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If you missed it, you can catch up on this podcast.
Friday 5 April 2019, 6.15pm-7.15pm at The Wheeler Centre
Never the Less: Disability, Displacement and Human Rights
More than a billion people live with some form of disability. That's about 15% of the world's population and yet across the globe, people with disabilities face regular contraventions of their basic rights. These range from egregious abuses – such as being put in shackles – to basic barriers to education, employment, safety and inclusion.
In this conversation, presented in partnership with Human Rights Watch, we'll focus on some key issues and priorities, especially relating to disability rights in the region and in conflict zones. We'll hear from Shantha Rau Barriga from Human Rights Watch and from author and disability rights advocate Nujeen Mustafa. Nujeen's book, Nujeen: One Girl's Incredible Journey from War-torn Syria in a Wheelchair, tells the story of her extraordinary journey from Syria to Germany in a wheelchair – a journey she undertook in 2014 at the age of 16.
The pair will discuss Nujeen's personal story and speak more broadly on issues of displacement, detention, disability and human rights. Hosted by David Manne.
Presented in partnership with Human Rights Watch.
This event will be Auslan interpreted.
Readings will be our bookseller for this event.
Free speech, human rights & social issues
Nujeen Mustafa
@NujeenMustafa
In January 2014, when Nujeen Mustafa was 16, she began a 5,600 kilometre journey from Syria to Germany in a steel wheelchair. She has since become a powerful advocate for the rights of refugees and for people with disabilities, sharing the harrowing story of her journey to move hearts and change policies. Mustafa was born with cerebral palsy, unable to walk without assistance. In her home city of Aleppo, Syria, she never attended school. She taught herself English by watching American soap operas.
Mustafa's account was chronicled in a book co-authored by a British journalist and author, Christina Lamb, Nujeen: One Girl's Incredible Journey from War-torn Syria in a Wheelchair. Her persuasive speaking has also encouraged international disability reform efforts.
Shantha Rau Barriga
@ShanthaHRW
Shantha Rau Barriga is the founding director of the disability rights division at Human Rights Watch. She leads research and advocacy on human rights abuses against persons with disabilities worldwide including: the shackling of people with psychosocial disabilities, denial of education for children with disabilities, violence against women and girls with disabilities, institutionalisation of children and adults with disabilities, and the neglect of people with disabilities in humanitarian emergencies.
David Manne
@david_manne
David Manne is a human rights lawyer and Executive Director of Refugee Legal (previously the Refugee & Immigration Legal Centre (RILC)). He has worked in various capacities assisting refugees and asylum seekers for over 20 years. In January 2001, he joined Refugee Legal, at the forefront of defending the rights, the dignity and the lives of asylum seekers, refugees and disadvantaged migrants.
Safe Harbour / Migration
With Sally Warhaft, Mariam Veiszadeh, and David Manne
Law & Order Week
Compassionate Bastard / Law, ethics & philosophy
With Peter Mitchell, David Manne, and Peter Mares
So Who the Bloody Hell Are We?
The Fair Go
With Stuart Macintyre, Monica Dux, David Manne and 2 others
We've Got This: Stories by Disabled Parents / Disability
With Jax Jacki Brown, Mandy McCracken, Shakira Hussein and 1 other
Together in Literature: 100 Years of PEN International / Free speech, human rights & social issues
With Shokoofeh Azar, Hidayet Ceylan, Chris Lwin and 4 others
Pah! Deaf Storytelling Night / Disability
With Sam Martin, Danni Wright, Jasmine Shirrefs and 3 others


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Patrick Semansky-Pool/Getty Images
U.S. Gen. Mark Milley allegedly asked his Russian counterpart last week to clarify an earlier offer by Russian President Vladimir Putin for the U.S. to use Russian military bases in Central Asia to monitor emerging security threats from Afghanistan, the Wall Street Journal (WSJ) reported Monday, citing unnamed U.S. government officials.
Gen. Mark Milley serves as the chairman of the U.S. Joint Chiefs of Staff. The position means he advises the U.S. president, National Security Council, and other U.S. government entities on military matters.
According to the WSJ, U.S. President Joe Biden's National Security Council staff "requested" Gen. Milley "clarify whether Mr. Putin was simply making a debating point or was hinting at a serious offer," during his September 22 meeting with Russian Chief of General Staff Valery Gerasimov in Helsinki, Finland.
Russian President Vladimir Putin, accompanied by Defence Minister Sergei Shoigu and Valery Gerasimov, the chief of the Russian General Staff. (MIKHAIL KLIMENTYEV/SPUTNIK/AFP via Getty Images).
"Gen. Gerasimov was noncommittal during the Helsinki meeting, the U.S. officials said. A Kremlin spokesman declined to comment," the WSJ reported.
U.S. President Joe Biden met in person with Russian President Vladimir Putin on June 16 in Geneva, Switzerland, for a bilateral summit. Putin allegedly offered Biden "the use of Russian military bases in Central Asia for information gathering from Afghanistan," during the meeting according to a July 17 report by Russia's Kommersant newspaper.
Putin proposed Moscow and Washington "coordinate on Afghanistan and put Russia's bases in Tajikistan and Kyrgyzstan to 'practical use,'" the newspaper reported, citing anonymous sources.
Kommersant said the proposal "could involve the exchange of information obtained using drones but that there had been no concrete response from the U.S. side."
The theoretical arrangement would involve U.S. forces using Russian military bases in Tajikistan and Kyrgyzstan for "pre-coordinated operations in Afghanistan. Another area for cooperation would be in the exchange of intelligence, including of data collected by drones," Kommersant cited its unnamed sources as saying.
The newspaper noted that Russian bases in the two Central Asian countries "are equipped with close- and mid-range unmanned aerial systems."
"If the Americans are only interested in monitoring the situation in Afghanistan, they would accept this generous proposal. But they have not yet given a clear response, which raises suspicions that they have different ideas in mind," one anonymous source told Kommersant.
Media reports suggesting the U.S. seeks to use an existing military facility in Central Asia as a launching pad for its operations in Afghanistan began circulating in mid-April as the Taliban led a takeover of the country. The hardline Sunni group successfully deposed Kabul's U.S.-backed government on August 15.
An analysis of the unverified July 17 Kommersant report by Eurasianet.org on July 19 found that it "indicates that Moscow is open to ideas, but that it wants U.S. forces to be strongly constrained in their scope for action and to provide detailed accounts of their operations [in Central Asia]."
"The Kremlin is evidently suspicious about reported American ambitions to establish a military footprint in Central Asia through the creation of structures variously described as logistics or training centers," the news site continued.
Eurasianet.org noted that the Kommersant article quoted an unnamed CSTO source as saying, "This cannot be believed. It will be a screen. The Americans will start small and then expand."
CSTO is the initialism for the Collective Security Treaty Organization, which is a regional military alliance of former Soviet republics led by Moscow. Both Tajikistan and Kyrgyzstan are CSTO members.
Eurasianet.org is a U.S.-based website funded in part by the Open Society Institute, a network founded by the leftist billionaire George Soros.

redpajama_set_name: RedPajamaCommonCrawl


We did something desperately silly yesterday: we pushed not one but six fighting bulls along a one kilometre treck (including a road crossing) at once, just before milking time. Silly because I was very worried someone might get hurt. Desperate because they'd broken into the yearlings' paddock.
Yearlings get as randy as a mature cow but until they're 15 months old, their bodies just aren't up to carrying a calf, let alone a one-tonne Friesian bull.
Strangely enough, the six jousting bulls went across the road okay. It was "Buster" who had my full attention. Buster the bull was in a group of seven until, suddenly, he was by himself over the fence. A seemingly impregnable, tightly strained eight-barb was no match for him and his mates. We hadn't seem him exit the laneway but the fence was the worse for wear and a slow drip of blood from his tail showed he wasn't completely unscathed.
As we approached – me, Zoe and Alex in the Bobcat and Wayne on a quad – Buster's first response was to swing round at Wayne and put his head down. Now, that's not a good start. That's a threat.
Wayne very wisely stopped and feeling a little safer on the Bobcat, I called Buster's bluff, who stood his ground. There we were in a bull to bull-bar standoff. I squeezed the accelerator and Buster pushed forward, then swung around again facing the Bobcat a-midships. Reverse, redirect, start again. This went on for about 15 minutes before we finally got Buster back out into the laneway.
We decided Buster was bound to make even more trouble with the "crew" in tow, so he had to be cajoled the entire way by himself. He was better with the cows but, even then, decided to pick a fight. Hope Buster just had PMT!


Okay, remember how in season 4 we got the revelation that if you went far enough back in time, that Sebaceans, Interions, and Humans were all related? And we all went Ooooh, Aaaah and Woah!?? And there were all these cool Egyptian heiroglyphics that Crichton recognized, right?
Today, while poking around on the web (instead of working on what I should be doing) I came across this neato software that takes your phrases and turns them into Egyptian heiroglyphics.
Here's the phrase "Pilot's Den" in "egyptianese"
Kind of neat, huh? The software, called Imhotext, is shareware, with a free trial period, and can be downloaded here. Who knows, it might come in handy for the Farscape webmaster or fan-fiction writer who wants to trick out their masterpieces with illustrations.
Now if only there were some Farscape wingdings!


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Department of Engineering / Research / Academic Divisions / Electrical Engineering
Strategic Aim: Pursuing fundamental electrical, electronic and photonic research at the material, device and system levels with a focus on creating integrated solutions in the fields of nanotechnology, sensing, energy generation, energy conversion, displays and communications.
The research in the Electrical Engineering Division covers all aspects of electrical engineering from the nano-scale to heavy-duty power applications. Professor Andrew Flewitt is the Divisional Head and Dr Tawfique Hasan the Deputy Head.
Photonics is an active and growing area of research with three groups investigating different aspects of photonics, applications, and materials whilst collaborating with each other and a variety of industrial partners.
The Solid State Electronics and Nanoscale Science group conducts research in large area electronic materials and high-power semiconductor devices, carbon nanotubes, and semiconducting nanowires.
The Electrical Power and Energy Conversion group focuses on power electronic devices and integrated circuits, and their uses in various applications. Other major research strands include solar cells and their integration in power systems, integrated design of electrical machines and drives, electromagnetic modelling, radio frequency and microwave power for industrial applications, and electrical power applications of superconductivity.
The Bioelectronics Laboratory is developing better tools for healthcare.
Centre for Advanced Photonics and Electronics (CAPE) is based on a partnership agreement between the University of Cambridge and a number of major industrial companies for the purpose of jointly commissioned research and device development. Global companies China Aerospace BIACD, China Rail Zhuzhou Institute, Disney Research, and Jaguar Land Rover already put their trust in CAPE to convert thought leadership to industry applications through jointly commissioned research in photonics and electronics.
The mission of the Cambridge Graphene Centre is to investigate the science and technology of graphene, carbon allotropes, layered crystals, and hybrid nanomaterials. The Centre allows our partners to meet and effectively establish joint industrial-academic activities to promote innovative and adventurous research with an emphasis on applications.
The Nanoscience Centre is an 1800m2 research facility completed in January 2003 and located at the north east corner of the University's West Cambridge Site. The Centre provides open access to over 300 researchers from a variety of University Departments to the nanofabrication and characterisation facilities housed in a combination of Clean Rooms and low noise laboratories.
The EPSRC Centre for Innovative Manufacturing in Large-Area Electronics addresses key manufacturing research challenges aimed to meet end-user needs for multifunctional large-area electronic systems that include sensors, power generation and storage, signal processing and logic elements, and output capability through information display or by wireless transmission.
Cambridge Graphene Centre
Centre for Advanced Photonics and Electronics (CAPE)
EPSRC Centre for Innovative Manufacturing in Large-Area Electronics
Bioelectronics Laboratory
The Nanoscience Centre
Research facilities in Electrical Engineering
Electrical Engineering web site
Faculty in Electrical Engineering
All people in Electrical Engineering
How carbon cousins shaped warfare and can electrify the future
Dr Stephan Hofmann awarded the 2014 Journal of Physical Chemistry C Lectureship
Carbon nanotubes find real world applications
Near error-free wireless detection made possible


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Florianopolis Carnival Celebrations
Get ready to the next Carnival Celebration in Florianopolis.
Florianopolis has over the years built up a reputation as a Carnival hotspot. Visitors from all over the globe have set their eyes on this South American paradise with 42 pristine beaches. The Carnival in Florianopolis is only second to Rio for gay and lesbian travelers looking for sun, sand, and a taste of the Carnival spirit.
Florianopolis' vast natural beauty isn't the only attraction during the Carnival. Thousands of party goers flock to the city for the Carnival with no let up in the celebrations for a week. From samba parades at the Sambadrome to street parties, gay festivals and, street parades held throughout the city; revelers have a choice of entertainment with live bands leading the wild parties at almost every street corner. Several samba schools have emerged over the years, putting up a splendid performance at the Sambadrome.
Consulado, Copa Lord, and União da Ilha da Magia are the major samba schools that compete for top honors at the sambadrome. The schools also rehearse for months leading up to the Carnival, which is a good time to catch up with them if you are in town early. Tickets for Carnival nights at the Sambadrome are available. The stadium consists only of two grandstands, so you need to book early if you want to soak in the excitement from the sidelines.
Celebrations at the Sambadrome commence with a firework display at midnight followed by the first samba school. The crowds are already in a party mood well before the first samba school makes its way down the runway. With motorized floats and live bands in attendance, samba dancers put everyone in a Carnival trance which lasts until 4 am.
Florianopolis Gay Festival
Residents of Florianopolis welcome gay tourists by throwing one of the biggest gay festivals during the Florianopolis Carnival. The Pop Gay Festival at Tancredo Neves Square features a contest for drag queens and transgender people. Over 50,000 gay and lesbian tourists join in the celebrations that carry on right through the Carnival week. The festival draws a mixed crowd with many straight people joining in the fun and frolic.
Carnival Sunday around Town
Straight men have their night out on Carnival Sunday with the traditional Blocos dos Sujos. Cross dressed men parade through the town singing and dancing with many families choosing to join in. In addition, a number of small samba groups put up their own parades in downtown Florianopolis so there is never a dearth of entertainment in the city.


According to Nevada Revised Statutes, all property that is not defined or taxed as "real estate" or "real property" is considered to be "personal property." Taxable personal property includes manufactured homes, aircraft, and all property used in conjunction with a business. Business personal property is taxable whether it is owned, leased, rented, loaned, or otherwise made available to the business. The taxation of business personal property has been in effect since Nevada became a state in 1864. Nevada Revised Statutes, Chapter 360-361, provide for the taxation of all property, unless specifically exempted by law.
Property that is exempt from taxation includes business inventory held for resale, consumable supplies, livestock, boats, and personal household belongings. The exemption of household goods does not extend to personal property or furnishings rented or leased to another party or rented in conjunction with the rental of a dwelling unit. Motor vehicles required to be registered with the Nevada Department of Motor Vehicles and Public Safety are exempt from the property tax, though subject to a governmental service tax.
All businesses having assets within Lyon County must complete and file an annual declaration which lists any personal property that is used in conjunction with the business as of the lien date, which is July 1st.
Though the declaration may be completed and returned to the Assessor in July, the personal property tax billing may be calculated and sent any time between the time it is received by the Assessor and the following April 30. The returned declaration will be processed by the appraisal and billing staff as the declaration is received. The appraisal staff may conduct field verifications of any data on the completed declaration. The tax billing becomes delinquent and subject to a penalty 30 days after the first billing date.
In Nevada, property taxes are based on "assessed value." In the case of business personal property tax, a "taxable value" is arrived at by reducing the original or acquisition cost by depreciation factors described above. Assessed value is computed by multiplying the taxable value by 35%, rounded to the nearest $1.00.


Your friends from el Jimador, the No. 1 selling 100 percent blue agave tequila in Mexico, recently commissioned a survey on this traditional tequila cocktail to offer up some unique ways you can enjoy margaritas with your friends this holiday.
In a shaker filled with ice, add ingredients and shake to mix. Pour into margarita glass rimmed with salt (optional). Garnish with a lime wedge.
Tip #4: Or, Keep it Simple. Because Margaritas Are Best Made With Friends.


When we were college students in the mid-1970s, some of our friends wanted to change the world. Their work aimed at providing cheap energy, improving information technology, curing cancer, and generally making our lives better. By the 1990s, attitudes had changed. Many top students, including newly-minted Ph.D.s, moved from natural science and engineering to finance. Their goal was to get high-paying jobs.
Would we be better off today if some of these financial wizards had focused instead on inventing more efficient solar cells or finding ways to forestall dementia? The older we get, the more we think so. And, believe it or not, there is now notable, cross-country evidence buttressing this view.


This release contains bug fixes and minor improvements for 2.7.0.
Open vSwitch is a production quality, multilayer open source virtual switch. It is designed to enable massive network automation through programmatic extension, while still supporting standard management interfaces. Open vSwitch can operate both as a soft switch running within the hypervisor, and as the control stack for switching silicon. It has been ported to multiple virtualization platforms and switching chipsets.


2017 MXS Italian Championship Rd 10: Namur - it continues to live!
Then followed a pretty long double jump to the double step-up, and...here comes the most beautiful part of the track: 4 massive up-hill jumps just near the castle of the Citadelle. Today that part is still alive and is used for mountain biking (like the rest of the track anyway). Then a pretty steep down-hill to the final jump into the arena once again to start a new lap.
In 2015 MXS Italian Championship, Johan Roger succeeded to win the overall in the Pro class followed by Ben Seaburg and Jordan Boyer. On the other side, in the Amateur class, Maxime Vanderbeek won the overall, Niko Sollmann 2nd and David Debealieu 3rd.
Last year, in the Pro class Connor Lynds managed to take the overall win followed by Frederik Van Eckhoven and Damien Mayer. In the Amateur mx2 class, it was the RKI mate Andrea Di Pietro who won the overall, Matthias Havy 2nd and Luca Cavallero 3rd racing as a wild card for that round. In the Amateur mx1 class Thomas Jaz arrived 1st followed by Christoffer Jonsson, Alban Dubois 3rd.
Re: 2017 MXS Italian Championship Rd 10: Namur - it continues to live!
If you can still double down the smaller steps, i'll be happy Looks good, can't wait to try it!
By far the best track of the year!
Improvement from previous version in pretty much every way.
Its funny how as soon as we get a track with semi-realistic traction, everyone complains even more.
I just love it! Good job Gabi!
Thank you guys you know Chris...only few warriors still like to battle on a semi realistic traction but this year i think we provided you many different traction styles, correct me if i am wrong and this is absolutely the most realistic. It would be a pity if i changed it, i would ruin the atmosphere of the track.
honda23 wrote: Thank you guys you know Chris...only few warriors still like to battle on a semi realistic traction but this year i think we provided you many different traction styles, correct me if i am wrong and this is absolutely the most realistic. It would be a pity if i changed it, i would ruin the atmosphere of the track.
Yeah I agree. The track is very challenging and technical, just like Namur is supposed to be.
I can see in chat lots of people complaining about the traction. Did everyone assign the throttle to a button or what's the problem? Does people really want the same stupid arcade traction and 1m ruts week in and week out? As soon as something is slightly challenging for once people just blame the game and ragequits.
Rayvenator wrote: just don't get it.


Gradient stripes, another take on lines and colors of landmark bridges. Patented technology is what makes BN3TH the best fitting, most comfortable underwear available. The 3-dimensional pouch provides complete support from every angle so you feel great without the need for shifting and adjusting.


GlaxoSmithKline has begun enrolling patients in a mid-stage trial assessing the safety and efficacy of an experimental therapy for hand osteoarthritis licensed from MorphoSys.
Osteoarthritis is the most common form of joint disease caused by breakdown of joint cartilage and underlying bone, resulting in pain and stiffness.
According to Arthritis Research UK, 1.56 million people in the UK have sought treatment about osteoarthritis of the hand or wrist, while one in six people who sought treatment for osteoarthritis have it in their hand or wrist.
GSK3196165 is a monoclonal antibody against GM-CSF (granulocyte-macrophage colony-stimulating factor) cytokine, a target molecule for a broad range of inflammatory diseases.
The European multi-center Phase II, double-blind, placebo-controlled study will investigate the efficacy and safety of subcutaneous injections of the drug in 40 adult subjects with inflammatory hand osteoarthritis.
GSK picked up a license to the antibody from MorphoSys back in 2013, for an upfront fee of 22.5 million euros plus developmental, regulatory and commercial milestones of up to 423 million euros, as well as double-digit royalties on net sales.
The drugs giant is also currently testing GSK3196165 in a Phase IIb study in rheumatoid arthritis.
Meanwhile, GSK said it has now opened a £56-million state-of-the-arty facility in Ware, UK.
The move, which has created 150 new jobs in the region, is in response to growing demand for the firm's portfolio of respiratory medicines delivered through its Ellipta inhaler.
It is anticipated that the new facility will nearly double production of Ellipta inhalers at Ware to at least 37 million per year by 2017, 95% of which are to be exported.


The National Risk Retention Association (NRRA) announced that on February 16, 2017 the state of New York released a second set of revisions to 23 NYCRR 500, this time finally exempting non-domiciliary, or foreign, risk retention groups from compliance. On November 11, 2016, NRRA escalated its opposition to the regulation with a firm letter to the NY Department of Financial services, stating that, while recognizing the regulation did exempt smaller companies, the onerous requirements of the regulation were nevertheless completely preempted by the Liability Risk Retention Act, 15 U.S.C. 3901(a) (LRRA), which NRRA argued would exempt all RRGs from compliance.
On September 13, 2016, New York Governor Andrew M. Cuomo announced the first in-the-nation proposed cybersecurity regulation designed to "protect consumer data and financial systems…." The regulation imposes standards for the establishment of a cybersecurity program, a written cybersecurity policy, the designation of a Chief Information SecurityOfficer as well as policies and procedures to protect information systems and non-public information accessible by third-parties. The proposed regulation also mandates security policies and procedures provisions to be included in "third-party" service provider contracts.
Compounding the illegal preemption issue as to non-domiciliary RRGs, NRRA felt that the regulation also poses a possible existential threat to all companies which might now be facing the prospect of numerous other states following the lead of New York and thereby adopting their own potentially inconsistent cyber regulations.
NRRA has made it clear that it is certainly not opposed to "cyber protection" and has never questioned the prerogative of the domiciliary states to impose consistently reasonable and sensible cyber requirements for their home state RRGs. The NAIC has been working on a model cyber data protection law, but unless it ever passes one, and even if it does, there should be concern that more states will try to follow New York. There has to be a uniform, reasonable, and scalable set of rules that can be followed so that the industry can avoid problems like RRGs potentially faced in New York before the LRRA came to their rescue.
The newly inserted exemption can be found at new section 500.19 (f), including "persons subject to NY Insurance law section 5904" (Risk Retention Groups not Chartered in this State.) NRRA thanks other industry leaders, domicile regulators, and key members of the association for their support of its activities in this and other initiatives seeking to protect the interests of RRGs and PGs nationwide.
For further information on NRRA's advocacy and member services, contact Joe Deems, Executive Director, NRRA, at (818) 995-3274, email: joe.deems@gmail.com, or visit www.riskretention.org.


PEARL RIVER, N.Y., Aug. 28, 2018 /PRNewswire/ -- Evolution Health Group, a full service global healthcare group, announces the formal launch and branding of their newest specialty division, Maestro360. Maestro360 will focus on the management and execution of high quality and compliant speakers bureau, conventions, meetings and events programs for the healthcare industry.
The Maestro360 team has been supporting a wide range of pharmaceutical meetings, events, speaker programs and convention activities since Evolution's inception in 2005 and has experienced significant growth over the past several years due to the loyalty of our customers and the depth of industry expertise of our team.
"The keys to success for us have always been our people and our customized approach. Our people are experts in the healthcare industry and they're passionate about the details because they know how those details can translate into establishing strong customer connections. We have built our business around the fact that we do not believe in a one-size-fits-all approach. Through the years we've been incredibly fortunate to have built long term relationships with our customers that has allowed us to continue to grow and expand our offerings," notes Angela Searles, Sr. Vice President of Operations. "A competitive differentiator for Maestro360 has been the unwavering commitment to developing flexible and customizable technology solutions."
Maestro360 will remain in the Pearl River, NY headquarters, which will be further expanding in September 2018.


Mark Wylie's 1970 Dodge Challenger. Mark always dreamed of owning a sublime 70 Challenger R/T. He searched for years for the elusive "green machine" only to come up empty handed. It was then that Mark decided to build his own. Starting with a clean 318 car, Mark realized his dream in the form you see here. Powered by a 292 .509" cammed 440, power is sent through the 727 torqueflite out back to the 4:10 geared Dana 60. A couple of R/T badges later, and Mark's dream had come true.
Marion Wylie's 1970 Dodge Challenger 340. If that name seems a little familiar, that's because you probably just finished looking at her son, Mark's, 70 Challenger.
Mike Lacroix's 1971 Dodge Challenger R/T 340. This car capped off a long search for Mike who was originally looking for a 440 R/T.


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Mr Snow Review, The Herald
"Now for most adults, 'snow' has become a four letter word that has fallen out of favour. But if each new bout of 'adverse weather conditions' leaves the grown-ups scunnered, the white stuff in all its forms - even greying slush - has an endless fascination for tots. Mr Snow would probably want to recruit these wee enthusiasts to join him in his profession: he's a snowologist, a kind of David Attenborough of the polar wastes who seeks out different species of snow to record and classify.
Mind you - there is an Important Exam to pass, before you can pin on the official badge and go snow-collecting. Blessyou - Mr Snow's son - has already failed this test. Maybe because he's a bit harum-scarum, apt to fall into day-dreaming about adventures in space as well as in snow and a little bit disobedient as well. So when he's told, absolutely, not to touch a certain kind of snow...Oops! Despite some little voices raised in earnest warning, Blessyou not only uses up all the magic snow - creating a fabulous light show that also brings inanimate objects on stage to life - he decides to go out, alone, and find some more.
If writer and director Rob Evans fills the first part of Mr Snow with ingenious fun - who would have thought there were so many tricksy kinds of snow? - he moves into riskier, darker territory when an exhausted Blessyou (Steven Rae) lies down in the freezing snow and doesn't move. The life-affirming force here isn't just the special magic snow, it's the unconditional love of a father (Kieran Fay's Mr Snow) who won't give up looking for his son. Dads in the audience did some throat-clearing at this point. The production is full of lovely whimsical touches, with Claire Halleran's intriguingly cluttered set a treasure-trove of lateral thinking - for instance, a half-buried wardrobe is the door, while a wall of transparent storage bags lights up for shadow-puppet sequences of dashing sleigh-rides." Mary Brennan, The Herald, ****


Oscar-winning actress Frances McDormand delivers a stunningly powerful performance in this darkly comic drama. Several months have passed since her daughter was murdered, but with no sign of a culprit Mildred Hayes makes a bold move - painting the three billboards into her town with a strong message aimed at the town's Chief of Police. This ignites a battle between a volatile cop, the authorities and Mildred as the search for the truth continues.
TicketSource • SeeTickets • or on the door.


In honor of National Ag Week (March 23-March 29), I previously wrote (http://www.irvinehousingblog.com/blog/comments/irvines-tanaka-farm-and-our-agriculture-past) about Irvine's Tanaka Farm. Today, I'll continue the theme by highlighting Irvine's farmers markets, which are outdoor markets at which you can buy many fresh fruits and vegetables that are often organic and from local farmers. In addition, other items are frequently available.
• The Orange County Great Park farmers market is operated by the Orange County Farm Bureau and is open on Sundays from 10 am to 2 pm. It is located in the Great Park on Marine Way near Sand Canyon. The contact number is 714-573-0374.While you are there you might also visit the nearby Great Park Farm and Food Lab.
• The Orange County Farm Bureau farmers market at University Center is on the corner of Bridge and Campus (across from UCI). It is open Saturdays from 8 am to noon, rain or shine. This is the largest farmers market in Orange County.


Oravital patient care focuses on the early detection and treatment of oral infections including periodontal disease (gum disease) and bad breath (halitosis).
For more information on the Oravital® System and how it works, visit their website at oravital.com/professional-info/.
If you have any pain while brushing or have any questions about how to brush properly, please be sure to call the office at Yorkville Dental Associates Toronto Phone Number 416-924-4695.
Dr. Veisman, Dr. Tam, Dr. Luk, Dr. Kelly or Dr. Liu recommend using a soft to medium tooth brush. Position the brush at a 45 degree angle where your gums and teeth meet. Gently move the brush in a circular motion several times using small, gentle strokes brushing the outside surfaces of your teeth. Use light pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort.


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NEXO: The next-generation Fuel Cell Vehicle from Hyundai
Hyundai names technological flagship fuel cell vehicle NEXO
New ADAS technologies revealed including self-parking and Lane following features
9 January 2018 - Hyundai Motor today announced that NEXO will be the name of its all-new, dedicated Fuel Cell EV during a press conference at CES 2018, and disclosed Advanced Driver Assistance Systems (ADAS).
Hyundai Motor today announced that NEXO will be the name of its all-new, dedicated Fuel Cell EV during a press conference at CES 2018, and disclosed Advanced Driver Assistance Systems (ADAS) that expand its autonomous driving potential. NEXO is the technological flagship of Hyundai's growing eco-vehicle portfolio and marks Hyundai's continued momentum toward having the industry's most diverse CUV powertrain lineup.
The NEXO model will spearhead Hyundai Motor's plans to accelerate development of low emission vehicles, in line with Hyundai Motor Group's renewed goal of introducing 18 eco-friendly models to global markets by 2025. This new development roadmap also represents the next step for Hyundai Motor toward realizing the ultimate ambition of creating a cleaner environment through eco-friendly vehicles.
Blind-spot View Monitor (BVM)
Hyundai's Blind-spot View Monitor is an industry-first technology. It shows drivers on a center cluster screen the rear and side views of NEXO using cameras while changing lanes in either direction. The system uses wide angle surround view monitors (SVM) on each side of the vehicle to monitor areas that cannot be seen by a traditional rearview mirror. Hyundai is the first automaker to provide drivers video footage from both sides of the vehicle.
Lane Following Assist (LFA) and Highway Driving Assist (HDA)
Lane Following Assist is an all-new technology for Hyundai and it debuts in the NEXO. LFA automatically adjusts steering to help keep NEXO centered in its lane of travel. LFA can keep NEXO centered at speeds between 0 and 90 miles per hour on both highways and city streets. When paired with Hyundai's Highway Driving Assist (HDA) which utilizes sensors and map data to ensure safe operation as well as automatically adjust speed in limited environments, drivers will be able to traverse long distances with greater ease and improved safety.
Remote Smart Parking Assist (RSPA)
RSPA enables NEXO to autonomously park or retrieve itself from a parking space with or without a driver in the car. The RSPA system can even back a NEXO into a parking spot by itself with a touch of a button from the driver. When faced with any challenging parking scenario, NEXO drivers will be able to park with complete confidence and accuracy.
Hyundai NEXO
Hydrogen energy is the key to building a more sustainable society. Hyundai Motor Company has already taken a lead in hydrogen technology with introduction of its fuel cell vehicles. Yet as another result of this earth-saving effort, today, I am so proud to introduce to you our second-generation Fuel Cell Electric Vehicle which is a culmination of our cutting-edge technologies.
Dr. Woong-Chul YangVice Chairman, Hyundai Motor Company
NEXO is Hyundai's second-generation of commercialized fuel cell electric vehicle that will be available in select markets around the world starting in early 2018. Improving upon the acclaimed ix35 Fuel Cell, the NEXO has an estimated driving range of 800 kilometres (NEDC). Acceleration and power have increased to improve the overall performance.
Designed to handle extreme temperature and environments, the NEXO testing has proven that the vehicle is capable of starting after being subject to overnight temperatures of -20 degrees Fahrenheit. NEXO boasts cold start capability within 30 seconds which is an industry-leading achievement and the fuel cell system warms up faster for maximum performance. The NEXO also has excellent cooling performance on steep grades with temperatures exceeding 120 degree Fahrenheit.
Improvements in the air supply system, performance at high altitudes and refueling times, along with overall efficiency and fuel economy put the NEXO in a class all its own. In addition the NEXO has improved power density and durability comparable with gasoline-powered vehicles.
Dedicated Architecture
For the first time ever, Hyundai's fuel cell vehicle is built with a dedicated vehicle architecture. This architecture has many benefits including:
Lighter weight
Improved power-to-weight ratio
Faster acceleration from 0 to 60 mph than its predecessor
More cabin space
Allows the battery to be relocated to the trunk
Improved fuel cell system layout
NEXO vs. previous Hyundai Fuel Cell System Architecture
NEXO's fuel cell stack and battery have more net power to supply a more powerful motor
NEXO's powertrain is lighter and has improved packaging
Improved hydrogen storage tanks
Powertrain Improvements
NEXO's powertrain is lighter and takes up less space
Better module integration
Peak acceleration is increased by 25 percent compared with its predecessor
NEXO accelerates from 0 to 60 mph 20 percent faster than its predecessor
NEXO has more torque than its predecessor
NEXO has an estimated range of 800 kilometres (NEDC)
Quiet and Comfortable Driving Characteristics
NEXO maintains the quiet and comfortable driving characteristics of its predecessor
All of the NEXO's moving parts are inside the engine bay which isolates the noise to one area
NEXO has the same level of durability as internal combustion engine vehicles
NEXO's storage system is lighter than its predecessor
NEXO's storage system has world-class storage density
NEXO can be refueled within five minutes
* All NEXO specification and technologies mentioned above may vary according markets
Best of the year: press reactions to Hyundai's 2018 model launches
Hyundai NEXO and Kona Electric land on 2019 Wards 10 Best Engines List
All-New Hyundai NEXO among Euro NCAP's Best in Class Cars of 2018


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[EE] Poster
P (Space and Planetary Sciences) » P-EM Solar-Terrestrial Sciences, Space Electromagnetism & Space Environment
[P-EM15] Dynamics in magnetosphere and ionosphere
Mon. May 21, 2018 3:30 PM - 5:00 PM Poster Hall (International Exhibition Hall7, Makuhari Messe)
convener:Yoshimasa Tanaka(National Institute of Polar Research), Tomoaki Hori(Institute for Space-Earth Environmental Research, Nagoya University), Aoi Nakamizo(情報通信研究機構 電磁波研究所, 共同), Mitsunori Ozaki(Faculty of Electrical and Computer Engineering, Institute of Science and Engineering, Kanazawa University)
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[PEM15-P14] N2+ resonant scattering light in the topside ionosphere observed with the auroral spectrograph
Yu Endo1, *Takeshi Sakanoi1, Yasunobu Ogawa2, Masato Kagitani1 (1.Planetary Plasma and Atmospheric Research Center, Graduate School of Science, Tohoku University, 2.National Institute of Polar Research)
Keywords:aurora, ion upflow, atmospheric escape
We focus on the molecular ion upflow in the topside ionosphere based on a ground-based optical data. Ion upflow is important since it is considered to be a source of ion outflow which contributed planetary atmospheric escape and controls magnetospheric dynamics. The heavier ions including molecular ions (N2+, NO+, O2+) have been observed in the magnetosphere [Klecker et al., 1986] in spite of their existence in the lower ionosphere (E-region) originally. The mechanism of ion upflow in the ionosphere for molecular ions is uncertain because it is rather difficult for heavy ions to move upward overcoming the gravitational force. Furthermore, N2+ ion production mechanism in the topside ionosphere in relevance to N2+ ion upflow is not understood well. Thus, we examined the unresolved mechanisms for N2+ ion production and N2+ ion upflow using ground-optical instruments data.
We investigated the data obtained with the Auroral Spectrograph (ASG) located at Longyearbyen (78.15N, 16.04E) during the period of 2004 - 2016 to measure the N2+ resonant scattering light at 427.8 nm in the sunlit region of topside ionosphere associated with N2+ ion upflow and/or caused by locally generated N2+ ion. The field of view for ASG is 180 deg. for the geomagnetic meridian, and the spectral range is 420 – 730 nm. We found totally 13 events of N2+ resonant scattering light in the sunlit topside ionosphere out of 75 analysis days selected from the data obtained at one month before and after the winter solstice. The MLT range of the events was 9 - 18 MLT in the dayside sector. In this study, we selected for a single auroral arc case by using the data taken by ASG and All-sky Color Digital Camera (CDC). In this case, we assumed that the observed emissions of N2+ 427.8 nm, O 557.7 nm and 630.0 nm are along a single geomagnetic field line, and calculated the auroral emission heights converting elevation angle to altitude.
During the period of 7:00 - 8:34 UT, a stable aurora was observed in the southward of the field of view for ASG with relatively bright 630.0 nm aurora (~ 10 kR). The maximum intensity of 427.8 nm emission was recorded at 8:34 UT, and was ~ 650 R at an altitude of 350 km. The intensity above ~ 600 km kept brighter than 100 R extending up to 1,000 km, and the inclination above the peak of 427.8 nm emission was relatively steeper than that of 557.7 nm and 630.0 nm emission above ~ 450 km. In addition, we investigated the time variation of the N2+ resonant scattering light in the F-region and in the topside ionosphere during the period of 7:00 - 8:20 UT when there were no clouds in the southward of the field of view for ASG. The time variation of N2+ emission in the F-region (400 km) was different from that in the topside ionosphere (800 km). The intensity at 400 km randomly varied in the range of 150 - 500 R, while at an altitude of 800 km, gradually increased throughout this period (~ 100 R to ~ 300 R). Next, we evaluated the N2+ emission with the GLOW model and compared with the ASG data at 7:36 UT when the DMSP satellite passed over the aurora. The auroral electron flux measured by DMSP was used in the GLOW model. When we increased the atmospheric scale height in the altitude range above 200 km, the calculated 630.0 nm emission peak is consistent with observed emission and the height profile of calculated 557.7 nm emission above 200 km was similar to the observed emission. For 427.8 nm emission, both of the emission peaks at 300 km and the height profile below 450 km were similar.
From the results obtained in this study, we suggest that N2+ ion upflow starts from F-region or above the F-region, not the E-region, and N2+ ion in the topside polar ionosphere in the dayside sector is dominantly produced by the charge exchange reaction between N2 and O+. Our results also demonstrate that the existence of soft electrons precipitation is correlated well with N2+ ion upflow probably due to strong ambipolar electric field and N2+ ion production in the topside ionosphere which implies that the enhancement of O+ generated by precipitating soft electrons in the F-region. The relationship between N2+ ion upflow and outlflow, and its effect on the magnetospheric dynamics will be examined by the Arase (ERG) satellite or future missions. Furthermore, the understanding of N2+ ion escape would contribute to evaluating the long-term planetary atmospheric evolution.
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Articles – Ongoing Research Themes
1 NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
2 icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh
3 Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
4 Save The Children, Dhaka, Bangladesh
5 World Health Organization Dhaka, Bangladesh
* Joint first authorship.
† Joint senior authorship.
(14 pages)
Pneumonia is the leading cause of under-five child deaths globally and in Bangladesh. Hypoxaemia or low (<90%) oxygen concentration in the arterial blood is one of the strongest predictors of child mortality from pneumonia and other acute respiratory infections. Since 2014, the World Health Organization recommends using pulse oximetry devices in Integrated Management of Childhood Illness (IMCI) services (outpatient child health services), but it was not routinely used in most health facilities in Bangladesh until 2018. This paper describes the stakeholder engagement process embedded in an implementation research study to influence national policy and programmes to introduce pulse oximetry in routine IMCI services in Bangladesh.
Based on literature review and expert consultations, we developed a conceptual framework, which guided the planning and implementation of a 4-step stakeholder engagement process. Desk review, key informant interviews, consultative workshops and onsite demonstration were the key methods to involve and engage a wide range of stakeholders. In the first step, a comprehensive desk review and key informant interviews were conducted to identify stakeholder organisations and scored them based on their power and interest levels regarding IMCI implementation in Bangladesh. In the second step, two national level, two district level and five sub-district level sensitisation workshops were organised to orient all stakeholder organisations having high power or high interest regarding the importance of using pulse oximetry for pneumonia assessment and classification. In the third step, national and district level high power-high interest stakeholder organisations were involved in developing a joint action plan for introducing pulse oximetry in routine IMCI services. In the fourth step, led by a formal working group under the leadership of the Ministry of Health, we updated the national IMCI implementation package, including all guidelines, training manuals, services registers and referral forms in English and Bangla. Subsequently, we demonstrated its use in real-life settings involving various levels of (national, district and sub-district) stakeholders and worked alongside the government leaders towards carefully resuming activities despite the COVID-19 pandemic.
Our engagement process contributed to the national decision to introduce pulse oximetry in routine child health services and update the national IMCI implementation package demonstrating country ownership, government leadership and multi-partner involvement, which are steppingstones towards scalability and sustainability. However, our experience clearly delineates that stakeholder engagement is a context-driven, time-consuming, resource-intensive, iterative, mercurial process that demands meticulous planning, prioritisation, inclusiveness, and adaptability. It is also influenced by the expertise, experience and positionality of the facilitating organization.
Our experience has demonstrated the value and potential of the approach that we adopted for stakeholder engagement. However, the approach needs to be conceptualised coupled with the allocation of adequate resources and time commitment to implement it effectively.
Pneumonia is the leading cause of childhood mortality, accounting for around 16% of 5.2 million under-five deaths globally [1–3]. In addition to mortality, childhood pneumonia contributes significantly to the global burden of disease through morbidities and long-term complications [4,5]. Moreover, most of these deaths and morbidities occur in low- and middle-income countries (LMICs) [1,2]. In Bangladesh, childhood pneumonia causes approximately 24 300 deaths per year, making it the leading cause of death in children younger than five years [6,7].
Hypoxaemia, defined by low (<90%) oxygen saturation in the arterial blood, is common among children with pneumonia and is one of the strongest predictors of mortality caused by pneumonia and other lower acute respiratory tract infections [8–12]. Early identification of hypoxaemia and timely administration of oxygen therapy can avert a significant portion of hypoxaemia-related deaths [8,10]. Pulse oximetry is an easy, non-invasive, and low-cost procedure used to measure and monitor the oxygen saturation level of arterial blood (SpO2) [13]. In high-income countries, pulse oximetry device is almost universally available as a standard for paediatric care but is rarely available and used in LMICs, particularly in routine outpatient services [11]. However, in 2014, the World Health Organization (WHO) revised its guidelines for routine outpatient services, ie, Integrated Management of Childhood Illness (IMCI), recommending the introduction and use of pulse oximetry in the early detection of hypoxaemia and referral decisions even in low-resource settings [12,14–16].
Bangladesh was one of the sites in the Multi-Country Evaluation of IMCI coordinated by WHO [17]. Based on the evidence generated from this study and global recommendations, the Government of Bangladesh adopted the IMCI strategy in 1998 as its primary approach to delivering outpatient-based services for sick children, including those with pneumonia. A decade later, by 2008, health facility-based IMCI was scaled up in all 64 districts and 420 of the 483 sub-districts (locally known as Upazilas) [18]. However, despite this progress, the use of pulse oximetry was still not recommended in routine IMCI services until 2018, as the assessment for pneumonia was primarily based on clinical history taking and physical examinations [19]. Therefore, an implementation research study was initiated in 2018 to assess the feasibility of introducing pulse oximetry in routine IMCI services in Bangladesh. The National Newborn Health and IMCI Programme of the Ministry of Health and Family Welfare led the study with technical support and facilitation from icddr,b (an international health research institute based in Bangladesh, which was formally known as International Centre for Diarrhoeal Disease Research, Bangladesh), and funding from the NIHR Global Health Research Unit on Respiratory Health (RESPIRE) through the University of Edinburgh, UK [20,21]. The implementation research was conducted in one district hospital, five sub-district hospitals (locally known as the Upazila Health Complexes) and five primary care health centres (locally known as Union Health and Family Welfare Centres) in Kushtia, a rural district in Bangladesh. The National Newborn Health and IMCI Programme in consultation with icddr,b selected Kushtia as the demonstration site as the under-five and neonatal mortality rates of the district were close to the average national estimates [22]. The objective of the study was to incorporate the recommendations for using pulse oximetry in routine IMCI services in national policy and programme documents, and assess the useability, acceptability, fidelity and utility based on WHO's implementation research guideline [23].
Engaging a wide range of stakeholders is a key step for ensuring the relevance of research studies and improving the utilisation of research findings in local health systems settings [24,25]. As a result, health research funding agencies are increasingly promoting stakeholder engagement as an important step towards achieving impact [26]. Unfortunately, there is a dearth of evidence regarding the process of conceptualization, planning, implementation as well as mitigating challenges associated with stakeholder engagement in real-life settings. One of the main objectives of our implementation research was to promote context-specific solutions to implementation, participatory approach, government leadership, country ownership, scalability and sustainability by engaging key stakeholders at every stage of design, development, implementation and decision-making [25]. In this paper, we describe the rationale, strategy and process of influencing the policy and programme through a context-driven stakeholder engagement approach.
Approach-adaptation of a conceptual framework for stakeholder engagement
Stakeholders are individuals, organisations, or communities that can influence or are affected by a project's process and outcomes, research or policy [27]. Stakeholder engagement is an iterative process of actively soliciting interested and influential individuals' knowledge, experience, and values to create a shared understanding, mutually agree on outcomes, and make relevant, transparent, and effective decisions. Essentially, a bi-directional relationship between the stakeholders and the researchers results in informed decision-making about the prioritisation, implementation, and use of research findings [28]. The literature on stakeholder engagement in health research points towards various processes and approaches, primarily derived from priorities, opportunities and contexts [24,28–30]. Guided by the literature, consultations with policymakers and experts, and based on practical experiences in implementing development projects in the context of Bangladesh, we adapted a conceptual framework to guide the stakeholder engagement related activities in our study (Figure 1). This framework proposes four steps. Step-1: Identification and prioritisation of stakeholders for subsequent sensitisation, involvement and engagement. Step-2: Sensitising the majority of stakeholders regarding the context, rationale, importance and process of the proposed research to build interest, confidence and trust. Step-3: Involving key stakeholders in planning, ensuring agreement regarding the implementation process and solidifying commitments for shared responsibilities. Step-4: Engaging the stakeholders at every stage of design, development, implementation and evaluation.
Figure 1. Conceptual framework adapted to guide the stakeholder engagement process to integrating pulse oximetry in routine Integrated Management of Childhood Illness (IMCI) services in Bangladesh.
Process steps taken to implement stakeholder engagement related activities
Step 1: Identifying stakeholders for sensitisation, involvement, and engagement
In Bangladesh, health services are provided by two directorates under the Ministry of Health and Family Welfare. They are the Directorate General of Health Services and Directorate General of Family Planning. Each directorate has a dedicated programme for child health, which manages the child health services, including IMCI services in Bangladesh. In addition, several other programmes are also related to child health services. Besides the government programmes, several development partners and professional societies support the Government of Bangladesh in managing and implementing child health services, including IMCI services. The National Newborn Health and IMCI Programme under the Directorate General of Health Services of the Ministry of Health and Family Welfare is responsible for coordinating with all partners and ensuring the delivery of IMCI services in Bangladesh.
First, comprehensive desk review was conducted on IMCI related documents and eight key informant interviews to identify national and district level stakeholders related to IMCI implementation in Bangladesh (Table S1 and S2 in the Online Supplementary Document). We purposively selected the key informants based on their former and current involvement with the IMCI programme in Bangladesh. After reaching reasonable level of data saturation, we identified 15 national-level and 16 district-level stakeholder organisations ranging from government health programmes, professional societies, UN agencies, local, national, and international non-government organisations (NGO), health service providers, etc. As Kushtia was our demonstration district, we identified the IMCI related stakeholder organisations exclusively working in Kushtia district.
We primarily focused on influencing the policy and guidelines to introduce and integrate pulse oximetry in routine IMCI services in Bangladesh. We also wanted to maximise the use of limited resources by prioritising a few stakeholder organisations that we would engage with. Hence, we organised a consultative workshop with the Programme Manager and all of the five Deputy Programme Managers of the National Newborn Health and IMCI Programme, where we used the Power-Interest matrix for stakeholder prioritisation [31].
At the workshop, the participants scored each stakeholder organisation on their level of power and interest regarding IMCI implementation in Bangladesh based on a 10-point Likert scale where one was regarded as the lowest and ten was considered the highest (Table S3 in the Online Supplementary Document) [32]. We then plotted each stakeholder organisation (identified through desk review and key informant interview) in the Power-Interest matrix based on their average scores allotted by the workshop participants (Figure 2). Any stakeholder organisation with an average interest score of 6 and above was considered to have high interest. Similarly, any stakeholder organisation having an average power score of 6 and above was considered to have high power. Thus, of the 15 stakeholder organisations identified at the national level, five were categorised in the high power-high interest group, five in the high power-low interest and two low power-high interest groups, while four stakeholders were classed into the low power-low interest group. The 16 district-level stakeholder organisations were categorised similarly, with six prioritised as having high power-high interest. We decided to inform (described in step 2) all the stakeholders with high power or high interest but focus our attention on stakeholders with high power-high interest during the involve (described step 3) and engage (described in step 4) phases.
Figure 2. Power-Interest mapping of national and district level stakeholder organisations related to Integrated Management of Childhood Illness (IMCI) implementation in Bangladesh.
Step 2: Sensitising stakeholders for awareness building and understanding
Two sensitisation workshops were conducted with national-level stakeholders prioritised in the previous step. In the first workshop, we invited 40 participants from stakeholder organisations representing the high power-high interest, high power-low interest, and high interest-low power groups. The Programme Manager of the National Newborn Health and IMCI Programme chaired the workshops to promote country ownership and government leadership. In the first workshop, the research team of icddr,b presented the burden of hypoxaemia among children suffering from pneumonia, the importance of using pulse oximetry in hypoxaemia assessment and the updated WHO recommendation for introducing pulse oximetry in routine assessment and classification of pneumonia. In the second workshop, the invitation was limited to 19 participants from five organisations representing the high power-high interest group [14,15,33,34]. The participants discussed both the technical and operational feasibility of introducing pulse oximetry in routine IMCI services in Bangladesh.
A sensitisation workshop was conducted in Kushtia, with 32 participants from all district level stakeholder organisations, including the district health manager (locally known as Civil Surgeon, ie, CS), district level family planning manager (locally known as Deputy Director Family Planning, ie, DDFP), all (five) sub-district health managers (locally known as Upazila Health and Family Planning Officers, ie, UH&FPO) and all sub-district level family planning managers (Upazila Family Planning Officers, ie, UFPO). In addition, managers from the National Newborn Health and IMCI Programme attended the event. They presented the importance of identifying hypoxaemia in pneumonia assessment and classification and discussed the operational feasibility of introducing pulse oximetry in real-life settings.
Subsequently, we organised five such sensitisation workshops in each sub-district, with 14 participants in each workshop, including IMCI service providers such as doctors, nurses and paramedics (locally known as Sub-assistant Community Medical Officers, ie, SACMO) and their respective supervisors. For each sub-district level workshop, the respective sub-district health managers gave the keynote presentation.
Lastly, 71 enlisted national and local level NGOs actively working in Kushtia district were identified, of which 21 had strong community acceptance and health-related activities. We organised another sensitisation workshop with representatives from these 21 organisations. The district health manager gave the keynote presentation, and all the sub-district managers contributed to the subsequent discussions. All participating NGO partners agreed to raise awareness regarding pneumonia and hypoxaemia and promote appropriate care-seeking practices in the local communities.
Step 3: Involving stakeholders in joint planning and sharing responsibilities
Like the previous sensitisation phase, we organised workshops at the national, district, and sub-district levels to involve stakeholder organisations representing the high power and high-interest group, discuss a strategy, and develop a mutually agreed plan for introducing pulse oximetry in routine IMCI services of Bangladesh. At the national level, the Programme Manager of the National Newborn Health and IMCI Programme chaired the workshop. All the participants discussed and developed a national action plan to introduce pulse oximetry in routine IMCI services in Bangladesh. The roles of all key stakeholder organisations were clarified and defined in this comprehensive action plan. The National Newborn Health and IMCI Programme agreed to lead this process, and WHO, UNICEF, Save the Children and icddr,b committed to providing technical assistance and implementation support. The National Newborn Health and IMCI Programme also decided to update the National IMCI Implementation Package based on the updated WHO recommendations, including introducing pulse oximetry in pneumonia assessment and classification. This National IMCI Implementation Package consists of guidelines, registers, referral forms, reporting forms, job aids, monitoring checklist, list of essential equipment, medicine and logistics and training manuals. It was also decided that the development partners will be initially responsible for the procurement and supply of pulse oximetry devices in some demonstration facilities. The National Newborn Health and IMCI Programme declared to include pulse oximeters in the national procurement plan if the demonstration is successful.
A small working group was formed with technical experts from each stakeholder organisation with high power-high interest to update the implementation package. The small working group recommended assessing the feasibility of implementing the updated implementation package (including pulse oximetry) through an implementation research study. icddr,b volunteered to lead this implementation research study in Kushtia district. The working group members identified the evidence gaps and finalised key research questions for the implementation research through a consultative process. Further, at this workshop, it was also decided that the experience gathered through this implementation research would assist the Government of Bangladesh in taking evidence-based decisions for a national scale-up.
A planning workshop was organised in Kushtia district headquarter, which was chaired by the district health manager and attended by all sub-district health managers. At this workshop, the participating stakeholders decided that the implementation research would include all types of health facilities providing IMCI services. Hence, the Kushtia District Hospital, all five Upazila Health Complexes and one Union Health and Family Welfare Centre from each sub-district were selected as demonstration sites for the implementation research study. A district-level action plan was jointly developed outlining the roles of different district level stakeholders and the key activities, including training, distribution of pulse oximetry device, revised IMCI registers, referral forms and reporting forms, supportive supervision visits and assessments. Subsequently, a planning workshop was organised in each sub-district with the supervisors of IMCI service providers. The respective sub-district managers chaired this event and shared guidance on developing a sub-district level implementation plan for introducing pulse oximetry. A preparatory and planning meeting followed in each demonstration facility with IMCI service providers, respective supervisors, and facility managers, leading to the finalisation of a facility-specific implementation plan (with a timeline) to introduce pulse oximetry minimally impacting their routine services and existing practices.
Step 4: Engaging stakeholders in design, development, and implementation
In this stage, National Newborn Health and IMCI Programme and icddr,b worked closely with the high power-high interest stakeholders on the following steps to update the IMCI implementation package and implement it in the demonstration facilities in real-life settings.
Formation of a working group: The Line Director of Maternal, Newborn, Child and Adolescent Health Programme of the Ministry of Health and Family Welfare formed a small working group with 13 IMCI experts representing the five high power-high interest groups to review and update the National IMCI Implementation Package (Table S4 in the Online Supplementary Document). The Programme Manager of the National Newborn Health and IMCI Programme chaired this group and icddr,b provided secretarial support. The group agreed to review the current availability of pulse oximetry devices in public health facilities and the overall oxygen delivery system in the country in addition to incorporating the recommendations and instruction to use pulse oximetry in the national IMCI implementation package.
Updating the National IMCI Implementation Package: The working group reviewed the National IMCI Implementation Package, which was based on the previous WHO guideline in 2009 and compared them with the updated WHO guidelines in 2014 [15,35] (Table S5 in the Online Supplementary Document). In addition to the new guidance on using pulse oximetry in pneumonia assessment and classification, WHO recommended other major changes in the assessment, classification and management of possible serious bacterial infection (among children aged 0-59 days), pneumonia (among children aged 2-59 months), diarrhoea, dehydration and malnutrition. The working group discussed these changes and decided to incorporate them in the national IMCI guidelines based on the country context, rationale, and operational feasibility. Based on these decisions, the working group also updated the national IMCI chart booklet of Bangladesh. The key changes that are incorporated in the National IMCI chart booklet and summarised in Table S6 in the Online Supplementary Document. Subsequently, relevant training manuals were updated for IMCI services providers (doctors, nurses, and paramedics), community health workers and medical students (pre-service training). The working group also updated the IMCI-related service register, referral form, reporting form and job aids. Additional implementation materials such as the essential list of IMCI-related equipment, drugs and logistics, and monitoring checklists were also updated. All the National IMCI Implementation Package documents were developed in English and Bangla (the official language of Bangladesh). It took the working group a total of thirteen meetings (each lasting from three to five hours) to review and update all the documents in the IMCI implementation package (Figure 3).
Figure 3. Documents in the National Integrated Management of Childhood Illness (IMCI) Implementation Package updated to incorporate the recommendation for using pulse oximetry in routine IMCI services.
Orientation training of national IMCI master trainers and pre-testing with IMCI service providers: We organised a workshop to orient the national IMCI master trainers to the updated National IMCI Implementation Package, including the use of pulse oximetry in pneumonia assessment and classification. The master trainers reviewed the updated documents (primarily the chart booklet and training manuals) and shared their feedback.
Afterwards, the updated training package was pre-tested among IMCI service providers, including doctors, nurses, and paramedics. The National Newborn Health and IMCI Programme organised the training, the national master trainers facilitated the sessions, and icddr,b conducted assessment and evaluations. A total of 40 doctors, 91 nurses and 67 paramedics received training in 10 batches. We collected feedback from the IMCI providers on the National IMCI Implementation Package, including the training manuals, registers, job aids and reporting forms. Figure 4 shows the response of the IMCI service providers regarding the perceived importance, acceptance and confidence of using pulse oximetry in a five-point Likert scale, which were collected after the end of the training. The average Likert scale score was more than four across all response categories. We also did not find any significant difference (ANOVA test) across the three types of providers for any of the response categories.
Figure 4. Response of Integrated Management of Childhood Illness (IMCI) service providers regarding perceived importance, acceptance and confidence of using pulse oximetry after receiving training with the updated implementation package, presented in average score in a five-point Likert scale, doctors = 40, nurses = 91, paramedics = 67.
Finalisation of the National IMCI Implementation Package: Following the training workshops with master trainers and IMCI service providers, the working group updated the national implementation package based on their feedback. Then National Newborn Technical Working Committee for Newborn Health and the National IMCI Technical Working Committee, the highest-level technical committees regarding newborn and child health in Bangladesh, reviewed the updated package and shared feedback. The National IMCI Implementation Package was finalised after incorporating their feedback and inputs.
Incorporation of the use of pulse oximetry and hypoxaemia in the national health service records: Over a series of six consultative workshops, the National Newborn Health and IMCI Programme convinced the Management Information System (MIS) department of the Directorate General of Health Services to update the national IMCI dataset (maintained in the national DHIS2) based on the updated monthly reporting form (including updated pneumonia classification and hypoxaemia status). icddr,b provided technical assistant and secretarial support in organising these events.
Involving national-level stakeholders in the implementation research: A co-design and co-creation approach was adopted to develop the implementation research protocol. icddr,b led the process and engaged the National Newborn Health and IMCI Programme and other stakeholder organisations representing the high-power and high-interest group to prioritise research questions and finalise the research design, data collection methods, and data collection instruments. Additionally, one of the Deputy Programme Managers of the National Newborn Health and IMCI Programme joined the research team as a Co-Investigator.
Local-level involvement in the implementation research: A district advisory committee was formed to guide the implementation research study in Kushtia-district. The district health manager chaired the committee, and all the sub-district level health managers were included as members. First, the advisory committee was oriented regarding the research questions and study design. Later, the committee developed a macro plan to introduce pulse oximetry in the selected facilities and conduct quantitative and qualitative assessments as outlined in the research protocol. Subsequently, a planning meeting was organised in each facility with respective IMCI service providers and their supervisors to review the macro plan and develop a micro plan with a timeline. A dissemination meeting was organised with the district advisory committee after the baseline and each round of data collection. icddr,b provided technical assistance and secretarial support throughout the process.
Resuming study activities during the COVID-19 pandemic: The Government of Bangladesh declared a nationwide lockdown in the last week of March 2020 to prevent the surge of COVID-19 infections and deaths. Unfortunately, all the implementation research-related activities were suspended due to the strict restrictions imposed during the lockdown period. In August 2020, the government started to reduce restrictions. The National Newborn Health and IMCI Programme issued an official order to resume the research activities with appropriate infection prevention and control measures. A series of meetings were organised in Kushtia-district with the district health manager and sub-district health managers to resume the suspended activities and revise the implementation plan (both macro plan and micro plan) accordingly.
Resources required for stakeholder engagement
Figure 5 summarises the resource required for undertaking the above-mentioned stakeholder engagement related activities.
Figure 5. Resources required and invested for stakeholder engagement activities.
Desk Review: A total of 37 documents with approximately 2507 pages were reviewed to identify the stakeholders and update the National IMCI Implementation Package. It required around 120 person-days of effort by medical graduates with basic IMCI training.
Resource person interview: A total of eight interviews and a group discussion was organised with IMCI experts to identify and prioritise the stakeholder organisations, requiring ten person-hours for interviewing and an additional 30 person-hours for transcribing and analysis.
Document development, editing and formatting: The National IMCI Implementation Package containing 24 documents with 1685 pages were updated, which required approximately 140 person-days of reviewing, editing and formatting to prepare the final versions.
Workshops: At the national level, 30 workshops were organised to sensitise (step 2), involve (step 3) and engage (step 4) the stakeholders, requiring approximately 416 person-days of involvement by IMCI experts and stakeholders. In addition, about 42 person-days of investment was needed from icddr,b for taking preparation and organising the events. Furthermore, around 30 person-days was required to prepare and approve the meeting notes for official documentation.
At the district level, 45 meetings were organised, requiring approximately 183 person-days of involvement by IMCI service providers, 86 person-days by their clinical supervisors, and 101 person-days by district, sub-district and facility managers.
Travel and transport: To sensitise (step 2), involve (step 3) and engage (step 4) stakeholders at the district level, extensive travel and transport were required. A total of 97 person-days of travel and transportation were needed from central-level staff and 312 person-days from local-level staff to organise and participate in the stakeholder engagement related events
Figure 6 presents the timeline of major stakeholder engagement related activities.
Figure 6. Milestones and timeline of stakeholder engagement activities.
Step 1-Identify: This process began in October 2018 and continued till December 2018.
Step 2- Sensitise: At the national level, the sensitisation process started in January 2019 and continued till the end of that year, while at the district level, the sensitisation activities went on from October 2019 till February 2020.
Step-3-Involve: At the national level, the involvement process took place in June 2019 and at the district level, the process took place in March 2020.
Step 4-Engage: The national-level engagement process started in June 2019 and ended in January 2021. The district-level engagement process began in December 2020 and ended in July 2021.
Impact of the stakeholder engagement process
Change in national policy and strategy
The Government of Bangladesh and all the key stakeholders acknowledged the importance of identifying hypoxaemia through SpO2 assessment for improving pneumonia assessment, classification, and management. As a result, the Government of Bangladesh decided to introduce pulse oximetry in routine IMCI services in Bangladesh.
Change in the national programme
The National Newborn Health and IMCI Programme formed a national-level working committee with high power-high interest stakeholder organisations related to IMCI implementation in Bangladesh. This high-level working committee updated the National IMCI Implementation package including the chart booklet, register, referral form, reporting form, monitoring checklist and training manuals and incorporated specific recommendations to use pulse oximetry in relevant sections. Further, three hypoxaemia related indicators were included in the national IMCI data set in DHIS2. The Government of Bangladesh trained 4872 IMCI service providers from across the country based on the updated National IMCI Implementation Package.
Progress towards scalability and sustainability
The Government of Bangladesh decided to scale up the use of pulse oximetry in routine IMCI services in a phased manner. As a result, the National Newborn Health and IMCI Programme revised its existing plan and decided to procure pulse oximetry devices for the IMCI corners in approximately 200 Upazila health complexes. In the next phase, the National Newborn Health and IMCI Programme is planning to procure pulse oximetry devices for the remaining of the IMCI corners in the Upazila Health Complexes (approximately 250) and other union-level facilities (approximately 5000). Additionally, UNICEF has committed to support the Government of Bangladesh's national scale-up endeavour by introducing pulse oximetry in eight districts. icddr,b has committed to support in two districts, and Save the Children in one district. Moreover, WHO has supported the government by printing the updated IMCI registers for all facilities.
We present the key learnings from the stakeholder engagement activities based on the SWOT analysis approach [36,37]. The summary of the SWOT analysis is presented in Figure 7.
Figure 7. Strength, weakness, opportunity, and threat analysis of the stakeholder engagement process.
Context-driven: Our implementation research study primarily aimed to influence the national policy and programmes. Based on the context and prior experience, we adopted a framework with four steps for stakeholder engagement and prioritised only the high power-high interest stakeholder organisations. The framework guided the whole process and all related activities, and the prioritisation helped maximise the use of limited resources. Therefore, any implementation research study aiming to engage stakeholders need to adapt and modify the framework based on the objective and context.
Country ownership, government leadership and multi-partner involvement: The Government of Bangladesh demonstrated leadership in forming and leading the national working group, chairing the workshops, developing the strategic plans, and bringing multiple partners together for building national consensus on introducing pulse oximetry in routine IMCI services in Bangladesh. All the major non-government organisations and development partners related to IMCI implementation in Bangladesh committed to using the updated National IMCI Implementation Package in their respective health system strengthening initiatives.
Expertise, experience and relationships of the facilitating organisation: The technical expertise and experience of icddr,b in the introduction and scale-up of IMCI services in Bangladesh and pre-existing relationships with other high power-high interest stakeholder organisations substantially contributed to the identification, sensitisation, involvement, and engagement of other high power-high interest stakeholder organisations. Moreover, the communication, and organising skills of icddr,b contributed to facilitating the stakeholder engagement process efficiently. Therefore, the positionality of implementing organisations needs to be considered before adopting a particular approach for engaging stakeholders.
Time-consuming: It took more than two and a half years to implement the stakeholder engagement related activities and achieve the objective of incorporating the use of pulse oximetry in national policy and programme. Numerous workshops were organised based on the availability of all high power-high interest stakeholders, which was difficult considering their busy schedules, especially during ongoing COVID-19 pandemic. Extensive deskwork and preparations were necessary before organising these workshops, which called for several days or weeks of preparation. Hence, engaging the stakeholders effectively is time-consuming and will require patience and commitment by the facilitating organisation.
Resource-intensive: The initial stage involved reviewing a significant number of documents to identify stakeholders and update the National IMCI Implementation Package, which required a substantial amount of person-time involvement of project staff. In addition, organising workshops at national, district and sub-district levels required numerous person-days of involvement from IMCI experts, managers, service providers and project staff. It also required extensive travelling by the project staff. Since stakeholder engagement is a resource-intensive process, it is important to have a planning and specific budgetary allocation for stakeholder engagement at the outset of any project.
Iterative: Reviewing, editing, and formatting several lengthy documents were essential for updating the National IMCI Implementation Package. Some of these documents required numerous rounds of editing and formatting to address and incorporate the feedback of all the stakeholders across the national, district and sub-district levels before finalisation. For example, IMCI chart booklet had 23 rounds of iteration and IMCI registers had 19 rounds of iteration before finalisation. Hence, the facilitating organisation need to have dedication and attention to details to effectively steer the stakeholder engagement process.
Mercurial: The power-interest matrix of the stakeholders does not stay static and could change at any given time. For example, during the engagement process, one of the stakeholders with high power and low interest unexpectedly turned into a high power-high interest actor and started posing a risk to the process. Therefore, some part of the stakeholder engagement process was adapted based on the agenda of that particular stakeholder. In addition, during the stakeholder engagement process, there can be changes in leadership positions. For example, the National Newborn Health and IMCI Programme manager was changed twice, and the district health manager was changed three times during the engagement process, owing to administrative transfers. It required investing additional time and efforts to sensitise the new stakeholders and garnering their active buy-in to introduce pulse oximetry in routine IMCI services. Hence, stakeholder engagement is an adaptive process and will require flexibility in revising, updating and changing the plan based on the context and circumstances.
COVID-19 pandemic- general awareness regarding hypoxaemia: The COVID-19 pandemic has raised awareness among the health care provider and care receiver for using pulse oximetry in measuring the oxygen saturation level and assessing the severity of pneumonia. This opportunity has facilitated the implementation process more easily.
COVID-19 Pandemic- lockdown and restrictions: The stakeholder engagement related activities and plans required extensive modification and revision due to the COVID-19 pandemic. During the first lockdown period between March and August 2020, all project-related activities were suspended. The team advocated with the National Newborn Health and IMCI Programme to resume project activities after the COVID-19 related restrictions were eased.
Other national and programme priorities: The engagement process and project-related activities were also interrupted by unanticipated events, such as implementing the national Measles-Rubella campaign, which kept the district and sub-district health managers and IMCI service providers occupied during February and March 2021. Therefore, the potential impact of an emerging threat on the overall outcome and timeline of the stakeholder engagement process must be acknowledged and should have the flexibility of modifying the plan to take course corrective measures.
Our experience has demonstrated the value and potential of the approach that we adopted for stakeholder engagement. Our engagement process contributed to the national decision to introduce pulse oximetry in routine IMCI services and update the national implementation package, which are steppingstones towards scalability and sustainability. However, our experience also reveals that stakeholder engagement is a context-driven, time-consuming, resource-intensive, iterative, mercurial process that demands planning, prioritisation, inclusiveness and adaptability. It is also influenced by the expertise, experience and positionality of the facilitating organisation. However, the approach needs to be conceptualised coupled with the allocation of adequate resources and time commitment to replicate its impact and implement it effectively in other settings.
Online Supplementary Document
We want to acknowledge all our field level staffs who made this arduous work possible through their relentless effort. We also want to show our thankfulness to Anika Tasneem Chowdhury (Project Research Physician), AFM Azim Uddin (Senior Research Officer) and Md. Ziaul Haque Shaikh (Senior Field Research Officer) for their continuous dedicated support.
Ethical consideration: Ethical approval of the study was obtained from the Institutional Review Board of icddr,b (Protocol Number: PR-18054). Research Governance of The University of Edinburgh declared the study does not need any UK based ethical opinion as it was categorised as low risk.
[1] Funding: This research was commissioned by the NIHR Global Health Research Unit on Respiratory Health (RESPIRE) through The University of Edinburgh, UK, using UK Aid from the UK Government. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care.
[2] Author contributions: AER and SJ conceptualised, developed and finalised the manuscript as joint first authors with equal contribution. GF assisted in the conceptualisation and drafting of the manuscript. GB, JI, SA, SA, ATH, HMSA, TM, AS, AUA, EK, MJC, SA, MK, TJ, DHD, HN reviewed the first draft and provided their inputs. SEA, MSI and HC provided their guidance and feedback to AER and SJ at every stage as senior authors. All authors read and approved the final manuscript.
[3] Competing interests: Harry Campbell is the Co-Editor in Chief of the Journal of Global Health. He was not involved in the decision-making process. To ensure that any possible conflict of interest relevant to the journal has been addressed, this article was reviewed according to best practice guidelines of international editorial organisations. The authors have completed the ICMJE Declaration of Interest Form (available upon request from the corresponding author) and declare no further conflicts of interest.
[1] L Liu, S Oza, D Hogan, Y Chu, J Perin, and J Zhu. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388:3027-35. DOI: 10.1016/S0140-6736(16)31593-8. [PMID:27839855]
[2] World Health Organization. Causes of child mortality: Global Health Observatory (GHO) Data 2015. Available: http://www.who.int/gho/child_health/mortality/causes/en/. Accessed: 6 September 2021.
[3] UNICEF. Annual Report 2020: Turning research into action for children and young people. 2020. Available: https://reliefweb.int/report/world/unicef-annual-report-2020-turning-research-action-children-and-young-people/. Accessed: 6 September 2021.
[4] . Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1684-735. DOI: 10.1016/S0140-6736(18)31891-9. [PMID:30496102]
[5] DA McAllister, L Liu, T Shi, Y Chu, C Reed, and J Burrows. Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis. Lancet Glob Health. 2019;7:e47-57. DOI: 10.1016/S2214-109X(18)30408-X. [PMID:30497986]
[6] The National Institute of Population Research and Training (NIPORT) MoHaFWD, The DHS Program, ICF. Bangladesh Demographic and Health Survey 2017-18. 2017-18. Available: https://dhsprogram.com/pubs/pdf/PR104/PR104.pdf. Accessed: 6 September 2021.
[7] AE Rahman, AT Hossain, AB Siddique, S Jabeen, MJ Chisti, and DH Dockrell. Child mortality in Bangladesh–why, when, where and how? A national survey-based analysis. J Glob Health. 2021;11:04052 DOI: 10.7189/jogh.11.04052. [PMID:34552721]
[8] T Duke, J Mgone, and D Frank. Hypoxaemia in children with severe pneumonia in Papua New Guinea[oxygen therapy in children] Int J Tuberc Lung Dis. 2001;5:511-9. [PMID:11409576]
[9] AE Rahman, AT Hossain, MJ Chisti, DH Dockrell, H Nair, and S El Arifeen. Hypoxaemia prevalence and its adverse clinical outcomes among children hospitalised with WHO-defined severe pneumonia in Bangladesh. J Glob Health. 2021;11:04053 DOI: 10.7189/jogh.11.04053. [PMID:34552722]
[10] T Duke, F Wandi, M Jonathan, S Matai, M Kaupa, and M Saavu. Improved oxygen systems for childhood pneumonia: a multihospital effectiveness study in Papua New Guinea. Lancet. 2008;372:1328-33. DOI: 10.1016/S0140-6736(08)61164-2. [PMID:18708248]
[11] ED McCollum, C King, T Colbourn, H Graham, M Bernstein, and IH Wilson. Pulse oximetry in paediatric primary care in low-income and middle-income countries. Lancet Respir Med. 2019;7:1001 DOI: 10.1016/S2213-2600(19)30358-3. [PMID:31631030]
[12] World Health Organization. Recommendations for management of common childhood conditions: evidence for technical update of pocket book recommendations: newborn conditions, dysentery, pneumonia, oxygen use and delivery, common causes of fever, severe acute malnutrition and supportive care. 2012. Available: https://apps.who.int/iris/bitstream/handle/10665/44774/9789241502825_eng.pdf;sequence=1. Accessed: 6 September 2021.
[13] AE Rahamn, S Mhajabin, D Dockrell, H Nair, S El Arifeen, and H Campbell. Managing pneumonia through facility-based integrated management of childhood management (IMCI) services: an analysis of the service availability and readiness among public health facilities in Bangladesh. BMC Health Serv Res. 2021;21:1-13.
[14] World Health Organization. Pocket book of hospital care for children: guidelines for the management of common childhood illnesses: World Health Organization. 2013. Available: http://apps.who.int/iris/bitstream/handle/10665/43206/9241546700.pdf;sequence=1. Accessed: 6 September 2021.
[15] World Health Organization. Integrated Management of Childhood Illness (Chart Booklet). 2014. Available: https://www.who.int/publications/i/item/9789241506823. Accessed: 6 September 2021.
[16] World Health Organization. Revised WHO classification and treatment of pneumonia in children at health facilities: evidence summaries. 2014. Available: https://apps.who.int/iris/bitstream/handle/10665/137319/9789241507813_eng.pdf;sequence=1. Accessed: 6 September 2021.
[17] SE Arifeen, DE Hoque, T Akter, M Rahman, ME Hoque, and K Begum. Effect of the Integrated Management of Childhood Illness strategy on childhood mortality and nutrition in a rural area in Bangladesh: a cluster randomised trial. Lancet. 2009;374:393-403. DOI: 10.1016/S0140-6736(09)60828-X. [PMID:19647607]
[18] Government of the Peoples' Republic of Bangladesh MoHaFW. Health Bulletin 2019. Available: https://dghs.gov.bd/images/docs/Publicaations/Health%20Bulletin%202019%20Print%20Version%20(2)-Final.pdf. Accessed: 6 September 2021.
[19] National Institute of Population Research and Training (NIPORT) II. Bangladesh Health Facility Survey 2017. 2019. Available: https://dhsprogram.com/pubs/pdf/SPA28/SPA28.pdf. Accessed: 24 October 2021.
[20] icddr b. icddr,b. Available: https://www.icddrb.org/. Accessed: 24 October 2021.
[21] The University of Edinburgh. NIHR Global Health Research Unit on Respiratory Health (RESPIRE). Available: https://www.ed.ac.uk/usher/respire/acute-respiratory-disorders/pulse-oximetry-bangladesh. Accessed: 24 October 2021.
[22] National Institute of Population Research and Training (NIPORT) ME. Bangladesh District Level Socio-demographic and Health Care Utilization Indicators. 2019. Available: http://rdm.icddrb.org/wp-content/uploads/2020/04/Bangladesh-District-Level-Socio-demographic-and-Health-Care-Utilization.pdf. Accessed: 24 October 2021.
[23] Peters DH, Tran NT, Adam T. Implementation research in health: a practical guide. 2013. Available: https://apps.who.int/iris/bitstream/handle/10665/91758/9789241506212_eng.pdf;jsessionid=582156F0C85F443FDBAECA87DCF7BB15?sequence=1. Accessed: 25 October 2021.
[24] A Boaz, S Hanney, R Borst, and A O'Shea. Kok MJHrp, systems. How to engage stakeholders in research: design principles to support improvement. Health Res Policy Syst. 2018;16:1-9. DOI: 10.1186/s12961-018-0337-6
[25] T Huzzard. Achieving impact: Exploring the challenge of stakeholder engagement. Eur J Work Organ Psychol. 2020;30:1-11.
[26] MO Kok, JO Gyapong, I Wolffers, and DO Adjei. J R. Which health research gets used and why? An empirical analysis of 30 cases. Health Res Policy Syst. 2016;14:36 DOI: 10.1186/s12961-016-0107-2. [PMID:27188305]
[27] PA Deverka, DC Lavallee, PJ Desai, LC Esmail, SD Ramsey, and DL Veenstra. Stakeholder participation in comparative effectiveness research: defining a framework for effective engagement. J Comp Eff Res. 2012;1:181-94. DOI: 10.2217/cer.12.7. [PMID:22707880]
[28] TW Concannon, M Fuster, T Saunders, K Patel, JB Wong, and LK Leslie. A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research. J Gen Intern Med. 2014;29:1692-701. DOI: 10.1007/s11606-014-2878-x. [PMID:24893581]
[29] TW Concannon, S Grant, V Welch, J Petkovic, J Selby, and S Crowe. Practical guidance for involving stakeholders in health research. J Gen Intern Med. 2019;34:458-63. DOI: 10.1007/s11606-018-4738-6. [PMID:30565151]
[30] Coretta Mallery DG. Jessica Fernandez, Lauren Smeeding, Sandra Robinson, Marilyn Moon. Innovative Methods in Stakeholder Engagement: An Environmental Scan. 2021. Available: https://effectivehealthcare.ahrq.gov/sites/default/files/pdf/stakeholders-engagement-others_research-2012-1.pdf. Accessed: 6 September 2021.
[31] National Health Service (NHS) Institute for Innovation and Improvement. The organising for quality and value: Delivering improvement programme. 2009.
[32] A Joshi, S Kale, S Chandel, and DK Pal. Likert scale: Explored and explained. Current Journal of Applied Science and Technology. 2015;7:396
[33] J Floyd, L Wu, D Hay Burgess, R Izadnegahdar, D Mukanga, and AC Ghani. Evaluating the impact of pulse oximetry on childhood pneumonia mortality in resource-poor settings. Nature. 2015;528:S53-9. DOI: 10.1038/nature16043. [PMID:26633766]
[34] R Subhi, M Adamson, H Campbell, M Weber, K Smith, and T Duke. The prevalence of hypoxaemia among ill children in developing countries: a systematic review. Lancet Infect Dis. 2009;9:219-27. DOI: 10.1016/S1473-3099(09)70071-4. [PMID:19324294]
[36] MM Helms and J Nixon. Exploring SWOT analysis–where are we now? A review of academic research from the last decade. Journal of Strategy and Management. 2010;3:215-51. DOI: 10.1108/17554251011064837
[37] C Namugenyi, SL Nimmagadda, and T Reiners. Design of a SWOT analysis model and its evaluation in diverse digital business ecosystem contexts. Procedia Comput Sci. 2019;159:1145-54. DOI: 10.1016/j.procs.2019.09.283
Correspondence to:
Ahmed Ehsanur Rahman
PhD Student at The Usher Institute
Edinburgh Medical School: Molecular, Genetic and Population Health Sciences
Edinburgh EH8 9DX
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