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Rawal, LB orcid:0000-0003-1106-0108 ; Noncommunicable diseases (NCDs) have been increasing rapidly and are now the major cause of disease burden and deaths in the Asia Pacific region. This rising disease burden has challenged health systems in countries of the region and could hamper achievements of the Millennium Development Goals. This has raised concerns among policy-makers about the need to identify innovative approaches to control NCDs and meet the health needs of the public. Strengthening primary health care (PHC) services and the workforce to deliver such services has been considered as an option to address the growing need of services for NCDs. Community health workers (CHWs) have increasingly been recognized as a frontline health-care workforce to support government actions to combat NCDs. However, the role of CHWs within the PHC system is not well defined. To provide policy-makers with a package of options to engage CHWs in NCD care, this policy brief summarizes CHW-led programmes, describes challenges to integrating CHW-led NCD programmes and make recommendations. The development of this policy brief was based on experiences in four countries of the region – Bangladesh, China, Nepal and Viet Nam. However, it is worth emphasizing from the outset that our study is not designed to be representative of the four countries but exploratory in nature.

Under the leadership of the Directorate General of Health Services, the Population Council in collaboration with James P. Grant School of Public Health, BRAC University and with support from UNICEF is testing an innovative service delivery model to provide financial incentives to institutions to enhance their performance on maternal, newborn, and child health (MNCH) services in three districts of Bangladesh as part of GOB-UNICEF's ongoing MNCH/MNH projects. A comparative analysis on the availability and condition of physical and human assets across 16 health facilities will inform what is needed in a facility in terms of inputs and processes. This report presents the key findings of the rapid assessment of 16 government health facilities conducted in the preparatory phase of the P4P project. A comprehensive assessment will be followed before incentive-related intervention activities can be initiated. This facilities assessment report indicates that no facilities are in perfect condition to provide quality MNCH services because all are burdened with problems related to human resource, physical infrastructure, equipment, logistics and supplies, and medicine. Before initiating the performance-based incentives, the lack in physical and human assets must be addressed.

[EN] Upgrading of the heavy reformate fraction (HR), containing mainly C9+ aromatics, is usually performed by dealkylation or by transalkylation with added benzene and/or toluene to obtain the more valuable xylenes. However, when the costs related to the use of benzene and toluene are considered, the one-step dealkylation/transalkylation of the C9+ alkylaromatics to xylenes becomes economically attractive. Thus, in a first step, ethylmethylbenzenes (EMB) will have to be dealkylated to toluene, which will then react with the trimethylbenzenes (TMB) present in the HR feed to produce xylenes by transalkylation. Medium pore zeolites will favor dealkylation, whereas large pore zeolites will be more adequate for carrying out the transalkylation reaction. In this work, we present the one-pot synthesis of beta-pentasil aggregates with tunable ratios of the large pore beta to the medium pore component. We show that the close proximity of the beta and pentasil nanocrystals obtained by one-pot co-crystallization synthesis, results in a highly efficient catalyst for the consecutive dealkylation/transalkylation process. The bifunctional catalyst based on the co-crystallized aggregate is more active and selective to xylenes than a catalyst based on a physical mixture of equivalent beta and pentasil nanozeolites synthesized following an analogous procedure. The small crystallite sizes of the co-crystallized zeolites provide the additional advantage of a lower deactivation rate as compared to a reference benchmark catalyst. Results are shown on both, model molecules and industrial HR feed. ; This work has been supported by Saudi Aramco, by the Spanish Government-MICINN through "Severo Ochoa" (SEV 2012-0267) and RTI2018-101033-B-I00, by the European Union through ERC-AdG-2014-671093 (SynCatMatch) and by the Ftmdacion Ramon Areces through a research contract of the "Life and Materials Science" program. We thank Belen Esparcia for technical assistance, and the Electron Microscopy Service of the UPV for their help in sample ...

This is a cross-sectional study that examined the association between fitness trainers' educational qualifications and experience, and the risk of their trainees' musculoskeletal pain. The study included 1177 trainees (aged 15–60 years) from 74 fitness centers in Bangladesh. Data were collected by using the Nordic musculoskeletal questionnaire, including potential confounders such as demographic factors (e.g., age, occupation), and training-related factors (e.g., workout knowledge, overweight lifting). Multiple logistic regression was performed for a binary outcome (pain—yes or no), and a generalized linear model was fitted for the ordinal outcome (pain—sites of the body). The trainers' lower experience (no or ≤1 year) was associated with higher odds of their trainees' musculoskeletal pain (OR: 2.53, 95% CI: 1.18–5.44) compared to trainers with >5 years of experience; however, no association was found between the trainers' education and the risk of their trainees' musculoskeletal pain, after controlling for potential confounders. Similarly, the trainees trained by trainers with lower experience had more than two-time the risk of having pain in different sites (IRR: 2.04, 95% CI: 1.50–2.79). The trainers' experience may play a pivotal role in the trainees' musculoskeletal pain. Further study is warranted in this regard.

Purpose: The major objectives of the study were to assess the knowledge, attitude & practice (KAP) towards community preparedness and response on prevention of COVID-19 among the community people. Method: A sample survey was conducted to collect data from people admitted to a district-level tertiary hospital for the treatment of various health complications during the COVID-19 pandemic. A total of 300 randomly selected patients and their attendants were interviewed in the hospital setting. Results: The mean knowledge score was 18.73 out of 24 and the main sources of information were TV (86.5%), radio (13%), newspaper (13%), social media (13.5%), friends/relatives (14%), formal healthcare providers (6%) and religious leaders (3%). Knowledge was significantly poor among aged people, women, less educated, and less earning. The majority of the participants (79%) suggested wearing facemasks as effective tools to prevent COVID-19 from spreading, whereas 56% mentioned maintaining physical or social distance as crucial to prevent the infection. We found strong relationship between monthly total family expenses and wearing of facemasks by gender to prevent the COVID-19 (x2= 18.405; Cramer's V= .17, df = 8; sig; P= < .018). Similarly maintaining physical/social distance to prevent COVID-19 is also related to respondents' economic strata (x2= 43.741; Cramer's V= .14, df = 20; Sig; P= < .002). Conclusions: Awareness program on COVID-19 is very important to prevent the spread of the deadly virus. Effective communication intervention with increasing treatment facilities is essential for the prevention and control of COVID-19. Government and development agencies should prioritize the COVID-19 response program with regular health care services.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. Based on the findings of the non-communicable disease Risk Factors Survey Bangladesh 2010, the prevalence of hypertension in adults 25 years or older in Bangladesh is 20.1%. The Bangladesh Demographic Health Survey, 2011 showed that approximately 50% of those affected are unaware of their hypertensive condition. The May Measurement Month 2017 (MMM17) is a global initiative of the International Society of Hypertension (ISH) aimed at raising awareness of high BP. We participated in MMM17 to raise awareness of hypertension screening and identify those with elevated BP who were unaware, and those on treatment with still uncontrolled hypertension. Following the standard protocol designed by the ISH, we participated in MMM17, an opportunistic cross-sectional survey of volunteers aged ≥18. It was carried out in May 2017. BP measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. Data were collected from 35 screening sites in 33 districts in Bangladesh. Personnel from several government and non-government organizations volunteered in this huge event. A total of 11 418 individuals were screened during MMM17, of which 5401 (47.3%) were found to have hypertension. Of 8365 individuals not receiving anti-hypertensive medication, 2348 (28.1%) were hypertensive. Of 3053 individuals receiving anti-hypertensive medication, 1594 (52.2%) had uncontrolled BP. MMM17 was the largest BP screening campaign undertaken in Bangladesh. This study suggests that opportunistic screening can identify significant numbers of people with raised BP. A periodic public health programme at a national level needs to be initiated to increase hypertension detection and control rate and thus for the prevention of cardiovascular diseases.

BACKGROUND: During the time a diarrhea patient presents at a health facility, the household members of the patient are at higher risk of developing diarrheal diseases (> 100 times for cholera) than the general population. The Cholera-Hospital-based-Intervention-for-7-Days (CHoBI7) is a health facility-initiated water treatment and handwashing with soap intervention designed to reduce transmission of diarrheal diseases between patients and their household members. The present research aimed to (1) develop a scalable approach to integrate the CHoBI7 intervention program into services provided at government and private health facilities in Bangladesh; and (2) tailor the intervention program for the household members of all diarrhea patients, irrespective of the etiology of disease. METHODS: We conducted 8 months of formative research, including 60 semi-structured interviews, 2 group discussions, and a pilot study. Thirty-two interviews were conducted with diarrhea patients and their family caregivers, government stakeholders, and health care providers both to explore existing WASH and diarrhea patient care practices in health facilities and to identify considerations for scaling the CHoBI7 program. Fifty-two diarrhea patient households participated in a pilot study of a modified version of the CHoBI7 intervention program for tailoring. Twenty-eight interviews and 2 group discussions were conducted with pilot households to explore experiences with and recommendations for intervention delivery. RESULTS: The intervention program was modified based on formative research findings. Pilot study participants recognized the benefits of the CHoBI7 intervention program and made suggestions to improve the acceptability and feasibility of the intervention. Modifications included 1) providing additional pictorial modules, cues to action, enabling technologies, and supplies for safe drinking water and handwashing with soap behaviors in the health facility; 2) switching out technology prone to breaks and leaks as well as ...