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1.
Environ Res ; 258: 119397, 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38876419

RESUMEN

Global warming and unpredictable nature possess a negative impact on fisheries and the daily activities of other habitats. GIS and remote sensing approach is an effective tool to determine the morphological characteristics of the lake. The present study addresses the interactive effect of climate and landuse changes hit on fish catch in lake fisheries. We used a combination of the landscape disturbance index, vulnerability index, and loss index to construct a complete ecological risk assessment framework based on the landscape structure of regional ecosystems. The results indicate an increase from around 45%-76% in the percentage of land susceptible to moderate to ecological severe risk in the landscape from 2004 to 2023. Since 1950, temperature changes have increased by 0.4%, precipitation has decreased by 6%, and water levels have decreased by 4.2%, based on the results. The results indicate that landuse, water temperature, precipitation, and water depth significantly impact the aquaculture system. The findings strongly suggest integrating possible consequences of environmental change on fish yield for governance modeling techniques to minimize their effects.

2.
J Educ Health Promot ; 13: 107, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38726071

RESUMEN

BACKGROUND: Coronavirus disease (COVID-19) is a global pandemic caused by the severe acute respiratory syndrome coronavirus, SARS-CoV-2. Infection with SARS-CoV-2 primarily occurs through binding to angiotensin-converting enzyme-2 (ACE2), which is abundantly expressed in various anatomical sites, including the nasopharynx, lungs, cardiovascular system, and gastrointestinal and genitourinary tracts. This study aimed to nurses' knowledge and protective health behaviors about prevention of covid-19 pandemic complications. MATERIALS AND METHODS: A descriptive design study was conducted from October 1, 2022, to March 15, 2023. A non-probability purposive sample of 50 nurses from different educational levels, genders, and departments at Baghdad teaching hospitals was selected. Data collected were analyzed using SPSS version 25.0. RESULTS: The study comprised an equal distribution of male and female participants, with the majority (44%) aged between 22 and 30 years. A significant proportion (52%) of nurses held institute degrees. Forty-six percent were single, and the majority (74%) had 1-5 years of experience. The mean scores were 0.70 for nurses' knowledge and 3.22 for nurses' protective health behaviors. CONCLUSIONS: The findings indicate that nurses possess satisfactory knowledge and exhibit high levels of protective health behaviors regarding complications associated with the COVID-19 pandemic. It is recommended to conduct future research focusing on nurses' knowledge and practices related to patient care in the context of a pandemic.

3.
J Am Chem Soc ; 146(20): 13949-13961, 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38739624

RESUMEN

Aqueous-phase electrocatalytic hydrogenation of benzaldehyde on Cu leads not only to benzyl alcohol (the carbonyl hydrogenation product), but Cu also catalyzes carbon-carbon coupling to hydrobenzoin. In the absence of an organic substrate, H2 evolution proceeds via the Volmer-Tafel mechanism on Cu/C, with the Tafel step being rate-determining. In the presence of benzaldehyde, the catalyst surface is primarily covered with the organic substrate, while H* coverage is low. Mechanistically, the first H addition to the carbonyl O of an adsorbed benzaldehyde molecule leads to a surface-bound hydroxy intermediate. The hydroxy intermediate then undergoes a second and rate-determining H addition to its α-C to form benzyl alcohol. The H additions occur predominantly via the proton-coupled electron transfer mechanism. In a parallel reaction, the radical α-C of the hydroxy intermediate attacks the electrophilic carbonyl C of a physisorbed benzaldehyde molecule to form the C-C bond, which is rate-determining. The C-C coupling is accompanied by the protonation of the formed alkoxy radical intermediate, coupled with electron transfer from the surface of Cu, to form hydrobenzoin.

4.
Artículo en Inglés | MEDLINE | ID: mdl-38743249

RESUMEN

BACKGROUND: Mobile phone applications (apps) can potentially enhance patient care as they are easy to use and offer multifunctions. In 2019, 305 orthodontic apps were documented, many of which were patient-focused; however, there was little information on how popular these applications are with orthodontic patients. The main aim of this study was to evaluate how well patients were now aware of orthodontic applications. METHODS: A survey asking 700 orthodontic patients about their knowledge of, access to, and use of orthodontic apps to facilitate their treatment resulted in 615 responses. RESULTS: The results showed that a smartphone was owned by 96% of patients. Apple (Apple Inc., Cupertino, CA, USA) was the most used platform, followed by Android (Google LLC, Mountain View, CA, USA). Seventy-five percent of patients have previously used social media to research information, with YouTube (YouTube, San Mateo, CA, USA) being the most popular site. Only 3% of patients knew that applications were available to aid with orthodontic therapy and 12 patients had utilized an app linked to orthodontics. Nevertheless, 88% of patients said they would be open to using an app to supplement their treatment. CONCLUSIONS: Although 88% of patients said they would be prepared to use an app to help with orthodontic treatment, there is currently a low level of knowledge of the existence of apps. Given the availability of applications geared toward those patients, it is necessary to evaluate these apps' quality and, when critical, direct patients toward high-quality, efficient apps.

5.
ACS Appl Mater Interfaces ; 16(14): 17574-17586, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38556732

RESUMEN

The efficiency of oxygen electrocatalysis is a key factor in diverse energy domain applications, including the performance of metal-air batteries, such as aqueous Zinc (Zn)-air batteries. We demonstrate here that the doping of cobalt oxide with optimal amounts of copper (abbreviated as Cu-doped Co3O4) results in a stable and efficient bifunctional electrocatalyst for oxygen reduction (ORR) and evolution (OER) reactions in aqueous Zn-air batteries. At high Cu-doping concentrations (≥5%), phase segregation occurs with the simultaneous presence of Co3O4 and copper oxide (CuO). At Cu-doping concentrations ≤5%, the Cu ion resides in the octahedral (Oh) site of Co3O4, as revealed by X-ray diffraction (XRD)/Raman spectroscopy investigations and molecular dynamics (MD) calculations. The residence of Cu@Oh sites leads to an increased concentration of surface Co3+-ions (at catalytically active planes) and oxygen vacancies, which is beneficial for the OER. Temperature-dependent magnetization measurements reveal favorable d-orbital configuration (high eg occupancy ≈ 1) and a low → high spin-state transition of the Co3+-ions, which are beneficial for the ORR in the alkaline medium. The influence of Cu-doping on the ORR activity of Co3O4 is additionally accounted in DFT calculations via interactions between solvent water molecules and oxygen vacancies. The application of the bifunctional Cu-doped (≤5%) Co3O4 electrocatalyst resulted in an aqueous Zn-air battery with promising power density (=84 mW/cm2), stable cyclability (over 210 cycles), and low charge/discharge overpotential (=0.92 V).

7.
ESMO Open ; 9(4): 102386, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38507897

RESUMEN

BACKGROUND: Immune checkpoint inhibitors (CPIs) have not been shown to be active in well-differentiated neuroendocrine tumors (NETs), with response rates <5%. Lenvatinib is a multitargeted tyrosine kinase inhibitor which binds to vascular endothelial growth factor and fibroblast growth factor receptors and has demonstrated efficacy in pancreatic and gastrointestinal NETs [44% and 16% objective radiographic response rate (ORR), respectively]. The combination of antiangiogenic and CPI therapies can be synergistic. We therefore evaluated the combination of lenvatinib and pembrolizumab in well-differentiated gastrointestinal (GI) and thoracic NETs. PATIENTS AND METHODS: A prospective, phase II trial evaluated patients with advanced GI/thoracic NETs (pancreatic NETs were excluded due to high response rate of lenvatinib monotherapy in this patient population), with evidence of progression within 8 months of study entry and at least two prior lines of systemic therapy. Patients received lenvatinib 20 mg daily and pembrolizumab 200 mg intravenously every 3 weeks until unacceptable toxicity or progression of disease. Primary endpoint was objective response rate, and an interim analysis was planned once 20 patients were enrolled. Four ORRs were required to continue enrollment. RESULTS: Twenty patients were enrolled on protocol from April 2021 to January 2022 (nine small intestine, five lung, two thymic, two unknown primary, one cecal, one presacral primaries). Two patients (10%) achieved a partial response (atypical lung and small intestinal primaries). Median progression-free survival (PFS) was 8 months (95% confidence interval 5.8-10.2 months). Twelve (60%) patients experienced probably or definitely associated grade 3 adverse events (10 hypertension). Fourteen patients (70%) required dose reductions or discontinued one of the medications. Two patients discontinued treatment before radiographic assessment. CONCLUSIONS: The combination of pembrolizumab and lenvatinib did not show sufficient response in patients with NETs to warrant continued enrollment on trial.


Asunto(s)
Anticuerpos Monoclonales Humanizados , Tumores Neuroendocrinos , Compuestos de Fenilurea , Quinolinas , Humanos , Quinolinas/uso terapéutico , Quinolinas/farmacología , Masculino , Compuestos de Fenilurea/uso terapéutico , Compuestos de Fenilurea/farmacología , Femenino , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/farmacología , Tumores Neuroendocrinos/tratamiento farmacológico , Persona de Mediana Edad , Anciano , Estudios Prospectivos , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/farmacología
8.
BMJ Open ; 13(9): e066477, 2023 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-37714677

RESUMEN

OBJECTIVE: This study aims to investigate the role of community-level emergency contraceptive pill (ECP) awareness in reducing unwanted births (UWBs) in Bangladesh and explore the regional variation in women's appropriateness to adopt long-acting reversible contraceptives or permanent methods (LARCPMs) based on their child desire. DESIGN, SETTINGS AND PARTICIPANTS: We used data from the cross-sectional Bangladesh Demographic and Health Survey 2017-2018. We analysed the planning status of the last live birth 3 years preceding the survey of 20,127 ever-married women of reproductive age. METHODS: Considering women were nested within clusters, a mixed-effect multiple logistic regression was implemented to investigate the association between community-level ECP awareness and UWB by controlling for the effects of contextual, individual, and household characteristics. RESULTS: Only 3.7% of women belonged to communities with high ECP awareness. At the national level, 2% of women had UWB. About 2.1% of women who resided in communities of low ECP awareness had UWB, while UWB was only 0.5% among women residing in high ECP awareness communities. The odds of UWB was 71% lower among women who resided in high ECP awareness communities than among those who resided in communities with low ECP awareness. However, community-level ECP awareness could not avert mistimed birth. Dhaka, Chattogram and Rangpur held the highest share of UWB. Fertility persisted for 89% of the women who wanted no more children. Among women who wanted no more children, 15% were not using any method, 13% used traditional family planning methods and only 13% adopted LARCPM. These women mostly resided in Dhaka, followed by Chattogram and Rajshahi. CONCLUSION: This study highlights the significant positive role of ECP awareness in reducing UWB in Bangladesh. Findings may inform policies aimed at increasing LARCPM adoption, particularly among women residing in Dhaka and Chattogram who want no more children.


Asunto(s)
Niño no Deseado , Anticonceptivos Poscoito , Niño , Humanos , Femenino , Bangladesh , Estudios Transversales , Anticoncepción , Anticonceptivos Poscoito/uso terapéutico
9.
BMJ Open ; 13(9): e065146, 2023 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-37730396

RESUMEN

OBJECTIVE: With socioeconomic development, improvement in preventing and curing infectious diseases, and increased exposure to non-communicable diseases (NCDs) risk factors (eg, overweight/obesity, sedentary lifestyle), the majority of adult deaths in Bangladesh in recent years are due to NCDs. This study examines trends in cause-specific mortality risks using data from the Matlab Health and Demographic Surveillance System (HDSS). DESIGN, SETTINGS AND PARTICIPANTS: We conducted a follow-up study from 2003 to 2017 using data from Matlab HDSS, which covers a rural population of 0.24 million (in 2018) in Chandpur, Bangladesh. HDSS assessed the causes of all deaths using verbal autopsy and classified the causes using the 10th revision of the International Statistical Classification of Diseases. We examined 19 327 deaths involving 2 279 237 person-years. METHODS: We calculated annual cause-specific mortality rates and estimated adjusted proportional HRs using a Cox proportional hazards model. RESULTS: All-cause mortality risk declined over the study period among people aged 15 and older, but the risk from stroke increased, and from heart disease and cancers remained unchanged. These causes were more common among middle-aged and older people and thus bore the most burden. Mortality from causes other than NCDs-namely, infectious and respiratory diseases, injuries, endocrine disorders and others-declined yet still constituted over 30% of all deaths. Thus, the overall mortality decline was associated with the decline of causes other than NCDs. Mortality risk sharply increased with age. Men had higher mortality than women from heart disease, cancers and other causes, but not from stroke. Lower household wealth quintile people have higher mortality than higher household wealth quintile people, non-Muslims than Muslims. CONCLUSION: Deaths from stroke, heart disease and cancers were either on the rise or remained unchanged, but other causes declined continuously from 2003 to 2017. Immediate strengthening of the preventive and curative healthcare systems for NCDs management is a burning need.


Asunto(s)
Cardiopatías , Enfermedades no Transmisibles , Masculino , Persona de Mediana Edad , Humanos , Adulto , Femenino , Anciano , Bangladesh/epidemiología , Estudios de Seguimiento , Factores de Riesgo , Autopsia
10.
J Glob Health ; 13: 07006, 2023 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-37766652

RESUMEN

Background: Depending on race, ethnicity, and region, genetic variants determine human height by 65% to 80%, while the remaining variance of 20% to 35% is influenced by nutrition and other individual or environmental exposures in the early years of life. An improvement in nutrition and health in the early years in a population underprivileged in health and nutrition will likely increase the group's average height. Due to outstanding improvements in these areas in recent decades, we hypothesised that the average height of Bangladeshi women has increased. Moreover, because pregnancy at an early age affects women's health and nutrition, we hypothesised that women who began childbearing early would experience growth retardation compared to women who had pregnancies at a later age. Methods: We used data from five national surveys conducted between 2004 and 2018 that collected height data from ever-married women aged 15-49 years. We analysed the height of women aged 20-29 years (born between 1974 and 1998) and examined the mean height by birth years, age at first birth (AFB), economic status, religion and region. We conducted multiple linear regression models, controlling for the differential effects of the socio-demographic characteristics on women's height over time and by AFB. Results: The average height of women born between 1974 and 1998 significantly increased by 0.03 cm annually, with fluctuations between 150.3 and 151.6 cm. We also found an association between age at childbearing and height in adulthood - women who began childbearing before age 17 were approximately one centimetre shorter in adulthood than those who began childbearing at a later age. Conclusions: We found evidence of an increasing trend in women's height in Bangladesh and an inhibiting effect of early teenage childbearing on attaining the potential growth of women. The findings call for further studies to investigate early childbearing and its consequences on women's and their children's growth in diverse settings, considering socio-cultural customs influencing early marriage and childbearing.


Asunto(s)
Pueblo Asiatico , Estatura , Parto , Adolescente , Femenino , Humanos , Embarazo , Bangladesh/epidemiología , Cultura , Recolección de Datos , Adulto Joven , Adulto
11.
Phys Chem Chem Phys ; 25(33): 22022-22031, 2023 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-37555332

RESUMEN

Double perovskite materials have shown promising applications as an electrode in solid oxide fuel cells and Li-air batteries for oxygen reduction, evolution, and transport. However, degradation of the material due to cation migration to the surface, forming secondary phases, poses an existential bottleneck in materials development. Herein, a theoretical approach combining density functional theory and molecular dynamics simulations is presented to study the Ba-cation segregation in a double perovskite NdBaCo2O5+δ. Solutions to circumvent segregation at the molecular level are presented in two different forms by applying strain and introducing dopants in the structure. On applying compressive strain or Ca as a dopant in the NBCO structure, segregation is estimated to reduce significantly. A more direct way of estimating cation segregation is proposed in MD simulations, wherein the counting of the cations migrating from the sub-surface layers to the surface provided a reliable theoretical assessment of the level of cation segregation.

13.
J Glob Health ; 13: 07003, 2023 07 14.
Artículo en Inglés | MEDLINE | ID: mdl-37441775

RESUMEN

Background: Despite improvements in many health indicators, maternal mortality has plateaued in Bangladesh. Achieving the global target of reductions in maternal mortality and the associated Sustainable Development Goals will not be possible without actions to prevent deaths due to preeclampsia/eclampsia. Here we examined the levels, trends, specific causes, timing, place, and care-seeking behaviours of women who died due to these two causes. Methods: We used nationally representative Bangladesh Maternal Mortality and Health Care Surveys (BMMSs) conducted in 2001, 2010, and 2016 to examine levels and trends of deaths due to preeclampsia/eclampsia. We based the analysis of specific causes, timing, and place of preeclampsia/eclampsia deaths, and care seeking before the deaths on 41 such deaths captured in the 2016 survey. We also used BMMS 2016 survey verbal autopsy (VA) questionnaire to highlight stories that put faces to the numbers. Results: The preeclampsia/eclampsia-specific mortality ratio decreased from 77 per 100 000 live births in the 2001 BMMS to 40 per 100 000 live births in the 2010 BMMS, yet halted in the 2016 BMMS at 46 per 100 000 live births. Although preeclampsia/eclampsia accounted for around one-fifth of all maternal deaths in the 2010 BMMS, in the 2016 BMMS, the percentage contribution reached the 2001 BMMS level of 24%. An analysis of the VA questionnaire's open section showed that almost all such death cases left their homes to seek care; however, most had to visit more than one facility before they died, indicating an unprepared health system. Conclusions: A cluster of preeclampsia/eclampsia-specific mortality observed during the first trimester, during delivery, and within 48 hours of birth indicates a need for preconception health check-ups and strengthened facility readiness. Awareness of maternal complications, proper care seeking, and healthy reproductive practices, like family planning to space and limit pregnancy through client-supportive counselling, may be beneficial. Improving regular and emergency maternal services readiness is also essential.


Asunto(s)
Eclampsia , Preeclampsia , Embarazo , Femenino , Humanos , Mortalidad Materna , Bangladesh/epidemiología
14.
J Glob Health ; 13: 07002, 2023 06 09.
Artículo en Inglés | MEDLINE | ID: mdl-37288544

RESUMEN

Background: Despite a notable decline in recent decades, maternal mortality in Bangladesh remains high. A thorough understanding of causes of maternal deaths is essential for effective policy and programme planning. Here we report the current level and major causes of maternal deaths in Bangladesh, focusing on care-seeking practices, timing, and place of deaths. Methods: We analysed data from the 2016 Bangladesh Maternal Mortality and Health Care Survey (BMMS), conducted with nationally representative sample of 298 284 households. We adapted the World Health Organization's 2014 verbal autopsy (VA) questionnaire. Trained physicians reviewed the responses and assigned the cause of death based on the International Classification of Diseases (ICD-10). We included 175 maternal deaths in our analysis. Results: The maternal mortality ratio was 196 (uncertainty range = 159-234) per 100 000 live births. Thirty-eight per cent of maternal deaths occurred on the day of delivery and 6% on one day post-delivery. Nineteen per cent of the maternal deaths occurred at home, another 19% in-transit, almost half (49%) in a public facility, and 13% in a private hospital. Haemorrhage contributed to 31% and eclampsia to 23% of the maternal deaths. Twenty-one per cent of the maternal deaths occurred due to indirect causes. Ninety-two per cent sought care before dying, of which 7% sought care from home. Thirty-three per cent of women who died due to maternal causes sought care from three or more different places, indicating they were substantially shuttled between facilities. Eighty per cent of the deceased women who delivered in a public facility also died in a public facility. Conclusions: Two major causes accounted for around half of all maternal deaths, and almost half occurred during childbirth and by two days of birth. Interventions to address these two causes should be prioritised to improve the provision and experience of care during childbirth. Significant investments are required for facilitating emergency transportation and ensuring accountability in the overall referral practices.


Asunto(s)
Eclampsia , Muerte Materna , Mortalidad Materna , Hemorragia Posparto , Muerte Materna/etiología , Bangladesh/epidemiología , Causas de Muerte , Humanos , Femenino , Embarazo , Eclampsia/epidemiología , Hemorragia Posparto/epidemiología , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Accesibilidad a los Servicios de Salud
15.
Clin Radiol ; 78(9): 679-686, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37365116

RESUMEN

AIM: To evaluate hepatocellular adenoma (HCA) subtyping using qualitative magnetic resonance imaging (MRI) features and feasibility of differentiating HCA subtypes using machine learning (ML) of qualitative and quantitative MRI features with histopathology as the reference standard. MATERIALS AND METHODS: This retrospective study included 39 histopathologically subtyped HCAs (13 hepatocyte nuclear factor (HNF)-1-alpha mutated [HHCA], 11 inflammatory [IHCA], one beta-catenin-mutated [BHCA], and 14 unclassified [UHCA]) in 36 patients. HCA subtyping by two blinded radiologists using the proposed schema of qualitative MRI features and using the random forest algorithm was compared against histopathology. For quantitative features, 1,409 radiomic features were extracted after segmentation and reduced to 10 principle components. Support vector machine and logistic regression was applied to assess HCA subtyping. RESULTS: Qualitative MRI features with proposed flow chart yielded diagnostic accuracies of 87%, 82%, and 74% for HHCA, IHCA, and UHCA respectively. The ML algorithm based on qualitative MRI features showed AUCs (area under the receiver operating characteristic curve [ROC] curve) of 0.846, 0.642, and 0.766 for diagnosing HHCA, IHCA, and UHCA, respectively. Quantitative radiomic features from portal venous and hepatic venous phase MRI demonstrated AUCs of 0.83 and 0.82, with a sensitivity of 72% and a specificity of 85% in predicting HHCA subtype. CONCLUSIONS: The proposed schema of integrated qualitative MRI features with ML algorithm provided high accuracy for HCA subtyping while quantitative radiomic features provide value for diagnosis of HHCA. The key qualitative MRI features for differentiating HCA subtypes were concordant between the radiologists and the ML algorithm. These approaches appear promising to better inform clinical management for patients with HCA.


Asunto(s)
Adenoma de Células Hepáticas , Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Adenoma de Células Hepáticas/diagnóstico por imagen , Adenoma de Células Hepáticas/patología , Neoplasias Hepáticas/patología , Estudios Retrospectivos , Imagen por Resonancia Magnética/métodos , Algoritmos
16.
J Glob Health ; 13: 04019, 2023 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-37114719

RESUMEN

Background: Eclampsia, haemorrhage, and other direct causes are the primary burden of maternal mortality in Bangladesh, often reducing attention given to indirect maternal deaths (IMDs). However, Sustainable Development Goals may not be achieved without actions to prevent IMDs. We examined the levels, trends, specific causes, timing, place, and care-seeking, and explored the barriers to IMD prevention. Methods: We used three nationally representative surveys conducted in 2001, 2010, and 2016 to examine levels and trends in IMDs. The analysis of specific causes, timing, and place of IMDs, and care-seeking before the deaths was based on 37 IMDs captured in the 2016 survey. Finally, we used thematic content analysis of the open history from the 2016 survey verbal autopsy (VA) questionnaire to explore barriers to IMD prevention. Results: After increasing from 51 deaths per 100 000 live births in 2001 to 71 in 2010, the indirect maternal mortality ratio (IMMR) dropped to 38 deaths per 100 000 live births in 2016. In 2016, the indirect causes shared one-fifth of the maternal deaths in Bangladesh. Stroke, cancer, heart disease, and asthma accounted for 80% of the IMDs. IMDs were concentrated in the first trimester of pregnancy (27%) and day 8-42 after delivery (32%). Public health facilities were the main places for care-seeking (48%) and death (49%). Thirty-four (92%) women who died from IMDs sought care from a health facility at least once during their terminal illness. However, most women experienced at least one of the "three delays" of health care. Other barriers were financial insolvency, care-seeking from unqualified providers, lack of health counselling, and the tendency of health facilities to avoid responsibilities. Conclusions: IMMR remained unchanged at a high level during the last two decades. The high concentration of IMDs in pregnancy and the large share due to chronic health conditions indicate the need for preconception health check-ups. Awareness of maternal complications, proper care-seeking, and healthy reproductive practices may benefit. Improving regular and emergency maternal service readiness is essential.


Asunto(s)
Muerte Materna , Embarazo , Humanos , Femenino , Masculino , Muerte Materna/prevención & control , Causas de Muerte , Bangladesh/epidemiología , Aceptación de la Atención de Salud , Mortalidad Materna
17.
J Glob Health ; 13: 07001, 2023 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-37022713

RESUMEN

Background: Haemorrhage is a major cause of maternal deaths globally, most of which are preventable and predominantly happen in low and middle-income countries, including Bangladesh. We examine the current levels, trends, time of death, and care-seeking practices for haemorrhage-related maternal deaths in Bangladesh. Methods: We conducted a secondary analysis with data from the nationally representative 2001, 2010, and 2016 Bangladesh Maternal Mortality Surveys (BMMS). The cause of death information was collected through verbal autopsy (VA) interviews using a country-adapted version of the standard World Health Organization VA questionnaire. Trained physicians reviewed the VA questionnaire and assigned the cause of death using the International Classification of Diseases (ICD) codes. Results: Haemorrhage accounted for 31% (95% confidence interval (CI) = 24-38) of all maternal deaths in 2016 BMMS, which was 31% (95% CI = 25-41) in 2010 BMMS and 29% (95% CI = 23-36) in 2001 BMMS. The haemorrhage-specific mortality rate remained unchanged between 2010 BMMS (60 per 100 000 live births, uncertainty range (UR) = 37-82) and 2016 BMMS (53 per 100 000 live births, UR = 36-71). Around 70% of haemorrhage-related maternal deaths took place within 24 hours of delivery. Of those who died, 24% did not seek health care outside the home and 15% sought care from more than three places. Approximately two-thirds of the mothers who died due to haemorrhage gave birth at home. Conclusions: Postpartum haemorrhage remains the primary cause of maternal mortality in Bangladesh. To reduce these preventable deaths, the Government of Bangladesh and stakeholders should take steps to ensure community awareness about care-seeking during delivery.


Asunto(s)
Muerte Materna , Hemorragia Posparto , Femenino , Humanos , Mortalidad Materna , Bangladesh/epidemiología , Causas de Muerte
18.
Front Public Health ; 11: 1121858, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37056652

RESUMEN

Background: In Bangladesh, large gender differentials exist in outcomes in almost all spheres of life, stemming from conservative norms and attitudes around gender. Adolescence is a crucial period for social-emotional learning that can shape gender norms and attitudes. Objective: The aim of the paper is to investigate the extent to which adolescents hold egalitarian attitudes toward gender roles, and to examine the factors that influence egalitarian gender attitudes. Methods: The paper uses data from a nationally representative sample survey of 7,800 unmarried girls and 5,523 unmarried boys ages 15-19 years. Adolescents were considered to have egalitarian attitudes on gender role if they disagreed with all the following four unequal gender role statements with regards to socio-economic participation, while respondents who agreed with any one of the four statements were considered to have non-egalitarian attitudes: (1) It is important that sons have more education than daughters, (2) Outdoor games are only for boys, not girls, (3) Household chores are for women only, not for men, even if the woman works outside the home, and (4) Women should not be allowed to work outside the home. Multivariable linear probability regression analysis was implemented to identify the factors shaping attitudes on gender roles. Results: Unmarried girls and boys differ hugely in their views on gender roles regarding socio economic participation-girls were much more egalitarian than boys (58 vs. 19%). The multivariate linear probability model results show girls and boys who completed at least grade 10 were 31% points and 15% points more likely to have egalitarian views on gender roles respectively, compared to girls and boys with primary or less education. Having strong connection with parents is associated with having egalitarian views on gender roles among girls but not boys. Adolescents' individual attitude on gender role is highly associated with the views of their community peers for both girls and boys. Girls and boys who had participated in adolescent programs were 6-7% points more likely to have egalitarian attitude than those who were not exposed to these programs. Egalitarian views were also significantly higher, by 5% points among girls and 6% points among boys, who were members of social organizations compared to those who were not. Watching television had positive influence on egalitarian attitudes among girls but not among boys. To create a more egalitarian society, both men and women need to hold progressive attitudes toward gender roles. The interventions must be multilevel, influencing adolescents at the personal, interpersonal, communal, and societal levels.


Asunto(s)
Identidad de Género , Rol de Género , Masculino , Humanos , Adolescente , Femenino , Adulto Joven , Adulto , Bangladesh , Actitud , Grupo Paritario
19.
Front Public Health ; 11: 1125056, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37077187

RESUMEN

Background: Intimate partner violence (IPV), and especially intimate partner physical violence (IPPV), perpetrated by husbands, and within adolescence marriage are pervasive in Bangladesh. Younger women are more vulnerable to IPPV. Objectives: We examined factors associated with IPPV experienced by married adolescents ages 15-19 and tested four hypotheses: (1) adolescent girls married to relatively older husbands, (2) adolescents living in extended families with parents or parents-in-law, (3) adolescents who are minimally controlled by husbands, and (4) adolescents who have a child after marriage are protective of IPPV. Methods: We analyzed IPPV data from 1,846 married girls ages 15-19 obtained from a national adolescent survey conducted in 2019-20. IPPV is defined as the respondent having physical violence perpetrated by her husband at least once in the last 12 months. We implemented logistic regression models to test our hypotheses. Results: Sixteen percent of married adolescent girls experienced IPPV. Girls living with parents-in-law or parents had adjusted odds ratio (AOR) of 0.56 (p < 0.001) of IPPV compared to those girls who lived with husband alone. Girls with husbands ages 21-25 years and 26 years or older had AORs of 0.45 (p < 0.001) and 0.33 (p < 0.001) of IPPV compared to those girls with their husband ages 20 and younger. Married adolescent girls who did not own a mobile phone (an indicator of spousal power dynamics) had an AOR of 1.39 (p < 0.05) compared to those girls who had a phone. IPPV risk increases with an increased duration of marriage for those with no living children (p < 0.001) but not for those with at least one living child; the risk was higher among those who had a child within the 1st year of marriage than those who had not yet had a child. At a duration of 4 years and longer, IPPV risk was higher among those with no living children than those with children. Discussion: Findings related to those living with parents-in-law or parents, girls married to relatively older boys/men, having the ability to communicate with outside world, and having a child are protective of IPPV in Bangladesh are new, to our knowledge. Strictly adhering to the law that requires men waiting until the age of 21 to marry can reduce married girls' risk of IPPV. Raising girls' legal marriage age can minimize adolescents' IPPV and other health risks associated with adolescent childbearing.


Asunto(s)
Violencia de Pareja , Matrimonio , Humanos , Masculino , Adolescente , Niño , Femenino , Adulto Joven , Adulto , Bangladesh/epidemiología , Abuso Físico , Padres
20.
Braz J Biol ; 83: e264249, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36946787

RESUMEN

Xanthomonas oryzae pv. oryzae (Xoo) causes bacterial leaf blight that is a major threat to rice production. Crop losses in extreme situations can reach up to75%, and millions of hectares of rice are affected each year. Management of the disease required information about the spatial distribution of BLB incidence, severity, and prevalence. In this study, major rice-growing areas of Pakistan were surveyed during 2018-2019 for disease occurrence, and thematic maps were developed using geographic information system (GIS). Results showed that Narowal district had highest percentage of disease incidence (54-69%), severity (42-44%), and prevalence (72-90%) meanwhile Jhung district had the lowest incidence (21-23%), severity (18-22%), and prevalence (45-54%). To understand the environmental factors contributing to this major rice disease, the research analyze, the spatial relationships between BLB prevalence and environmental variables. Those variables include relative humidity (RH), atmospheric pressure (A.P), minimum temperature, soil organic carbon, soil pH, and elevation, which were evaluated by using GIS-based Ordinary Least Square (OLS) spatial model. The fitted model had a coefficient of determination (R2) of 65 percent explanatory power of disease development. All environmental variables showed a general trend of positive correlation between BLB prevalence and environmental variables. The results show the potential for disease management and prediction using environmental variable and assessment.


Asunto(s)
Oryza , Carbono , Suelo , Análisis Espacial , Pakistán , Enfermedades de las Plantas
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