acessibilidade aos Serviços de Saúde , Humanos , População Urbana , Áreas de Pobreza , Aceitação pelo Paciente de Cuidados de SaúdeRESUMO
BACKGROUND: Reliable and rigorously collected sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH) data in humanitarian settings is often sparse and varies in quality across different humanitarian settings. To address this gap in quality data, the World Health Organization (WHO) developed a core set of indicators for monitoring and evaluating SRMNCAH services and outcomes, and assessed their feasibility in Bangladesh, Afghanistan, Jordan, and the Democratic Republic of Congo. METHODS: The feasibility assessments aggregated information from global consultations and field-level assessments to reach a consensus on a set of core SRMNCAH indicators among WHO partners. The feasibility assessment in Bangladesh focused on the following constructs: relevance/usefulness of the core set of indicators, the feasibility of measurement, availability of systems and resources, and ethical issues during data collection and management. The field-level multi-methods assessment included five components; a desk review, key informant interviews, focus group discussions, and facility assessments including observations of facility-level data management. RESULTS: The findings suggest that there is widespread support among stakeholders for developing a standardized core set of SRMNCAH indicators to be collected among all humanitarian actors in Bangladesh. There are numerous resources and data collection systems that could be leveraged, built upon, and improved to ensure the feasibility of collecting this proposed set of indicators. However, the data collection load requested from donors, the national government, international and UN agencies, coordination/cluster systems must be better harmonized, standardized, and less burdensome. CONCLUSION: This core set of indicators would only be useful if it has the buy-in from the international community that results in harmonizing and coordinating data collection efforts and relevant indicators' reporting requirements.
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Saúde do Adolescente , Família , Adolescente , Bangladesh , Criança , Estudos de Viabilidade , Humanos , Recém-Nascido , ReproduçãoRESUMO
With the rise in public health awareness, research on point-of-care testing (POCT) has significantly advanced. Electrochemical biosensors (ECBs) are one of the most promising candidates for the future of POCT due to their quick and accurate response, ease of operation, and cost effectiveness. This review focuses on the use of metal nanoparticles (MNPs) for fabricating ECBs that has a potential to be used for POCT. The field has expanded remarkably from its initial enzymatic and immunosensor-based setups. This review provides a concise categorization of the ECBs to allow for a better understanding of the development process. The influence of structural aspects of MNPs in biocompatibility and effective sensor design has been explored. The advances in MNP-based ECBs for the detection of some of the most prominent cancer biomarkers (carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), Herceptin-2 (HER2), etc.) and small biomolecules (glucose, dopamine, hydrogen peroxide, etc.) have been discussed in detail. Additionally, the novel coronavirus (2019-nCoV) ECBs have been briefly discussed. Beyond that, the limitations and challenges that ECBs face in clinical applications are examined and possible pathways for overcoming these limitations are discussed.
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Técnicas Eletroquímicas/métodos , Nanopartículas Metálicas/química , Testes Imediatos , Biomarcadores Tumorais/análise , Técnicas Biossensoriais/instrumentação , Técnicas Biossensoriais/métodos , Teste para COVID-19/métodos , Carbono/química , Técnicas Eletroquímicas/instrumentação , Desenho de Equipamento , Feminino , Humanos , Masculino , Nanoestruturas/químicaRESUMO
In this report, we discussed rapid, facile one-pot green synthesis of gold and silver nanoparticles (AuNPs and AgNPs) by using tuber extract of Amorphophallus paeoniifolius, and evaluated their antibacterial activity. AuNPs and AgNPs were synthesized by mixing their respective precursors (AgNO3 and HAuCl4) with tuber extract of Amorphophallus paeoniifolius as the bio-reducing agent. Characterization of AuNPs and AgNPs were confirmed by applying UV-vis spectroscopy, field-emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) analysis, Fourier transform infrared spectroscopy (FTIR), and energy dispersive X-ray spectroscopy (EDS). From UV-vis characterization, surface plasmon resonance spectra were found at 530 nm for AuNPs and 446 nm for AgNPs. XRD data confirmed that both synthesized nanoparticles were face-centered cubic in crystalline nature, and the average crystallite sizes for the assign peaks were 13.3 nm for AuNPs and 22.48 nm for AgNPs. FTIR data evaluated the characteristic peaks of different phytochemical components of tuber extract, which acted as the reducing agent, and possibly as stabilizing agents. The antibacterial activity of synthesized AuNPs and AgNPs were examined in Muller Hinton agar, against two Gram-positive and four Gram-negative bacteria through the disc diffusion method. AuNPs did not show any inhibitory effect, while AgNPs showed good inhibitory effect against both Gram-positive and Gram-negative bacteria.
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Amorphophallus/química , Antibacterianos/química , Ouro/química , Nanopartículas Metálicas/química , Antibacterianos/síntese química , Antibacterianos/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Química Verde , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Tubérculos/química , Prata/química , Ressonância de Plasmônio de SuperfícieRESUMO
OBJECTIVE: To determine if perioperative administration of dexmedetomidine affects postoperative fluid intake in tonsillectomy patients. METHODS: A retrospective chart review was performed at University Medical Center, Texas Tech Health Science Center, Lubbock, Texas. The study identified 534 patients within the last five years who met the criteria. Common indications for the surgeries included recurrent tonsillitis, obstructive sleep apnea, and sleep disordered breathing. Patients with concurrent peritonsillar abscess drainage, microlaryngoscopy, bronchoscopy, supraglottoplasty, and other procedures that may impact fluid intake were excluded. The relationship between dexmedetomidine and fluid intake was evaluated using bivariate analysis as well as multivariable regression to account for possible confounders such as age, concurrent medication, surgery type, and method of surgery using STATA statistical software, version 17.0 (StataCorp LLC, College Station, TX). RESULTS: Administration of dexmedetomidine did not significantly impact the amount of fluid intake, fluid intake per kilogram per hour, or average postoperative pain levels in patients who underwent tonsillectomy or adenotonsillectomy in the bivariate analysis (p = 0.217, 0.489, 0.512 respectively) and multiple regression model (p = 0.156, 0.802, 0.795) CONCLUSION: Dexmedetomidine does not negatively influence postoperative fluid intake levels in patients and should continue to be utilized in appropriately selected patients experiencing anxiety or agitation prior to surgery.
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PURPOSE: Prostate Imaging-Reporting and Data System (PI-RADS) assists in evaluating lesions on multiparametric magnetic resonance imaging (mpMRI), but there are still ongoing efforts in improving the predictive value for the presence of clinically significant PCa (csPCa) with a Gleason grade group ≥ 2 on Fusion-Biopsy. This pilot study intends to propose an easily implementable method for augmenting predictability of csPCa for PI-RADS. METHODS: A cohort of 151 consecutive patients underwent mpMRI Fusion and random US Biopsy as a result of having at least one PI-RADS lesion grade 3-5 between January 1, 2019 and December 31, 2022. A single radiologist reads all films in this study applying PI-RADS V2. RESULTS: Of the 151 consecutive patients, 49 had a highest lesion of PI-RADS 3, 82 had a highest lesion of PI-RADS 4, and 20 had a highest lesion of PI-RADS 5. For each respective group, 12, 42, and 18 patients had proven csPCa. Two predictive models for csPCa were created by employing a logistical regression with parameters readily available to providers. The models had an AUC of 0.8133 and 0.8206, indicating promising effective models. CONCLUSION: PI-RADS classification has relevant predictability problems for grades 3 and 4. By applying the presented risk calculators, patients with PI-RADS 3 and 4 are better stratified, and thus, a significant number of patients can be spared biopsies with potential complications, such as infection and bleeding. The presented predictive models may be a valuable diagnostic tool, adding additional information in the clinical decision-making process for biopsies.
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Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias da Próstata , Humanos , Masculino , Idoso , Neoplasias da Próstata/patologia , Medição de Risco , Pessoa de Meia-Idade , Biópsia Guiada por Imagem/métodos , Projetos Piloto , Valor Preditivo dos Testes , Estudos RetrospectivosRESUMO
Objective A well-established association exists between academic performance and levels of depression and anxiety among medical students. However, the effects of positive psychological factors on symptoms of depression and anxiety and academic performance have not been adequately studied. This study explores the relationship between the above variables and identifies positive psychological factors that can promote medical student wellbeing. Methods Medical students were surveyed at four time points during their first two years of medical education using Qualtrics. The surveys used a five-point Likert scale to assess students' levels of loneliness, religiosity, engaged living, life fulfillment, resilience, psychological wellbeing, and symptoms of depression and anxiety. Academic performance was measured using students' Comprehensive Basic Science Examination scores. Linear mixed effect models with maximum likelihood estimation were used to investigate the relationship between positive psychological factors and scores on depression and anxiety as well as the relationship between demographic and psychological factors and exam scores. Results Seventy-two students completed the study. A significant positive correlation was observed between loneliness and symptoms of depression and anxiety, while the same symptoms had significant negative correlations with engaged living. None of the positive psychological factors were significantly predictive of exam scores. Conclusion Our findings suggest that medical students who develop meaningful relationships and live engaged lives are less likely to develop symptoms of depression and anxiety. Our study lays the groundwork for future research focusing on identifying and implementing pre-clinical curriculum changes aiming to improve medical students' mental health.
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To combat with energy crisis considering clean energy, oxygen evolution reaction (OER) is crucial to implement electrolytic hydrogen fuel production in real life. Here, straightforward chemical synthesis pathways are followed to prepare cobalt tetraoxide nanoparticles (Co3O4NPs) in an alkaline OER process using poly[(2-methacryloyloxy)ethyl]trimethylammonium chloride (Co3O4NPs@PMTC) as support to prevent aggregation. In material characterization, the X-ray diffraction (XRD) pattern confirms the crystallinity of the synthesized Co3O4NPs@PMTC, and Raman spectroscopy indicates that the Co3O4NPs contain cubic close-packed oxides. The morphological analysis reveals the wrinkle-like disruption which is distributed evenly owing to the folded nanosheet arrays. Energy-dispersive X-ray spectroscopy indicates the presence of a significant number of cobalt atoms in the Co3O4NPs, and elemental mapping analysis demonstrates the composition of the NPs. At a current density of 10â mA cm-2, oxygen is emitted at 1.67â V delivering an overpotential of 440â mV. This unique structure of Co3O4NPs@PMTC provides beneficial functions that are responsible for a large number of active sites and the rapid release of oxygen gas with long-term stability. Through kinetic study, we found a Tafel slope of 48.9â mV dec-1 which proves the catalytic behavior of Co3O4NPs@PMTC is promising toward the OER process.
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This work demonstrates the use of jute stick extract as a reducing and stabilizing agent for the synthesis of spherical gold nanoparticles (AuNPs). In UV-Vis spectroscopy, peak at 550â nm was used to confirm the formation of AuNPs. The spherical surface morphology of AuNPs was determined through SEM and TEM analysis. While XRD investigation revealed the crystallinity of the prepared AuNPs. To ensure the biocompatibility of synthesized AuNPs, a bacterial investigation was conducted with negative results towards bacterial strain. The, modified FTO with AuNPs were able to detect glucose in CV analysis and the constructed sensor displayed a wide linear range of 50â µM to 40â mM with a detection limit of 20â µM. Scan rate analysis was performed to determine the charge transfer coefficient (0.42) and Tafel slope (102â mV/decade). Furthermore, the interfacial surface mechanism is illustrated to understand the interaction of glucose with the electrode surface in an alkaline medium and the product formation through the dehydrogenation and hydrolysis process. The prepared sensor also showed good stability, reproducibility, and anti-interference capabilities. In the case of real sample analysis, we used a blood serum sample. A low RSD value (<10 %) suggests the practical use of AuNPs/FTO in real-life applications.
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Técnicas Biossensoriais , Técnicas Eletroquímicas , Eletrodos , Flúor , Ouro , Nanopartículas Metálicas , Compostos de Estanho , Ouro/química , Nanopartículas Metálicas/química , Flúor/química , Compostos de Estanho/química , Materiais Biocompatíveis/química , Materiais Biocompatíveis/síntese química , Glucose/análise , Propriedades de Superfície , Humanos , Glicemia/análise , Tamanho da PartículaRESUMO
Regardless of the adverse effects of Bisphenol A (BPA), its use in industry and in day-to-day life is increasing at a higher rate every year. In the present study, a simple and reliable chemical approach was used to develop an efficient BPA sensor based on a Co-Ru-based heterometallic supramolecular polymer (polyCoRu). Surface morphology and elemental analysis were examined using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). Furthermore, functional group analysis was accomplished by Fourier transform infrared spectroscopy (FT-IR). UV-vis spectroscopy was used to confirm the complexation in the ratio of 0.5:0.5:1 (metal 1/metal 2/ligand). Electrochemical characterization of the synthesized polyCoRu was conducted using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) analyses. The study identified two distinct linear dynamic ranges for the detection of BPA, 0.197-2.94 and 3.5-17.72 µM. The regression equation was utilized to determine the sensitivity and limit of detection (LOD), resulting in values of 0.6 µA cm-2 µM-1 and 0.02 µM (S/N = 3), respectively. The kinetics of BPA oxidation at the polyCoRu/GCE were investigated to evaluate the heterogeneous rate constant (k), charge transfer coefficient (α), and the number of electrons transferred during the oxidation and rate-determining step. A probable electrochemical reaction mechanism has been presented for further comprehending the phenomena occurring at the electrode surface. The practical applicability of the fabricated electrode was analyzed using tap water, resulting in a high percentage of recovery ranging from 96 to 105%. Furthermore, the reproducibility and stability data demonstrated the excellent performance of polyCoRu/GCE.
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Background: Using a theoretical perspective to guide research design and implementation can result in a coherent preventative intervention model. Among theoretical frameworks, Bandura's Social Cognitive Theory (SCT) is particularly useful for studies focused on behavior change in health promotion research. Objective: This scoping review explored and summarized the current evidence on health promotion interventions that integrated constructs of Social Cognitive Theory and the outcome of those interventions in primary care settings. Method: ology: We conducted this scoping review using the PRISMA scoping review guidelines; we reviewed articles from five electronic databases and additional sources that were peer-reviewed journal articles reporting interventions applying SCT constructs and synthesized the outcomes following the interventions. Results: Among 849 retrieved from multiple sources, 39 articles met our eligibility criteria. Most studies (n = 19) were conducted in the United States. Twenty-six studies followed a randomized control trial design. Most studies (n = 26) recruited participants utilizing the primary care network. All 39 studies mentioned "self-efficacy" as the most utilized construct of SCT to determine how behavior change operates, followed by "observational learning" through role models. Twenty-three studies integrated individual (face-to-face) or peered group-based counseling-training programs; eight interventions used telephonic health coaching by a specialist; eight studies used audio-visual mediums. All included studies reported positive health outcomes following the intervention, including increased self-reported moderate-to-vigorous physical activity, increased Knowledge of dietary intake, high-risk behaviors such as STIs transmission, adapting to a healthy lifestyle, and adherence to post-transplant medication. Conclusion: Current evidence suggests that SCT-based interventions positively impact health outcomes and intervention effectiveness. The results of this study indicate the importance of incorporating and assessing several conceptual structures of behavioral theories when planning any primary care health promotion practice.
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Emotion recognition using Artificial Intelligence (AI) is a fundamental prerequisite to improve Human-Computer Interaction (HCI). Recognizing emotion from Electroencephalogram (EEG) has been globally accepted in many applications such as intelligent thinking, decision-making, social communication, feeling detection, affective computing, etc. Nevertheless, due to having too low amplitude variation related to time on EEG signal, the proper recognition of emotion from this signal has become too challenging. Usually, considerable effort is required to identify the proper feature or feature set for an effective feature-based emotion recognition system. To extenuate the manual human effort of feature extraction, we proposed a deep machine-learning-based model with Convolutional Neural Network (CNN). At first, the one-dimensional EEG data were converted to Pearson's Correlation Coefficient (PCC) featured images of channel correlation of EEG sub-bands. Then the images were fed into the CNN model to recognize emotion. Two protocols were conducted, namely, protocol-1 to identify two levels and protocol-2 to recognize three levels of valence and arousal that demonstrate emotion. We investigated that only the upper triangular portion of the PCC featured images reduced the computational complexity and size of memory without hampering the model accuracy. The maximum accuracy of 78.22% on valence and 74.92% on arousal were obtained using the internationally authorized DEAP dataset.
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Inteligência Artificial , Eletroencefalografia , Nível de Alerta , Emoções , Humanos , Redes Neurais de ComputaçãoRESUMO
INTRODUCTION: People living in slums face several challenges to access healthcare. Scarce and low-quality public health facilities are common problems in these communities. Costs and prevalence of catastrophic health expenditures (CHE) have also been reported as high in studies conducted in slums in developing countries and those suffering from chronic conditions and the poorest households seem to be more vulnerable to financial hardship. The COVID-19 pandemic may be aggravating the economic impact on the extremely vulnerable population living in slums due to the long-term consequences of the disease. The objective of this review is to report the economic impact of seeking healthcare on slum-dwellers in terms of costs and CHE. We will compare the economic impact on slum-dwellers with other city residents. METHODS AND ANALYSIS: This scoping review adopts the framework suggested by Arksey and O'Malley. The review is part of the accountability and responsiveness of slum-dwellers (ARISE) research consortium, which aims to enhance accountability to improve the health and well-being of marginalised populations living in slums in India, Bangladesh, Sierra Leone and Kenya. Costs of accessing healthcare will be updated to 2020 prices using the inflation rates reported by the International Monetary Fund. Costs will be presented in International Dollars by using purchase power parity. The prevalence of CHE will also be reported. ETHICS AND DISSEMINATION: Ethical approval is not required for scoping reviews. We will disseminate our results alongside the events organised by the ARISE consortium and international conferences. The final manuscript will be submitted to an open-access international journal. Registration number at the Research Registry: reviewregistry947.
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COVID-19 , Acessibilidade aos Serviços de Saúde/economia , Áreas de Pobreza , Bangladesh , Países em Desenvolvimento , Feminino , Instalações de Saúde , Humanos , Índia , Quênia , Masculino , Pandemias , Literatura de Revisão como Assunto , SARS-CoV-2 , Serra LeoaRESUMO
Here, we report a semiempirical quantum chemistry computational approach to understanding the electrocatalytic reaction mechanism (ERM) of a metallic supramolecular polymer (SMP) with nitrite through UV/vis spectral simulations of SMP with different metal oxidation states before and after interactions with nitrite. In one of our recent works, by analyzing the electrochemical experimental data, we showed that computational cyclic voltammetry simulation (CCVS) can be used to predict the possible ERM of heterometallo-SMP (HMSMP) during electrochemical oxidation of nitrite (Islam T.ACS Appl. Polym. Mater.2020, 2( (2), ), 273-284). However, CCVS cannot predict how the ERM happens at the molecular level. Thus, in this work, we simulated the interactions between the repeating unit (RU) of the HMSMP polyNiCo and nitrite to understand how the oxidation process took place at the molecular level. The RU for studying the ERM was confirmed through comparing the simulated UV/vis and IR spectra with the experimental spectra. Then, the simulations between the RU of the polyNiCo and various species of nitrite were done for gaining insights into the ERM. The simulations revealed that the first electron transfer (ET) occurred through coordination of NO2 - with either of the metal centers during the two-electron-transfer oxidation of nitrite, while the second ET followed a ligand-ligand charge transfer (LLCT) and metal-ligand charge transfer (MLCT) pathway between the NO2 species and the RU. This ET pathway has been proposed by analyzing the transition states (TSs), simulated UV/vis spectra, energy of the optimized systems, and highest occupied molecular orbital-lowest occupied molecular orbital (HOMO-LUMO) interactions from the simulations between the RU and nitrite species.
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BACKGROUND: Rohingya diaspora or Forcibly Displaced Myanmar Nationals (FDMNs), took shelter in the refugee camps of Cox's Bazar, Bangladesh due to armed conflict in the Rakhine state of Myanmar. In such humanitarian crises, delivering sexual and reproductive health (SRH) services is critical for better health outcomes of this most-at-risk population where more than half are adolescent girls and women. This is a reflective paper on challenges and related mitigation strategies to conduct SRH research among FDMNs. The research on which this paper is based employed a concurrent mixed-method design combining a cross-sectional survey and qualitative interviews and group discussions with FDMNs to understand their SRH needs and demand-side barriers. Assessment of health facilities and qualitative interviews with healthcare providers and key stakeholders were carried out to assess facility readiness and supply-side barriers. CHALLENGES AND STRATEGIES: The researchers faced different challenges while conducting this study due to the unique characteristics of the FDMN population and the location of the refugee camps. The three key challenges researchers encountered include: sensitivity regarding SRH in the FDMNs, identifying appropriate sampling strategies, and community trust issues. The key approaches to overcome these challenges involved: actively engaging community members and gatekeepers in the data collection process to access respondents, identifying sensitive SRH issues through survey and exploring in-depth during qualitative interviews; and contextually modifying the sampling strategy. CONCLUSION: Contextual adaptation of research methods and involving community and local key stakeholders in data collection are the key lessons learnt from this study. Another important lesson was researchers' identity and positionality as a member of the host country may create distrust and suspicion among the refugees. The multi-level complexities of humanitarian settings may introduce unforeseen challenges and interrupt research plans at different stages of research which require timely and contextual adaptations.
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Safeguarding is rapidly rising up the international development agenda, yet literature on safeguarding in related research is limited. This paper shares processes and practice relating to safeguarding within an international research consortium (the ARISE hub, known as ARISE). ARISE aims to enhance accountability and improve the health and well-being of marginalised people living and working in informal urban spaces in low-income and middle-income countries (Bangladesh, India, Kenya and Sierra Leone). Our manuscript is divided into three key sections. We start by discussing the importance of safeguarding in global health research and consider how thinking about vulnerability as a relational concept (shaped by unequal power relations and structural violence) can help locate fluid and context specific safeguarding risks within broader social systems. We then discuss the different steps undertaken in ARISE to develop a shared approach to safeguarding: sharing institutional guidelines and practice; facilitating a participatory process to agree a working definition of safeguarding and joint understandings of vulnerabilities, risks and mitigation strategies and share experiences; developing action plans for safeguarding. This is followed by reflection on our key learnings including how safeguarding, ethics and health and safety concerns overlap; the challenges of referral and support for safeguarding concerns within frequently underserved informal urban spaces; and the importance of reflective practice and critical thinking about power, judgement and positionality and the ownership of the global narrative surrounding safeguarding. We finish by situating our learning within debates on decolonising science and argue for the importance of an iterative, ongoing learning journey that is critical, reflective and inclusive of vulnerable people.
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Saúde Global , Pobreza , Bangladesh , Humanos , Índia , QuêniaRESUMO
INTRODUCTION: Rohingya diaspora are one of the most vulnerable groups seeking refuge in camps of Cox's Bazar, Bangladesh, arising an acute humanitarian crisis. More than half of the Rohingya refugees are women and adolescent girls requiring quality sexual and reproductive health (SRH) services. Minimum initial service package of SRH are being rendered in the refugee camps; however, WHO is aiming to provide integrated comprehensive SRH services to meet the unmet needs of this most vulnerable group. For sustainable and successful implementation of such comprehensive SRH service packages, a critical first step is to undertake a situation analysis and understand the current dimensions and capture the lessons learnt on their SRH-specific needs and implementation challenges. This situation analysis is pertinent in current humanitarian condition and will provide an overview of the needs, availability and delivery of SRH services for adolescent girls and women, barriers in accessing and providing those services in Rohingya refugee camps in Cox's Bazar, Bangladesh, and similar humanitarian contexts. METHODS AND ANALYSIS: A concurrent mixed-methods design will be used in this study. A community-based household survey coupled with facility assessments as well as qualitative in-depth interviews, key informant interviews and focus group discussions will be conducted with community people of Rohingya refugee camps and relevant stakeholders providing SRH services to Rohingya population in Cox's Bazar, Bangladesh. Survey data will be analysed using univariate, bivariate and multivariable regression statistics. Descriptive analysis will be done for facility assessment and thematic analysis will be conducted with qualitative data. ETHICS AND DISSEMINATION: Ethical approval from Institutional Review Board of BRAC James P Grant School of Public Health (2018-017-IR) has been obtained. Findings from this research will be disseminated through presentations in local, national and international conferences, workshops, peer-reviewed publications, policy briefs and interactive project report.