Mother's dietary diversity and association with stunting among children <2 years old in a low socio‐economic environment: A case–control study in an urban care setting in Dhaka,Bangladesh

Mothers are often responsible for preparing nutritious foods in their households. However, the quality of mother's diets is often neglected, which may affect both mother's and child's nutrition. Because no single food contains all necessary nutrients, diversity in dietary sources is needed to ensure a quality diet. We aimed to study the association between mother's dietary diversity and stunting in children <2 years attending Dhaka Hospital of icddr,b, a diarrhoeal disease hospital in Dhaka, Bangladesh. A case–control study (n = 296) was conducted from November 2016 to February 2017. Data were collected from mothers of stunted children <2 years (length‐for‐age z score [LAZ] < ?2) as “cases” and nonstunted (LAZ ≥ ?1) children <2 years as “controls.” Mothers were asked to recall consumption of 10 defined food groups 24 hr prior to the interview as per Guidelines for Minimum Dietary Diversity for Women. Among the mothers of cases, 58% consumed <5 food groups during the last 24 hr, compared with 45% in control mothers (P = 0.03). Children whose mothers consumed <5 food groups were 1.7 times more likely to be stunted than children whose mothers consumed ≥5 food groups (P = 0.04). Intake of food groups such as pulses, dairy, eggs, and vitamin A rich fruit was higher in control mothers. Proportion of mother's illiteracy, short stature, monthly family income <BDT 11,480, absence of bank account, and poor sanitation was also found to be higher in stunted group. Further study particularly intervention or longitudinal study to see the causality of mother's dietary diversity with child stunting is recommended.     

Women's empowerment and fertility preferences of married women: analysis of demographic and health survey’2016 in Timor-Leste

A recently independent state, Timor-Leste, is progressing towards socioeconomic development, prioritizing women empowerment while its increased fertility rate (4.1) could hinder the growth due to an uncontrolled population. Currently, limited evidence shows that indicators of women''s empowerment are associated with fertility preferences and rates. The objective of this study was to assess the association between women empowerment and fertility preferences of married women aged 15 to 49 years in Timor-Leste using nationally representative survey data. The study was conducted using the data of the latest Timor-Leste Demographic and Health Survey 2016. The study included 4040 rural residents and 1810 urban residents of Timor-Leste. Multinomial logistic regression has been performed to assess the strength of association between the exposures indicating women''s empowerment and outcome (fertility preference). After adjusting the selected covariates, the findings showed that exposures that indicate women empowerment in DHS, namely, the employment status of women, house and land ownership, ownership of the mobile phone, and independent bank account status, contraceptive use, and the attitude of women towards negotiating sexual relations are significantly associated with fertility preferences. The study shows higher the level of education, the less likely were the women to want more children, and unemployed women were with a higher number of children. Our study also found that the attitude of violence of spouses significantly influenced women''s reproductive choice. However, employment had no significant correlation with decision-making opportunities and contraceptive selection due to a lack of substantial data. Also, no meaningful data was available regarding decision-making and fertility preferences. Our findings suggest that women''s empowerment governs decision-making in fertility preferences, causing a decline in the fertility rate.     

'Every mother is a mini-doctor': ethnomedicinal uses of fish, shellfish and some other aquatic animals in Bangladesh

Aim of the study

This research article examines the zootherapeutic uses of fish, shellfish and some other aquatic animals in two fishing villages in Bangladesh-one floodplain and one coastal.

Materials and methods

The floodplain fishing village Volarkandi is located within the Hakaluki wetland ecosystem in the northern Bangladesh and is inhabited mostly by Muslim fishers, whereas the coastal fishing village Thakurtala is located on Moheskhali island and most of the inhabitants are caste-based Hindu fishers. Participatory techniques were used to collect and validate information from the key informants.

Results

The research revealed that, historically, fishers have used fish and other aquatic animals not only as food items for nutrition, but also to solve a host of physical problems and diseases. Fish and shellfish are widely used for their galactogogue and aphrodisiac properties, for quick recovery from long-time sickness, to enhance the ‘intelligence level’ of children, and to prevent and treat a host of diseases like night blindness, chicken pox, dysentery, piles, muscular inflammation, fistula, malaria, skin diseases and ‘big belly’ syndrome in children. Depending on the objective of the use, different parts of the animal body, its derivatives, or the whole animal are used. The research also clarified different forms of the recipes used. The socio-cultural construction of the ethnomedicinal uses and the distinct gender roles of the fisherwomen were analyzed.

Conclusion

The research revealed that the aetiologies and the preventive measures against folk illness are socio-culturally embedded and such indigenous medical systems grow and are sustained as a situated body of knowledge within the boundaries of a typical world view framed by local culture and biodiversity.     

Racial Disparities in Erectile Dysfunction among Participants in the California Men's Health Study

IntroductionThe burden of erectile dysfunction (ED) among different racial and ethnic groups is unclear, in part, because prior studies have not included all four major racial and ethnic groups in the same population‐based sample.AimTo determine the prevalence and odds of ED among all four major racial and ethnic groups after adjustment for demographic, medical, socioeconomic, and lifestyle characteristics.MethodsThis cross‐sectional study was conducted using data from men, aged 45–69 years, without a diagnosis of prostate cancer (N = 78,445), who completed questionnaires as part of the California Men's Health Study, a large multiethnic cohort study with detailed demographic, medical and, socioeconomic data.Main Outcome MeasureErectile dysfunction measured by a previously validated four‐level response question.ResultsThe overall prevalence of ED by age category was 13%, 24%, and 44% for men aged 45–49 years, 50 and 59 years, and 60–69 years, respectively. In a multivariable model, relative to white men, Hispanic (OR 1.05, 95% CI 0.99, 1.12), Asian (OR 1.1, 95% CI 1.02, 1.19), and other men (OR 1.13, 95% CI 1.06, 1.1.21) had increased odds of moderate‐severe ED, while black men were less likely to report moderate to severe ED (OR 0.86, 95% CI 0.81, 0.92). Black (OR 0.54, 95% CI 0.48, 0.61) and Asian men (OR 0.91, 95% CI 0.80, 1.04) were less likely to have severe ED after adjustment for age, socioeconomic status, medical co‐morbidities, and lifestyle characteristics.ConclusionThese data demonstrate that the prevalence of ED among different racial and ethnic groups is likely the result of complex phenomena and depends upon the interplay of socioeconomic, demographic, medical, cultural, and lifestyle characteristics. After accounting for these factors, these data suggest that Asian and black men are less likely to have severe ED relative to white men. Smith JF, Caan BJ, Sternfeld B, Haque R, Quesenberry CP, Jr, Quinn VP, Shan J, Walsh TJ, Lue TF, Jacobsen SJ, and Van Den Eeden SK. Racial disparities in erectile dysfunction among participants in the California men's health study.     

Correlation between severity of coronary artery stenosis and perfusion defect assessed by SPECT myocardial perfusion imaging

Numerous non-invasive techniques are developed to assess the severity of coronary artery disease (CAD). Coronary angiography (CAG) is an established method for the diagnosis and to quantify the severity of coronary artery stenosis. Single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) using Technetium-99m (Tc-99m) tetrofosmin is also a useful established technique for the assessment of severity of CAD. This prospective observational study was carried out in Bangabandhu Sheikh Mujib Medical University (BSMMU) to assess the severity of coronary artery stenosis using Tc-99m Single Photon Emission Computed Tomography myocardial perfusion imaging (SPECT-MPI) in comparison with CAG. Eighty two (82) consecutive patients with mean age 53.51(SD+/-7.08) years and Candian Cardiovascular Society (CCS) class I and II severity of chest pain, male: female ratio (4.8:1) was studied. Tc-99m SPECT-MPI was performed by one-day exercise stress and rest protocol. A total of two hundred and forty six coronary artery territories examined in this study. By CAG normal coronary arteries were found in seventy six, moderate stenosis in twenty four and severe stenosis in one hundred and forty-six coronary artery territories whereas SPECT-MPI found normal perfusion in twenty seven, mild perfusion abnormality in seventeen, moderate perfusion abnormality in thirty two and severe perfusion abnormality in one hundred and sixty five coronary artery territories. Sensitivity and specificity of SPECT-MPI using Tc-99m tetrofosmin in detecting coronary artery stenosis were 87.09% and 80.95% respectively. The positive predictive value, negative predictive value and accuracy of the test were 91.01%, 73.91% and 85.18% respectively. From this study it can be concluded that Tc-99m SPECT-MPI was a safe, effective and excellent non-invasive tool for the detection of severity of coronary artery lesion and can be used to predict severity of CAD.     

Performance of Microchannel Heat Sink Made of Silicon Material with the Two-Sided Wedge

New designs of the microchannel with a two-sided wedge shape at the base were studied numerically. Five different wedge angles ranging from 3° to 15° were incorporated into the microchannel design. Simulation of this novel microchannel was carried out using Computational Fluid Dynamics (CFD). Three-dimensional models of the microchannel heat sink were created, discretized, and based on Navier–Stokes and energy equations; laminar numerical solutions were obtained for heat transfer and pressure drop. Flow characteristics of water as coolant in a microchannel were studied. It was observed that numerical results are in good agreement with experimental results. It was found that the Nusselt number and friction factor are significantly varied with the increase in Reynolds number. The Nusselt number varies in the following ranges of 5.963–8.521, 5.986–8.550, 6.009–8.568, 6.040–8.609, and 6.078–8.644 at 3°, 6°, 9°, 12°, and 15°, respectively. The microchannel with a wedge angle of 15° was found to be better in terms of Nusselt number and thermo-hydraulic performance. The enhancement in the Nusselt number is found as 1.017–1.036 for a wedge angle of 15°; however, friction factors do not show the perceptible values at distinct values of wedge angle. Moreover, the thermo-hydraulic performance parameters (THPP) were evaluated and found to be maximum in the range of 1.027–1.045 for a wedge angle of 15°. However, minimum THPP was found in the range of 1.005–1.0185 for a wedge angle of 3°.     

Evolution of a Systematic Approach to Smoking Cessation in Ontario’s Regional Cancer Centres

Smoking cessation after a cancer diagnosis can significantly improve a person’s prognosis, treatment efficacy and safety, and quality of life. In 2012, Cancer Care Ontario (now part of Ontario Health) introduced a Framework for Smoking Cessation, to be implemented for new ambulatory cancer patients at the province’s 14 Regional Cancer Centres (RCCs). Over time, the program has evolved to become more efficient, use data for robust performance management, and broaden its focus to include new patient populations and additional data collection. In 2017, the framework was revised from a 5As to a 3As brief intervention model, along with an opt-out approach to referrals. The revised model was based on emerging evidence, feedback from stakeholders, and an interim program evaluation. Results showed an initial increase in referrals to cessation services. Two indicators (tobacco use screening and acceptance of a referral) are routinely monitored as part of Ontario Health’s system-wide performance management approach, which has been identified as a key driver of change among RCCs. Due to the COVID-19 pandemic, many RCCs reported a decrease in these indicators. RCCs that were able to maintain a high level of smoking cessation activities during the pandemic offer valuable lessons, including the opportunity to swiftly leverage virtual care. Future directions for the program include capturing data on cessation outcomes and expanding the intervention to new populations. A focus on system recovery from COVID-19 will be paramount. Smoking cessation must remain a core element of high-quality cancer care, so that patients achieve the best possible health benefits from their treatments.