Background: There is increasing concern around the use of antibiotics in animal food production and the risk of transmission of antimicrobial resistance within the food chain. In many low and middle-income countries, including Bangladesh, the commercial poultry sector comprises small-scale producers who are dependent on credit from poultry dealers to buy day-old chicks and poultry feed. The same dealers also supply and promote antibiotics. The credit system is reliant upon informal relationships among multiple actors as part of social capital. This paper aims to describe dependencies and relationships between different actors within unregulated broiler poultry production systems to understand the social and contextual determinants of antibiotic use in low-resource settings. Methods: We used a cross-sectional qualitative design including in-depth interviews among purposefully selected commercial poultry farmers (n = 10), poultry dealers (n = 5), sales representatives of livestock pharmaceutical companies (n = 3) and the local government livestock officer as a key-informant (n = 1). We describe the food production cycle and practices relating to credit purchases and sales using social capital theory. Findings: Poultry dealers provide credit and information for small-scale poultry farmers to initiate and operate their business. In return for credit, farmers are obliged to buy poultry feed and medicine from their dealer and sell their market-ready poultry to that same dealer. All farms applied multiple antibiotics to poultry throughout the production cycle, including banned antibiotics such as colistin sulfate. The relationship between dealers and poultry farmers is reciprocal but mostly regulated by the dealers. Dealers were the main influencers of decision-making by farmers, particularly around antibiotic use as an integral part of the production cycle risk management. Our findings suggest that strategies to improve antibiotic stewardship and responsible use should exploit the patron-client relationship which provides the social and information network for small-scale farmers. Masud et al. Antibiotic Use in Poultry Production Conclusion: Social capital theory can be applied to the patron-client relationship observed among poultry farmers and dealers in Bangladesh to identify influences on decision making and antibiotic use. Within unregulated food production systems, strategies to promote the prudent use of antibiotics should target commercial feed producers and livestock pharmaceutical manufacturers as a first step in developing a sustainable poultry value chain.

A longitudinal stove intervention study was conducted in Northwest Bangladesh between August 2005 and June 2009 to quantify the reduction of indoor air pollution from a Bangladeshi manufactured and commercialized cookstove (the BCSIR improved stove). In the post-intervention phase of the study, the indoor particulate matter (PM) size distribution and chemical composition, as well as carbon monoxide (CO) concentration, were characterized in 40 kitchens, 50% with the BCSIR improved stoves and 50% with traditional stoves. The TSI DustTrak, P-TRAK and Q-TRAK Plus, along with the UCB Particle Monitor and the Onset HOBO, were simultaneously deployed to continuously characterize Carbon Monoxide (CO) and Particulate Matter (PM). Detailed chemical composition was quantified from X-Ray Flouroscence and Carbon Analyzer. Median 24-hr concentrations for CO and PM 2.5 were 2.5 mg/m 3 and 1.8 mg/m 3 , respectively, for the unimproved mud stove kitchens and were 2.0 mg/m 3 and 0.73 mg/m 3 , respectively, for the BCSIR improved stove kitchens. These differences were equivalent to 23% and 59% reduction of CO and PM 2.5 concentrations, respectively. The cook's daily exposure was estimated from these measurements to assess health impacts. Ultrafine particle number concentrations were 15,000 ± 7,200 pt/cm 3 during non-cooking periods and 75,000 ± 31,000 pt/cm 3 during cooking periods. Of the chemical composition of the PM 2.5 emitted from cooking, 59-60% was organic matter and 29-30% was elemental carbon. The predominant chemical species were elemental carbon (EC), organic carbon (OC), chlorine, and potassium. These results demonstrate possible reduction of PM and CO from cooking with improved stoves in rural areas in Bangladesh where solid fuels are used for cooking.

In high dimensional data analysis (such as gene expression, spatial epidemiology, or brain imaging studies), we often test thousands or more hypotheses simultaneously. As the number of tests increases, the chance of observing some statistically significant tests is very high even when all null hypotheses are true. Consequently, we could reach incorrect conclusions regarding the hypotheses. Researchers frequently use multiplicity adjustment methods to control type I error rates—primarily the family-wise error rate (FWER) or the false discovery rate (FDR)—while still desiring high statistical power. In practice, such studies may have dependent test statistics (or p-values) as tests can be dependent on each other. However, some commonly-used multiplicity adjustment methods assume independent tests. We perform a simulation study comparing several of the most common adjustment methods involved in multiple hypothesis testing, under varying degrees of block-correlation positive dependence among tests.

BackgroundBangladesh faces daunting challenges in addressing the sanitation needs of its urban poor. Maintaining the cleanliness and functionality of communal toilets is dependent upon periodic emptying of fecal sludge, and cooperation between users of communal toilets. Trash disposal into latrines can block the outflow pipes, rendering the toilets non-functional.MethodsPre-intervention: We conducted in-depth interviews with five operators of fecal sludge emptying equipment and five adult residents who were also caregivers of children. We identified factors contributing to improper disposal of trash into communal toilets, a barrier to operation of the equipment, in low-income communities of Dhaka, Bangladesh.Intervention design: We developed behavior change communication materials to discourage waste disposal in toilets, and promote use of waste bins. We conducted six focus group discussions with adult male, female, landlord and children to select the preferred design for waste bins to be placed inside toilets, and finalize communication materials.Post-intervention: We then pilot-tested an intervention package to promote appropriate trash disposal practices and thus facilitate periodic removal of fecal sludge when the latrine pits become full. We conducted 20 in-depth interviews and four focus group discussions with community residents, landlords and cleaners of communal toilets.ResultsBarriers to appropriate waste disposal included lack of private location for disposal of menstrual hygiene products, limited options for formal trash collection and disposal, and the use of plastic bags for disposing children’s feces. A pilot intervention including behavior change communication and trash bins was implemented in two urban slum communities. Spot checks confirmed that the bins were in place and used. Respondents described positive improvements in the appearance of the toilet and surrounding environment.ConclusionThe current practice on the part of local residents of disposing of waste into toilets impedes the safe removal of fecal sludge and impairs toilet functionality. Residents reported positive changes in toilet cleanliness and usability resulting from this intervention, and this both improves the user experience with toilets, and also promotes the sustainability of the entrepreneurial model of Vacutug operators supported by WSUP.

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In one of few efforts to promote shared toilet cleanliness, intervention compounds were significantly more likely to have cleaner toilets after six months. Future research might explore how residents can self-finance toilet maintenance, or employ mass media to reduce per-capita costs of behaviour change.

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Background: Rohingya refugees are one of the most vulnerable group due to lack of health care system, personal hygiene, shelter, sanitation and violence. Aim: The present study aims to find out the health problems and health care seeking behavior of Rohingya Refugees, to identify the socio-demographic information for such exposure group in relation to age, sex, occupation, living areas, to explore the patient's physical, emotional, perceptions, attitudes and environmental health problems and to bring out health care seeking behavior of refugees. Methodology: A cross-sectional study was conducted. A total of 149 samples were selected conveniently for this study from the refugee camps. Data was collected by using mixed type of questionnaire. Descriptive statistic was used for data analysis which has depicted through tables, pie chart and bar chart. Results: The finding of the study showed that 45.6% participants had multiple problems, followed by 16.8% participants who had other specific problems like musculoskeletal pain, visual problems and peptic ulcer. Urinary tract infection was the leading individual health problem with 11.4% of the sample group having it. 10.7% participants had hypertension, 6% had respiratory tract infection, 3.4% had nutrition deficiency, 4.75% had diabetes mellitus and 1.3% had sanitation & hygiene problems. Among the participants, 68.4% age ranged between 15-59 years. The study showed that, only 16.1% participants were satisfied with the quality of service they received while 37.6% participants said that they needed better services such as more laboratory test, radiological imaging, more medicine and more doctors. Conclusion: It is clear that refugees suffered from a variety of health problems, because their living condition and environmental situation were not similar like an independent nation. Further, basic amenities like medicines and other services were not available.