Ooler Master – Megaflow 110.0 Cfm 200mm Fan
Tempur-adapt + Cooling Mattress Topper – Tempur-pedic
For many, mattresses can trap in heat and feel very hot once the summertime starts. Cooling mattress pads can make your mattress feel cooler and comfier.
These bed mattress pads and toppers are from brands we love and have innovative functions for supreme cooling. For hot sleepers, our Textiles pros suggest looking for cooling technologies like Outlast, which shops and releases body heat as needed, and 37.
We selected these choices ahead based on our categorical expertise and decades of testing bedding., along your new cooling bed mattress pad. Ad – Continue Reading Below 1 Best General Cooling Mattress Pad Core Bed Mattress Pad Sleep, Cloud $234.
11 Best Cooling Mattress Pads For Better Sleep (2020) – Heavy …
Outlast, preventing night sweats in the first location. Using a mix of Outlast viscose and cotton material on the top, it has a soft feel while the pad is made from Lyocell to wick away wetness for extra cooling. We enjoy that this style is available in multiple colors, too.
com A lot of bed mattress pads will cost a minimum of $100, however this topper design is less than that. Made of gel infused memory foam, this mattress topper is designed to. With lots of open cells throughout, this choice is indicated to be extremely breathable. Affordable Breathable gel-infused memory foam 3 Best Pillowtop Cooling Mattress Pad Future Textiles Outlast Pillowtop Mattress Pad Design Weave amazon.
99 Pillowtop bed mattress pads offer This mattress pad from Style Weave utilizes Outlast innovation to keep you cool all night. The exterior is made from 350 thread count cotton material and the fill is 100% polyester fantastic if you have allergies and can not use traditional down! Last longer than technology Down alternative 4 Finest Cooling Mattress Pad For Couples Dual, Temperature Individual Layer Bed Mattress Pad Sleep Number sleepnumber. Ooler Master – Megaflow 110.0 Cfm 200mm Fan.
Best Cooling Mattress Pads 2021 – Sleepingculture.com
99 This mattress topper, With both cool and warm settings set from a remote, airflow technology changes the temperature level of the pad. Ooler Master – Megaflow 110.0 Cfm 200mm Fan. You can also set automated shutoff if you do not desire it running all night. Note that each side is sold independently, so to cover the whole bed mattress, you would need to buy two.
5 Water Resistant Mattress Pad Pottery Barn potterybarn. 00 When looking for a bed mattress topper, you desire the included comfort, but keeping your mattress safe from wear and tear is a bonus offer. This mattress pad from Pottery Barn is.
5 innovation Water resistant to protect mattress 6 Finest Deep Pocket Bed Mattress Pad 37. 5 Performance Bed mattress Pad SHEEX amazon.
Cooling Mattress Pads & Toppers For Bed & Bath – Jcpenney
5 innovation, this luxurious choice is created to store and launch heat to keep your body temperature level steady. 37. 5 technology Bonus deep pockets for thick bed mattress 7 Finest Foam Cooling Mattress Pad Iso-Cool Memory Foam Outlast Bed Mattress Topper Sleep Better costco. com $139. 99 This mattress pad uses Outlive innovation to prevent you from over heating in the evening.
There’s likewise a polyester fiberfill top and a cotton cover for additional plush. Reviewers love that the elastic fabric on the sides make it extremely simple to protect this topper to your bed mattress. Soft, luxurious memory foam Polyester fiber fill top 8 Finest Smart Cooling Bed Mattress Pad OOLER Sleep System Chili Technology chilitechnology.
00 Finally you can bring your Air Conditioning into your bed … well, almost – Ooler Master – Megaflow 110.0 Cfm 200mm Fan. The OOLER Sleep System has a control system that connects to the mattress pad where. The system is controlled from an application on your smartphone for incredibly simple usage. The pad has 1/8 inch tubes throughout with a water resistant polyester backing to keep everything in location.
Cooling Mattress Pads & Toppers For Bed & Bath – Jcpenney
Accurate temperature control Cools via water tubes This content is developed and maintained by a third party, and imported onto this page to help users provide their e-mail addresses – Ooler Master – Megaflow 110.0 Cfm 200mm Fan. You may be able to find more info about this and similar material at piano. io Advertisement – Continue Reading Below.
Nature’s Sleep, Thick Air, Cool IQ Economy Size 3 Inch-Thick This topper from Nature’s Sleep takes the leading spot concerning rate, but the additional dollars make their keep. The pad, which utilizes all-new, patented Air, Cool IQ Gel innovation, replicates the support and convenience of a thicker topper without the real weight and dense products – Ooler Master – Megaflow 110.0 Cfm 200mm Fan.
Besides, the item is Certi, Pur-US certified, guaranteeing that the foam is of the highest quality. Evaluations of the cooling topper call out its added capacity to suppress creaking and other sounds another common irritant that can interfere with one’s sleep. And among the wide variety of shining comments about its plushness and basic convenience, other evaluations note that the pad can broaden without issues and does not have any nose-wrinkling odors.
Top 7 Picks – Best Cooling Mattress Topper Reviews For June …
Courtesy There are couple of sensations quite as annoying (and gross) as waking up in a puddle of your own sweat.
, you can control your bed setup. Instead of throwing away your expensive bed mattress, though, you can merely invest in a cooling bed mattress pad.
Great, right? Ahead, shop the very best mattress pads and toppers that are designed particularly to offer you a cooler night’s sleep, according to online evaluations. Advertisement – Continue Reading Below 1 Best General Mattress Pad Sleep Cloud Core Cooling Bed Mattress Pad Developed with the very same tech astronauts utilize in area suits, this mattress topper reacts to you,.
Cooling Mattress Protector – Sweet Zzz Official®
“Seriously. I’ve never ever slept better,” one reviewer says. “The mattress cover and pillow cover have actually made my sleep temperature level drop to a pleased location while keeping my hubby’s temperature level still warm and cozy.” 2 Best Worth Mattress Pad Oaskys Cooling Bed Mattress Pad Unlike the diamond stitching you see on numerous mattress pads, this one.
“I like this bed mattress topper! I have actually bought 2 others and returned them both but this one was a keeper,” states one Amazon reviewer. “It is soft, includes a luxury sensation to my bed, and stays cool all night as assured (Ooler Master – Megaflow 110.0 Cfm 200mm Fan).
“This gel topper is ideal for assisting to keep you cool,” an Amazon client states. “It feels like you’re sleeping on a cloud or a lot of marshmallows. Ooler Master – Megaflow 110.0 Cfm 200mm Fan.” 4 Best Down-Alternative Pad Leisure Town Cooling Bed mattress Topper This super-cooling pad has the very same softness as goose and duck down, minus the feathers.
The Best Cooling Mattress Pad Options In 2021 – Bob Vila
“Although I enjoy the convenience of a foam mattress, I am of the age where I ‘sleep hot,'” one Amazon consumer writes. 5 Best Memory Foam Mattress Pad TEMPUR-Adapt + Cooling Topper Made from 3 inches of Tempur-Pedic’s exclusive memory foam, this extra-comfy bed mattress pad is.
Plus, “this topper has helped in relieving lower neck and back pain.” 6 Best Organic Bed Mattress Pad Saatva Mattress Topper Naturally glamorous mattress-maker Saatva uses among the very best cooling bed mattress pads on the marketplace, too. This organic cotton topper has: heat-distributing graphite, encouraging memory foam, and motion-minimizing transitional foam. Oh, and it’s hypoallergenic. Ooler Master – Megaflow 110.0 Cfm 200mm Fan.
“Comfortable and doesn’t need shaking. Perfect for a hard bed mattress.” 7 Best Bamboo Bed Mattress Pad Exceptional, Sheets Bamboo Bed mattress Pad This plush bed mattress pad has a fitted skirt that extends across bed mattress up to 18 inches thick. The brand also declares that this mattress pad is. “This bed mattress pad measures up to all the claims,” one purchaser states.
Best Cooling Mattress Pad & Cooling Mattress Topper …
00 Made with a 100% sateen cotton shell and premium, all-natural European down, this fluffy topper. Parachute reviewers state it’s like sleeping on a cloud: “I just purchased a new bed,” one shopper says. “The down bed mattress pad was the very best addition. It feels soft and comfortable … like I’m sleeping in a glamorous hotel bed.” 9 Finest Ready-to-Use Bed Mattress Pad Molecule Air, TEC Topper Tons of memory foam mattress pads require a few days to air out prior to you can use them, since they have an aroma (Ooler Master – Megaflow 110.0 Cfm 200mm Fan).
“The topper made sleeping more comfortable, and so far has actually assisted a bit with the Arizona heat,” one customer describes. 10 Finest Thick Bed Mattress Pad Sleep Innovations Dual Layer Bed mattress Topper amazon.
One Amazon customer who was not pleased with their new mattress purchase bought this topper to assist: “I like a softer bed. This offers the ideal soft for sleeping and remains cool so you don’t sweat like crazy.” 11 Finest Anti-Odor Mattress Pad Zinus Green Tea Bed Mattress Topper Durable and comfy, this top-rated cooling mattress pad is to assist remove odor-causing germs.
Which Is The Best Cooling Mattress Protector For You?
“The smell that included the packaging dissipated after just a couple days. Still utilizing it two years later on for our 4-year-old.” 12 Finest Year-Round Bed Mattress Pad Polar Point Cool Touch Mattress Pad Although this bed mattress pad can be utilized at any time of year, it’s finest for the warmer months because it assists soak up heat, permitting you snooze more soundly at night. Ooler Master – Megaflow 110.0 Cfm 200mm Fan.
It also has a hypoallergenic fiber fill for convenience and support. This material is developed and kept by a third party, and imported onto this page to help users provide their email addresses.
If you enjoy nearly whatever about your bed mattress however wish to make little modifications to personalize your sleep environment, a mattress pad is worth thinking about. Ooler Master – Megaflow 110.0 Cfm 200mm Fan. A mattress pad is a thin layer that sits on top of your present mattress, and is secured with elasticized straps or a skirt much like a fitted sheet.
Best Cooling Mattress Pads – Top Picks & Buyer’s Guide (2021)
While a mattress pad does not necessarily alter the general firmness of your mattress, it can change certain qualities like temperature level guideline. A cooling bed mattress pad actively or passively controls temperature and prevents sleeping hot. Some are made with breathable materials, like cotton or wool, while others are infused with gel to draw heat away from the body and dissipate moisture.
We’ll cover our leading choices for the finest cooling mattress pads and what to search for when purchasing one. We’ll likewise break down what kind of cooling mattress pad is best, in addition to responses to frequently asked concerns. Product Details Best General Rest Cloud Nacreous Mattress Pad Cover Material: Last longer than viscose and cotton fabric blend Fill: Polyester fibers Sleepers who vary in between being too hot and too cold Allergy sufferers Those who want a mattress pad that is easy to clean People with prominent bed mattress Features Outlast innovation to help manage temperature Fits mattresses as much as 20 inches deep Machine-washable fabrication Use this link for the most existing discount rate on Rest Cloud items The Sleep Cloud Nacreous Bed mattress Pad stands out with its exclusive Outlast innovation, which is crafted for optimal temperature guideline (Ooler Master – Megaflow 110.0 Cfm 200mm Fan).


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Sometimes, in the madness of Midtown, my mind wanders back to summer and simpler, greener places.
Here...where the Beaverkill meets the Willowemoc near Roscoe...where Sullivan meets Delaware County...where anglers gather brookside for the famous wild trout...where the Catskill Park peters out into the Campbell Mountain Wild Forest... where tributary streams make their way down to the legendary Beaverkill River (and then on to the Delaware and Hudson rivers and finally to the Atlantic Ocean!)....Horse Brook, Russell Brook (home of the gorgeous Falls we visited last summer), Spooner Brook.
And here. Horton Brook. This (2) is Peter Horton, aged 93. He was born in this glorious little home and has lived here ever since...on the stream named for his family, near the hamlet of Horton, named for them, too. His ancestors arrived in these parts just after the Revolutionary War, back in the 1780's! By the 1800's they had built this perfect specimen of Americana. The kind of farmhouse you see in your mind's eye, the one with apple pie, stars, stripes and all. . .
Exploring backroads, as we always do (it's the only way to really get the feel of a place, it's context and history + authentic country views), we came upon this scene. It was too perfect. Peter was on his tractor. The brook was gurgling past. The red barn over yonder. So beautiful, it hurt. . .
Farther up Horton Road we found Merrill's Farm, in a sleepy corner of the world since 1868. Five-star AirB&B accommodations I'd seen on a map of the nearby Delaware Wild Forest while researching the area. It's in a valley of it's own, where the road ends...just magic. .
Follow your wanderlust. It will take you to some lovely places. .
SWIPE👉and see stories for more. . .
#americana #countryhome #rurallife #farmhouselove #countryside #beaverkill #roscoenyc #upstateny #catskillpark #roscoeny #smalltownusa #cottagelife #cottagegarden #countryroad #wildtrout #brooktrout #troutfishing #troutstream #upstatenewyork #oldhouselove #countrycottage #whitefarmhouse #flyfishingaddict #flyfishingjunkie #flyfishingnation #flyfishing #anglers #backroad_visions #ruralamerica

domain: geography


Acquiring a set of Mercedes Benz S600 lift support is beneficial during times when one has to pop a trunk or tailgate wide open. People who possess work Mercedes Benz S600 cars or trucks choose the usage of the gas charged lift support systems which are capable of supplying any kind of additional thrust necessary to bolster an immense window or door. Mounting packages is now speedier because the unit is able to sustain the entrance long enough till every thing has already been loaded into your vehicle.
Adding the Mercedes Benz S600 lift support is vital for the utmost safety because it helps prevent injuries which may lead to broken fingertips, hands and wrists caught somewhere between the doorways or more intense is, a broken head caused by force of unintentional closing of your gate. The thing that sets this apart from other lift supports is the fact that even a beginner can easily set it up on the Mercedes Benz S600 car, as long as the directions will be followed appropriately. Enjoy a lot more rewards using this part by buying the appropriate lift support for Mercedes Benz S600 autos. You will get hold of your desired Mercedes Benz S600 lift supports here on this web site.
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Use our Part Fit Checker to view parts compatible with your vehicle.


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Garden plant cage support for growing plants,climbing plant and vegetables flower
Made of steel metal material,won't be bent or broke easily,great for any garden
Cute scroll design and it takes few times and effort to set up,build the trellis around plants,simply insert the shelf vine into the ground at a distance
Adding a metal cage to a plant or vegetable can prevent the breakage and fruit to fall off prematurely
36-inch in height
This scroll design garden plant cage is designed specifically for growing plants and other climbing fruits and vegetables,to vine support throughout the plant's growth. The cages have a strong steel core.great for any garden.
Metal Scroll Design Garden Plant Trellis 36-Inch - B01IERXZ9S

domain: agronomy


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SERAP & 365 concerned Nigerians have filed an application before the Federal High Court, Abuja, asking the court to reject a suit by a chieftain of APC, which seeks to shut down Twitter, prevent it from operating within the Nigerian cyberspace and ultimately restrict the rights to freedom of expression, peaceful assembly and media freedom in the country.
They are asking the court for leave to be joined in the suit as parties, and to be heard as of right, as provided for under the Nigerian Constitution, 1999 [as amended], the Fundamental Rights [Enforcement Procedure] Rules, 2009,& the African Charter.
Following endorsement by Twitter Chief Executive Officer, @jack of the #EndSARS campaign last month, Adamu Garba, filed a suit number FHC/ABJ/CS/1391/2020 seeking to compel the Nigerian Communications Commission [NCC] to stop operation of Twitter International Company in Nigeria
According to SERAP, “This application is brought in the public interest. It is important to grant the reliefs being sought, for the sake of justice, & the fundamental rights of people to freedom of expression, peaceful assembly and media freedom and as millions of Nigerians will be affected by any orders that the court may make in this suit.
“The Nigerian govt has legal obligations under sections 39 and 40 of the Nigerian Constitution, and articles 9 and 11 of the African Chapter to respect, protect, promote and fulfil the rights of everyone to freedom of expression, peaceful assembly, association and media freedom.
“The determination of this suit will impact our capability to use Twitter social media platform to carry out our work to promote transparency and accountability, and respect for socio-economic rights of Nigerians, as well as seriously undermine people’s fundamental rights to freedom of expression, peaceful assembly, and media freedom.
“SERAP and 365 concerned Nigerians have shown sufficient legal interest to warrant the granting of this application, as this will serve the interest of fair hearing, guaranteed by section 36 of the Nigerian Constitution, and natural justice rule of audi alteram partem meaning that in any dispute the court must hear the other side.
“SERAP, 365 concerned Nigerians and other Twitter users will be grossly affected if the orders being sought by Mr Garba are granted by the court, as his suit is seeking to undermine the constitutionally & internationally recognized rights of people to freedom of expression peaceful assembly, and media freedom.
“SERAP and 365 concerned Nigerians seek to be joined as Respondents and to be heard as of right, in line with the Nigerian Constitution and the provisions of Order XIII Rule I of the Fundamental Rights [Enforcement Procedure] Rules 2009”.

domain: sociology


text:
Ever wonder why you act a certain way or why you get upset at certain things? Ever wonder why relationships don’t work out? You can’t seem to put your finger on it! Well I have those answers for you!
Attachment is something we learn as infants when our parents/caregivers take care of us. Their style of parenting sets the stage for how we see and interact the world later on in life. For example, if your parent did not like showing their feelings and was stand-offish, you will act that same way in relationships as an adult because it was modeled to you as a child. Pretty crazy, right?!
But don’t worry, these attachment styles aren’t the end game. You can always change and heal your attachment style. That’s why I want to teach this class. Being aware of your attachment and what it means is the first step of healing and taking your power back.
We'll learn about the 4 types of attachment, their characteristics and how they interact in relationships. We’ll also go over how to heal each type and how to support and help your partner heal.
This class is free! It will be held over Zoom video calling at the time and date specified. I’ll be sending out an email with a handout and the link to the LIVE video one day before the class begins. There will be a Q and A session at the end.
Sign up before seats fill up!

domain: psychology


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1 shared bath
1 shared bath
Easily check yourself in with the lockbox.
Scott is a Superhost
Superhosts are experienced, highly rated hosts who are committed to providing great stays for guests.
Over 200 Five-Star Reviews! :)
Welcome! I have two, fully-furnished guest rooms in my 3-bedroom apartment, available for daily or weekly rental starting at just $53/night.
Laptop friendly workspace
1 king bed
Not safe or suitable for infants (under 2 years) and pets - Crying babies and infants may disturb my others guests while they are sleeping.
No smoking, parties, or events
Check-in time is flexible and check out by 10PM
Self check-in with lockbox
Scott's place is the perfect home away from home in Brooklyn. Great area and so close to everything you need on your trip. The bed is comfy and the room has plenty room for clothes to be put away or hung up Scott is great and Nancy is a super cute cat. I wouldn't hesitate to sta…
Scott's place had everything I needed. The location is good - close to the bars and restaurants of Williamsburg and near Hewes Street subway which can take you straight into Manhattan. It was an added bonus that the room was equipped with a PC and iPad. I didn't meet Scott but ch…
Thanks for a great stay! Super close to Bedford AV and Hewes and Marcy subway stations which are 4-5 stops from central Manhattan. It was really easy to commute. Really comfy bed and decent size bedroom. The kitties were a plus! So sweet and friendly. Scott was very attentive a…
Scott is a SuperhostSuperhosts are experienced, highly rated hosts who are committed to providing great stays for guests.
I work mornings, nights and weekends in hospitality (on the beverage side), and I like to give my guests enough space of their own to relax and unwind. My cat, Nancy, is a bit less reserved; you'll see what I mean when you meet her.
Always communicate through AirbnbTo protect your payment, never transfer money or communicate outside of the Airbnb website or app.

domain: travel


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Gov. Ricketts’ Leadership is Growing Renewable Fuels in Nebraska
Eric Maher, 402-471-1974
Luke Robson, 402-471-1967
Gov. Ricketts, along with representatives from other Midwestern states, discussing ag related issues with President Trump
earlier this year. At the meeting President Trump announced his support for year-round E-15.
Gov. Ricketts at E Energy Adams celebrating their expansion that helped Nebraska win the 2016 Site Selection
Magazine Governor’s Cup. E Energy Adams is a 50 million gallon dry mill ethanol plant in southeast Nebraska.
Gov. Ricketts addressing the Ethanol 2018: Emerging Issues Forum. Gov. Ricketts has closely collaborated
with industry leaders to push for a strong commitment to the Renewable Fuel Standard (RFS).
Gov. Ricketts cutting the ribbon on Bosselman Travel Center’s new flex fuel pumps in Grand Island
to celebrate Renewable Fuels Month in Nebraska.
LINCOLN – Under his administration, Governor Ricketts and the State of Nebraska have worked to grow demand for locally-produced renewable fuels in the state, across the country, and around the world. The Governor’s efforts to expand the biofuels industry has led to investments in production facilities and helped support a robust Renewable Fuel Standard (RFS). These efforts include:
- Advocating for Renewable Fuels on a National Level: Governor Ricketts has sat down with top U.S. officials, including President Trump, to highlight the importance of biofuels to Nebraska. Last year, the Governor visited Washington, D.C. for a roundtable with the President and leaders from across the U.S. to discuss energy, where he highlighted the innovative advancements in Nebraska’s biofuels production. In April, the Governor once again visited D.C. to discuss agriculture and trade, where the President expressed his support for E-15 sales for non-flex fuel vehicles all year long. Earlier this month, Governor Ricketts joined U.S. Department of Agriculture Secretary Sonny Perdue in Alliance for a fireside chat. At the fireside chat, the Secretary and Governor discussed a variety of agricultural issues with Nebraskans, including the ethanol industry’s concerns about the number of RFS waivers the EPA has granted to oil refineries.
- Growing Investment & Opportunity in the Biofuels Industry: Governor Ricketts, his administration, and industry officials have successfully recruited and supported new investment in the state’s ethanol industry. Nebraska has won back-to-back Site Selection Magazine Governor’s Cups, and the investment and growth in Nebraska’s biofuels infrastructure and industry were key components to achieving these awards. Over the years, the Governor has visited, toured, and helped cut ribbons on a variety of biofuel facilities throughout Nebraska. These include KAAPA Ethanol in Ravenna, Novozymes in Blair, and E Energy in Adams among many others. Novozymes’ investment in Blair followed a 2015 trade mission to Denmark where Governor Ricketts visited their headquarters and encouraged them to expand their commitment to Nebraska.
- Collaborating with Public Officials & Leaders in the Biofuels Industry: Governor Ricketts has traveled around the state and across the country advocating on behalf of the biofuels industry. For the past couple years, Governor Ricketts has served as the vice-chair and chair of the Governor’s Biofuels Coalition (GBC). His work with GBC led the Governor to testify in support of the RFS in front of the Environmental Protection Agency (EPA) in both Kansas City and Washington, D.C. The Governor is also a regular speaker at major biofuels events, including the American Coalition for Ethanol Annual Conference in 2017 and the Ethanol 2018: Emerging Issues Forum.
- Investing in Biofuels Infrastructure: Each year, Governor Ricketts proclaims May as Renewable Fuels Month in Nebraska to highlight the big impact biofuels have on our state’s economy. This year, the Governor celebrated Renewable Fuels Month in Grand Island at the Bosselman Travel Center to cut the ribbon on their new flex fuel pumps and help pump E-15 and E-85 gas for motorists. Over the past couple of years, the Governor’s team and the Nebraska Energy Office have been working with the Corn Board and Ethanol Board to install more flex fuel pumps in communities across the state. As new flex fuel pumps like these pop up across Nebraska, demand for biofuels will grow even more.

domain: news


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Skilled birth attendants (SBAs) play a crucial role in reducing infant and maternal mortality. Although the ratio of skilled assistance at birth has increased in Bangladesh, factors associated with SBA use are unknown. The main goal of our study was to reveal the individual- and community-level factors associated with SBA use during childbirth in Bangladesh. We also showed the prevalence and trend of SBA use and related independent variables in Bangladesh over the past decade.
This study utilized the Bangladesh Health and Demographic Survey (BDHS) 2017–2018, a cross-sectional study. We used binary logistic regression to examine the extent of variation in SBA use attributable to the individual- and community-level variables.
Overall, 53.35% of women received assistance from SBAs during childbirth. The average annual rate of increase (AARI) in the number of SBA-assisted births over the past 10 years was 8.88%. Respondents who gave birth at or above 19 years had 1.40 times (AOR = 1.40; 95% CI: 1.21–1.62) greater odds of having skilled delivery assistance than respondents aged 18 years old or less. Women and their husband’s education levels were significantly associated with using skilled assistance during delivery, with odds of 1.60 (AOR = 1.60; 95% CI: 1.45–2.01) and 1.41 (AOR = 1.41; 95% CI: 1.21–1.66), respectively compared to those with education up to primary level. Women from rich families and those receiving better antenatal care (ANC) visits were more likely to have professional delivery assistance. Community-level factors also showed significance towards having professional assistance while giving birth. Women from urban communities and those who utilized more than four ANC visits and had completed secondary or higher education showed a greater tendency to use an SBA during childbirth than their counterparts.
The use of SBAs during delivery was significantly associated with some individual- and community-level factors. To reduce maternal and child mortality, there is a need to focus on rural and uneducated people who are less likely to access these facilities. Special programs could increase awareness and help the poor community obtain the minimum facility in maternal care.
Citation: Nahar MT, Anik SMFI, Islam MA, Islam SMS (2022) Individual and community-level factors associated with skilled birth attendants during delivery in Bangladesh: A multilevel analysis of demographic and health surveys. PLoS ONE 17(6): e0267660. https://doi.org/10.1371/journal.pone.0267660
Editor: Enamul Kabir, University of Southern Queensland, AUSTRALIA
Received: April 28, 2021; Accepted: April 13, 2022; Published: June 29, 2022
Copyright: © 2022 Nahar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data can be found in the following link https://doi.org/10.7910/DVN/DOLTO9 or https://dataverse.harvard.edu/dataset.xhtml?persistentId=doi:10.7910/DVN/DOLTO9.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
List of abbreviations: SBAs, Skilled Birth Attendants; AARI, Average Annual Rate of Increase; BMI, Body Mass Index, ref = Reference; AOR, Adjusted Odds Ratio; CI, Confidence Interval; SE, Standard Error; ICC, Intraclass Correlation Coefficient; AIC, Akaiki Information Criteria; PCV, Percentage Change in Variance; NGO, Non-Governmental Organization
Maternal mortality continues to be a considerable challenge for public health systems worldwide. Every day, women and children die from complications related to pregnancy and birth, which are mostly preventable. In 2017, an estimated 0.295 million women died during childbirth, and developing countries like Bangladesh accounted for approximately 44% of this figure . Moreover, Southern Asia has the second-highest maternal mortality rate, leading to the global burden of maternal mortality . Bangladesh’s maternal health had remarkably improved over the past years based on Millennium Development Goal (MDG) targets in 2015 [3–5]. The country is on track to achieve the Sustainable Development Goals (SDGs) [6, 7]. However, according to the MDG 5 progress report , Bangladesh performed poorly in the service performance of skilled assistance during delivery, scoring below the center point [5, 9]. Many systematic reviews reported that maternal deaths occur due to obstetric hemorrhage or sepsis, obstructed labor, unsafe abortions, eclampsia, and prenatal and postnatal infections [10–12]. Most of these deaths could have been prevented by ensuring skilled professional services and adequate facilities were available .
Professional doctors, nurses, paramedics, midwives, family welfare visitors (FWVs), community skilled birth assistants (CSBAs), and sub-assistant community medical officers (SACMOs) are considered medically trained providers and defined as skilled birth attendants (SBAs) . Conversely, untrained traditional birth attendants (TBAs), and trained TBAs (orthodox village doctors without academic qualifications or uncertified community workers) are considered unskilled birth attendants [14–17]. The skills and proficiency of the person assisting in child delivery and the available healthcare facilities can influence complications during and after delivery . The World Health Organization recommends that every delivery be supervised by an SBA, a healthcare provider who can identify and manage normal labor and birth figure out and provide primary care and referrals [19, 20]. Though there are well-known benefits of high-quality obstetrics care for both mothers and babies, many lower-middle-income countries face large socioeconomic disparities in accessing and using SBA services [21, 22].
Bangladesh has notably improved maternal and newborn health over the past 10 years . The latest Bangladesh Demographic and Health Survey (BDHS) showed that the percentage of SBAs present during deliveries in Bangladesh increased from 21% in 2007 to 53% in 2017–2018 . The fourth Health Population and Nutrition Sector Development Program of the Government of Bangladesh targeted 65% SBA use at delivery by 2022 . To attain this target and increase the presence of SBAs during childbirth in Bangladesh, it is essential to determine the factors that affect the delivery provided by SBAs.
Several factors at different levels impact the utilization of SBAs during delivery . Existing studies in lower-middle-income countries have found that the utilization of SBAs is mainly influenced by a mixture of individual and community characteristics. These studies have found an association between SBA utilization and individual characteristics, such as maternal education , gender disparity , desire for the pregnancy, birth order , and family size . Community-level factors included rural or urban places of residence [29, 30], community education, mass media exposure , and antenatal care (ANC) service availability . However, in Bangladesh, a limited number of studies have focused on the factors of SBA utilization at different levels, including the utilization of maternal healthcare services [33, 34]. Therefore, we aimed to examine the individual- and community-level factors associated with the utilization of SBAs during delivery in Bangladesh. This study also fills a knowledge gap, drawing on the multilevel approach to uptake of SBAs in nationally representative data.
Materials and methods
Study design and data sources
This study was conducted using the BDHS 2017–2018 data. The BDHS 2017–2018 was conducted under the National Institute of Population Research and Training authority of the Ministry of Health and Family Welfare. A Bangladeshi research firm, Mitra and Associates, carried out the survey . In this survey, a two-stage stratified clustering sampling technique was used. The geographical area of Bangladesh was split into eight administrative divisions. Then, 675 Enumeration Areas (EAs) were selected in the first stage, with 250 urban and 425 rural areas. An EA is a geographic region that is either a collection of smaller towns, a large part of a village, or an entire village with an average of about 120 households. Thus, an EA was the primary sampling unit . In the second stage, 30 households were selected on average from each EA.
The BDHS 2017–2018 included five types of questionnaires. In this study, we used data from the women’s questionnaire. This questionnaire was based on model questionnaires developed for the worldwide Demographic and Health Surveys (DHS)-7 Program, adjusted to the circumstances and requirements in Bangladesh . During this survey, women were asked questions regarding their background characteristics (e.g., age, education, religion, and media exposure), reproductive history, knowledge of uses and sources of family planning methods, ANC, delivery, postnatal care, newborn care, and husband’s background . In our study, we only considered the occasion of the first live birth in a woman’s life. A weighted sample of 4,842 individuals who had had a live birth in the three years preceding the surveys. For women who had had more than one live birth, only the first live birth was considered in this study. For the selected respondent we consider all the delivery places where the birth took place as the home, hospital, clinic, and public, private or non-governmental organizations (NGOs) were included in our study [29, 35–41].
The outcome variable was whether an SBA was present while a woman gave birth to her child. In our analysis, we considered doctors, nurses, midwives and community SBAs ‘skilled birth attendants or SBAs’ and recoded these as ‘1’. Other birth attendants, such as TBAs, relatives, NGO workers and neighbours, were considered ‘unskilled birth attendants’ and recoded as ‘0’. This classification was based on previous studies in other countries [29, 42]. Thus, the SBA is a binary variable with two mutually exclusive and exhaustive categories.
In this multilevel analysis, we utilised both individual- and community-level variables as independent variables. Individual-level factors include the respondents’ current age, religion, occupation, division, employment status, education status, access to mass media, birth order, participation in healthcare decisions and ANC visits. Further, their husbands’ employment and education status and whether they wanted the pregnancy while pregnant were also considered. These variables were selected based on previous literature from developing countries [25, 29, 39, 40, 43–46].
Some variables were recoded for better interpretation. Women who had not watched TV, listened to the radio or read a newspaper at least once a week were categorized as ‘no access’, while others were grouped as ‘have access’. The variables ‘healthcare decision’ and ‘purchase decision’ were based on whether the respondent had participated in her healthcare or household purchases. Women who exclusively or mutually with a male partner had last say on their medical care choice were categorized as ‘participation’; otherwise, they were categorized as ‘no participation’. Moreover, ANC visits were categorized as ‘no ANC’, ‘1 to 8 ANC visits’ and ‘more than 8 ANC visits’. We also recoded religion (Islam, others), body mass index (BMI) (normal, not normal) and desire for pregnancy (yes, no more) into binary categories. When a woman became pregnant, a wanted pregnancy was categorized as ‘yes’ if the respondent wanted their pregnancy then or later, and ‘no more’ when they did not want pregnancy anymore. The wealth index was recoded by identifying ‘poorest’ and ‘poorer’ as ‘poor’, and ‘richest’ and ‘richer’ as ‘rich’, while the middle wealth category remained the same. Occupation was coded as ‘working’ and ‘not working’, while husband’s occupation was divided into two categories—‘farming and labour-intensive’ and ‘job or business’. Lastly, the education level of the respondents and their husbands were coded as ‘up to primary’ and ‘secondary and above’.
Five community-level factors were considered in this analysis. These are the residence (rural or urban), community wealth (concentration of households classified as rich or poor in a cluster), community media (concentration of women exposed to the media in a cluster), community ANC visits (concentration of women going for at least four ANC visits during her pregnancy in a cluster), community education (concentration of educated women in a cluster) and community healthcare distance (concentration of women who thought the distance was a problem in seeking healthcare in a cluster). These variables were created by aggregating selected categories to the clusters and dividing them into suitable categories based on the previous literature if no such variables were listed in the BDHS 2017–2018 [29, 40].
We conducted a univariate analysis to observe the frequency of the selected variables. In the bivariate analysis, the changes in associate variables were shown for the cross-tabulation outcome variable. The chi-square value of these variables was also demonstrated in this analysis. We also checked the average annual rate of increase (AARI) of four consecutive BDHS data, from 2007 to 2017–2018. For this calculation, we used the formula, Yt+n = Yt((1+r)n) for skilled delivery assistance, where Yt = prevalence of skilled delivery assistance, r = annual rate of change, n = number of years between two surveys and Yt+n = prevalence of skilled delivery assistance of the (t + n)th year, which was adjusted and adopted, utilizing the information given in the UNICEF technical note .
In the multilevel analysis, the fixed effect and random effect binary logistic regressions were used to examine the extent of variation in the SBA attributable to individual- and community-level variables. This model is more appropriate for hierarchically structured data such as DHS data . We first constructed an empty model that only used a random intercept to conduct this analysis. This estimated the degree of correlation in the skilled delivery assistance at cluster (community) levels. Then, we included all the individual-level factors in the second model to observe their effect on professional delivery assistance. Finally, we added the community-level characteristics in the third model to observe which contextual factors influenced the use of skilled delivery assistance. Then, the model was specified as:
In this equation, Yij = outcome variable for individual i in j group, Xij = individual-level variable for the ith individual in group j and eij = individual-level error assumed independent and normally distributed with mean zero and a variance of σ2. This model evaluated relationships and variances at multiple levels . The fixed effects were computed by the odds ratio of binary logistic regression, and the random effects were estimated by the intra-class correlation (ICC). ICC was calculated as , where τ is the community-level variance . In this study, all the analyses were performed using Stata version 14.2.
The univariate analysis from Table 1 revealed that, overall, 53.35% of women utilized SBAs. About 65.84% of the women lived in rural areas, and the majority (91.45%) were Muslim women. More than one-third of the women (34.01%) and nearly half (47.65%) of their husbands reported their education level as ‘up to primary’ level. In this research, more than half (55.82%) of the women gave birth to their first child at the age of 18 or below, and nearly two-thirds of the women (60.35%) were employed. During the survey, more than one-third of their husbands (41.88%) were engaged in farming and labour-intensive. Moreover, a high percentage of the women (41.97%) were in the poorest wealth quantile. Nearly two-thirds of the women had access to the mass media, and about 30% of them did not partake in their healthcare choice. However, 85.42% of the women reported having one to eight ANC visits before their most recent deliveries, and most of the women gave birth to more than one child. The women included in the study mostly wanted to be pregnant (91.76%) and mostly had normal BMI (61.57%). The analysis also showed the percentage of community-level factors. Women were living in communities where more than half of the affluent households (61.81%), secondary and higher educated (54.42%), access to media (69.83%), and slightly only 49.98% reported using ANC visits.
Table 2 shows the percentage distribution of bivariate association of individual and community characteristics for women’s chosen predictors according to SBAs. The selected individual- and community-level factors were statistically significant (p = 0.000) with the utilization of women’s SBAs.
The AARI of our dependent variable, SBA use or presence during delivery, from 2007 to 2017–2018 was 8.88%. Table 3 shows the AARI in SBA use during delivery of different independent variables from 2007 to 2017–2018 in Bangladesh. Rural women reported a higher (13.28%) AARI of the SBAs, comparably urban women. There was a remarkable change in the average annual rates of qualified assistance during delivery among Muslim women (9.04%) compared to women of other religions. The AARI in SBA use increased with the women and their husbands’ education levels. Between 2007 and 2017–2018, the total AARI in SBA use was highest (8.91%) among women who reported their education level as secondary and above. The total AARI in SBA use was also the highest (11.60%) among women whose husbands had received at least ‘up to primary’ level of education.
Further, working women reported utilizing SBAs (22.12%) more than not working women (1.98%). In contrast, their husbands who were engaged in farming and labour-intensive work were more conscious (9.61%) about SBA use over the 10 years than those who categorised their work as ‘job or business’ (3.95%). During the birth of their first child, women aged 18 or younger reported a slight increase (9.93%) in the use of attending SBAs. The overall AARI in SBA use also increased in women who wanted their pregnancy. Women with birth order more than one was also slightly increased in SBAs (9.42%). Women alone or women and their husbands or partners who made decisions on healthcare had a higher rate of increase in SBA use (18.49%). There was a decrease in the rate of SBA use in women who had no ANC check-ups (5.51%), but there was an increase (9.79%) in those who had one to eight ANC check-ups. Women who had no access to media reported a higher increase in SBA use (14.78%), and they mostly had a normal BMI (12.03%). The changes in SBA use were greatest among low-income families (19.22%).
The multilevel model analysis results from Table 4 show the SBAs of women in Bangladesh, according to 2017–2018 BDHS data. The intercept or null model (Model 0) revealed an ICC of 27.5%. This means that approximately 27.5% of the variance in the outcome influences the delivery assistance operated at the community level. This ICC value is good enough (as the ICC value is more significant than zero) to deal with the multilevel modelling in this case . Similarly, this null model (Model 0) depicted statistically substantial variability in the odds of SBA utilisation between communities (p-value = 0.000). Model 1 indicates that only individual-level predictors—age at first birth, the respondent’s education, their husband’s education, media exposure, wealth index, birth order, BMI, the respondent’s occupation, their husband’s occupation, religion, ANC visits, healthcare choice and desire for the pregnancy—were significantly associated with SBA utilisation. The ICC in Model 1 also indicated that 12.6% of women’s delivery assistance variation was attributable to vary across the community level.
Similarly, five community-level predictors were included in Model 2. These—including residence, community wealth level, community media exposure, community ANC visits and community education level—significantly impacted SBA use during delivery. The ICC of Model 2 also suggested an 11.2% variation in women’s delivery assistance between the communities. Model 3 (full model) combined both individual- and community-level predictors, and the random slop effects depicted a total of 71.43% variation compared with the null Model 0.
The multilevel analysis model depicted that women aged 19 or above at first birth were 40% (AOR = 1.40; 95% CI: 1.21–1.62) more likely to utilise SBAs during delivery than those aged 18 or below. The women and their husband’s education levels were both significantly associated with SBA use. Women with secondary-level education and above had greater odds (AOR = 1.60; 95% CI: 1.36–1.89) of using SBAs than with primary level education only. Similarly, women’s husbands who attained secondary-level education and above were 41% (AOR = 1.41; 95% CI: 1.21–1.66) more likely to use SBAs than those with primary level education. Regarding media exposure, women who had access to the mass media were 1.21 times more likely (AOR = 1.21; 95% CI: 1.02–1.43) to utilise SBAs during delivery than women who had no access to the mass media. Both women and their husband’s occupations were significant factors influencing the use of SBAs. Working women were 1.25 times more likely to use SBAs (AOR = 1.25; 95% CI: 1.07–1.45) than women who were not working. Women’s partners or husbands who had jobs or businesses had greater odds (AOR = 1.16; 95% CI: 1.00–1.35) or were16% more likely to utilise SBAs during delivery than those whose husbands were doing farming and labour-intensive work. In the case of the wealth index, women from affluent households had 105% greater odds (AOR = 2.05; 95% CI: 1.67–2.52), and women from middle families had 25% greater odds (AOR = 1.25; 95% CI: 1.07–1.45) of using SBAs compared to women from poor households. Regarding the birth order, women with the first birth order were 68% (AOR = 1.68; 95% CI: 1.44–1.96) more likely to use SBAs than others. Although the percentage of Muslim women was higher in our research, other religious women were 1.42 times (AOR = 1.42: 95% CI: 1.08–1.87) more likely to be conscious of using SBAs than Muslim women. Women alone or women and their husbands who made healthcare decisions were 1.17 times more likely to use SBAs (AOR = 1.17; 95% CI: 1.00–1.37) than those who relied only on their husbands or others for healthcare decisions. Further, women who were willing to be pregnant had 1.44 times greater odds (AOR = 1.44; 95% CI: 1.10–1.87) of using SBAs than women who were unwilling to be pregnant. Women who had one to eight ANC check-ups were 3.55 times more likely (AOR = 3.55; 95% CI: 2.55–4.94) to use SBAs than women who had no ANC visits. Similarly, women who had more than eight ANC visits had greater odds or were about 6.89 times (AOR = 6.89; 95% CI: 4.37–10.86) more likely to obtain SBA services than women who had no ANC visits.
The results of the community-level predictors revealed that community media exposure, community ANC visits and community education level were significant in relation to the use of SBAs. Women in communities with access to the mass media were 33% more likely (AOR = 1.33; 95% CI: 1.05–1.68) to use SBAs during delivery than women in communities with no media exposure. Likewise, women in the community who had four or more ANC visits were almost two times more likely to utilize SBAs during delivery (AOR = 1.52; 95% CI: 1.27–1.82) than the women from the cluster who had below four ANC visits. Women in communities who attained secondary-level education and above were almost twice as likely (AOR = 1.52; 95% CI: 1.24–1.85) to use SBAs compared to women who attained up to the primary level of education only.
This study aimed to assess the effect of the individual- and community-level characteristics on skilled assistance during delivery care in Bangladesh. The annual average rate of delivery by SBAs over the past 10 years showed how individual-level factors changed in their influence on SBA use. Our analysis detected a 27.5% contribution of unobserved community-level factors influencing SBA use during delivery.
Our findings show that religion is positively associated with the practice of SBA use. Similar to previous studies, our results show that Muslim women were less likely to use SBA care than non-Muslim women . This might be due to traditional beliefs, a conservative culture, subjects and related practices that have influenced these women or their husbands to not seek a delivery outside the home or obtain maternal healthcare services [52–54]. This study also found that the level of education of the respondents and their husbands was positively associated with SBA assistance during a recent delivery. This finding aligns with previous studies in Bangladesh and elsewhere that described a strong agreement between education and professional delivery assistance and other maternal health services [55–59]. Improvements in the women and their husbands’ educational achievement increased the likelihood of seeking SBA care. This may enhance participation in decision-making through economic independence and autonomy, intensifying health-seeking behavior and expanding social capital through the enlargement of social interfaces. Well-educated women may influence their neighbors and relatives with an educated perception, which would expose them to women who want to be more active in deciding on SBA care services during delivery . However, both educated women and their husbands may better obtain health messages and build attitudes towards skilled assistance during delivery through the mass media .
This study also showed the association between occupation and the likelihood of engaging SBA services during delivery. Moreover, women’s working status positively impacted the utilization of SBAs during delivery. Similarly, the high prevalence of skilled care for delivery was observed if their husbands were engaged in a professional job or business. This same scenario was revealed in other studies . The high rates of women unemployment and their husbands’ low income and poverty might prevent utilizing SBAs during delivery. Similar to earlier studies in Bangladesh [33, 35, 62] and other countries , our findings show that women with a higher wealth index had greater odds of utilizing SBAs during delivery. A possible reason for this may be that women from poor households may not have adequate funds for the added expense of engaging an SBA [62, 64]. However, increasing women’s economic empowerment can improve maternal health by using skilled personnel for child delivery.
The birth order was found to be significantly associated with SBA use. Women with the first birth order were more concerned about using an SBA than others. Women’s perceptions may be a factor here, and a study found that nearly 50% of women consider their first pregnancy riskier than subsequent pregnancies . Similarly, women with more ANC visits had higher expectations of using SBAs, which is consistent with previous studies . This suggests that women might have learned the importance of using SBAs during delivery from their ANC visits. Previous studies have found that ANC visits emphasize professional maternal delivery services [55, 65–67]. Greater community utilisation of ANC visits showed that people were more conscious of using SBAs than TBAs. Surprisingly, we found that the utilisation of SBAs for delivery was consistent with women who wanted a child when they became pregnant. Conversely, an earlier inquiry showed no significant association between SBA use and women wanting to be pregnant . At their first baby’s birth, women aged 19 years or older were more aware of utilising SBAs during delivery. A possible explanation for this is that they may have had more time for education and had received counselling from community health providers , who recommended SBAs . The individual predictor, access to media, and women from high concentration community mass media accessed also showed a significant association with the use of SBA care. A previous study found an effective measure between media exposure and SBA care . A possible explanation may be that watching TV, reading the newspapers and listening to the radio have motivated them to opt for delivery assisted by qualified providers, which might encourage safe and skilled delivery practices to reach the community.
The findings from this study using the individual-level predictor model revealed that women from rural areas were less likely to use SBAs during delivery than their counterparts in urban areas. Previous studies have reported similar findings, where rural mothers were less likely to utilize SBAs [35, 70, 71]. This can likely be attributed to the unavailability of healthcare facilities in rural areas and the difficulties of travelling to healthcare clinics or hospitals or making appointments with medical personnel.
Strengths and limitations
This research was done based on nationally representative data measured using tools that are acknowledged and approved worldwide. This study identified several factors, both individual- and community-level indicators, that influence the effects of using SBAs during delivery in Bangladesh. This study also showed the AARI in SBA use, using BDHS data published over the past 10 years. Further, the cross-sectional nature of the sample data was gathered retrospectively and tended to provide the desired information when estimating the results. No causality can be introduced thoroughly as the condition may change for the better even after the birth of a child. Still, this study has some limitations. For instance, we could not include and examine several factors related to the utilization of SBAs, such as the transportation system, distance from the healthcare facility, geographical areas, delivery cost and other medical conditions.
This study identified individual- and community-level variables associated with the use of SBAs during childbirth in Bangladesh. Our findings suggest that individual-level factors like age, education, husband’s education, wealth index, husband and respondent’s occupation, and ANC visits significantly impact SBA use. Community-level variables such as community residence, media access, ANC visit, education and wealth have a significant association with SBA use during delivery. Respondents from a highly educated cluster, a rich family cluster and those that utilised four or more ANC visits and had a high level of media exposure tended to utilise SBA services more than those from other clusters. The findings of this study have important implications for informing the government, health planners and other public health stakeholders to alleviate the socioeconomic inequalities in SBA services in Bangladesh. Education, awareness, increasing media access and monetary help for the poor might be key to boosting the utilization of SBA services. Additionally, organising awareness programs based on factors associated with SBAs might prevent maternal and child deaths in Bangladesh.
S1 Table. Multicollinearity test.
The authors are grateful to the Demographic and Health Surveys (DHS) Program for providing BDHS data accessibility for this study.
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- 53. Ha W, Salama P, Gwavuya S, Kanjala C. Is religion the forgotten variable in maternal and child health? Evidence from Zimbabwe. Soc Sci Med. 2014;118:80–8. pmid:25108694
- 54. Elter PT, Kennedy HP, Chesla CA, Yimyam S. Spiritual healing practices among rural postpartum Thai women. J Transcult Nurs. 2016;27(3):249–55. pmid:25297450
- 55. Colombara DV, Hernández B, Schaefer A, Zyznieuski N, Bryant MF, Desai SS, et al. Institutional delivery and satisfaction among indigenous and poor women in Guatemala, Mexico, and Panama. PLoS One. 2016;11(4):e0154388. pmid:27120070
- 56. Kinuthia J, Kohler P, Okanda J, Otieno G, Odhiambo F, John-Stewart G. A community-based assessment of correlates of facility delivery among HIV-infected women in western Kenya. BMC Pregnancy Childbirth. 2015;15(1):1–9. pmid:25885458
- 57. Gitimu A, Herr C, Oruko H, Karijo E, Gichuki R, Ofware P, et al. Determinants of use of skilled birth attendant at delivery in Makueni, Kenya: a cross sectional study. BMC Pregnancy Childbirth. 2015;15(1):1–7. pmid:25645900
- 58. Kamal SM, Hassan CH, Alam GM. Determinants of institutional delivery among women in Bangladesh. Asia Pacific Journal of Public Health. 2015;27(2):NP1372–NP88. pmid:23666835
- 59. Ononokpono DN, Odimegwu CO. Determinants of maternal health care utilization in Nigeria: a multilevel approach. The Pan African Medical Journal. 2014;17(Suppl 1). pmid:24643545
- 60. Xiao X, Wu Z-C, Chou K-C. A multi-label classifier for predicting the subcellular localization of gram-negative bacterial proteins with both single and multiple sites. PLoS One. 2011;6(6):e20592. pmid:21698097
- 61. Adedokun ST, Uthman OA. Women who have not utilized health Service for Delivery in Nigeria: who are they and where do they live? BMC Pregnancy Childbirth. 2019;19(1):1–14.
- 62. Yaya S, Bishwajit G, Ekholuenetale M. Factors associated with the utilization of institutional delivery services in Bangladesh. PLoS One. 2017;12(2):e0171573. pmid:28192478
- 63. Kitui J, Lewis S, Davey G. Factors influencing place of delivery for women in Kenya: an analysis of the Kenya demographic and health survey, 2008/2009. BMC Pregnancy Childbirth. 2013;13(1):1–10. pmid:23414104
Tamang TM, editor Factors associated with completion of continuum of Care for Maternal Health in Nepal. IUSSP XXVIII International Population Conference, Cape Town, South Africa; 2017.
- 65. Tekelab T, Yadecha B, Melka AS. Antenatal care and women’s decision making power as determinants of institutional delivery in rural area of Western Ethiopia. BMC Res Notes. 2015;8(1):1–8.
- 66. Agha S, Williams E. Quality of antenatal care and household wealth as determinants of institutional delivery in Pakistan: Results of a cross-sectional household survey. Reproductive health. 2016;13(1):1–8. pmid:27430518
- 67. Rahman A, Nisha MK, Begum T, Ahmed S, Alam N, Anwar I. Trends, determinants and inequities of 4+ ANC utilisation in Bangladesh. Journal of Health, Population and Nutrition. 2017;36(1):1–8.
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domain: literature


So manufactured solar cells since the solar cell that can directly convert sunlight into elektricetet developed by Chaplin, Fuller and Pearson in 1954, the trend has been framåt.Tillverkningen of solar cells is as follows. First cut off the thin silicon bitar.På top of this layer puts on a thin layer of phosphorus and underneath a thin layer of living. Between those sent, there is an electric charge when the sun shines on the solar cell. To get the raw material for production of-Paintings must be allowed silicon raw material is cleaned from all foreign elements, so that only silicon is kvar.Denna purification process takes place in specially designed ovens, where silicon is heated to 14000c.Kislet must in fact be completely clean from other substances. It is a andledning why solar cells are dyra.Resultatet of heating becomes a long black silicon rod, which is then cut into thin skivor.Priset on ordinary solar cells of silicon cost about 700 per kvadratmeter.Men now have a Swiss researchers have developed a new type of solar cell which only costs 140 crowns per square meter. The type of solar cells still function in low light.
How Solar Cells
A solar cell is shaped like a flat, round disc-like, which is usually black or dark blue. Solar cells convert solar energy into electrical energy. On top of the disc puts on a thin layer of phosphorus and underneath a layer of living. When the sun shines on the solar cell out, an electric charge between skill. The electrical charge is entered through a pattern of nickel wires. For a solar cell to be manufactured is required semiconductor material silicon. A solar power plant system consists of three parts: A number of solar panels, a charge controller and an accumulator. On one panel, there are a number of solar cells. Each solar cell provides a voltage of 0.5 V that is when sunlight hits it. The current from the solar cell is dependent on the size of the cell surface is and how strong sunlight. The power generated from solar cells led to an accumulator. (An accumulator battery, which will absorb energy from the solar cells). From the accumulator is current to what you want to drive. The battery supplies power even when the sun is not on, it loads during periods of excess energy. Solar energy can be stored to.
So torn solar cells out
Solar cells are very hållbara.Solceller have a life span of at least ten år.Det are different types of motor-minimumgaranti.Det are two different types of wear on photovoltaics: Wind-borne weather conditions, solar cells, it does so that the framework the solar cells are protected by breaks in time and it is the end of solcellerna.Det may also be semiconductor material, silicon will disappear helt.Solcellerna can operate for years without supervision, but the battery, battery pack, which will absorb energy from the solar cells only have a life span of about five years with good underhåll.Man can also be described with the concept ordinary car batteries to solar, but it is much worse.
After 10-20 years old is the enclosure of a solar cell to be torn out by the weather and most of the semiconductor material silicon is gone.
How a solar power plant works.
There are many different types of solar thermal power to generate solar energy. There is a system that reflects the sun's rays onto a receiver high up in a torn.Det are hundreds or thousands of mirrors that reflect sunlight into the tower mottagare.I receiver converts sunlight water into steam, which drives a turbine which generated electricity. Such a solar power plant in California in the United States.
You can also use the mirrors on the way to let the focus beam reach a tube filled with oil. The oil is heated to 3000 C and heat, in turn water into steam that drives a steam turbine.
To capture the sun's rays are currently used satellite dishes. A large dish covered when multiple mirrors directed the sun's rays to a receiver which then converts them into power.
The most common variety is the extraction of solar photovoltaic. The solar cells are a direct response to solar energy and converts it into power.
Maintenance in areas with solar power.
Solar power can be described with the concept in many areas. Most described with the concept to homes and neighborhoods, where solar energy supplement conventional heating, or solar energy drives the entire residential area or villan.Det are also places where solar energy drives an entire area with hospitals, schools, street lighting and housing område.Ett such a system is bl.ai Australia. Even animals RPG sun energikälla.Det is a butterfly must have 300c.i kroppstemeratur to flyga.För to get the temperature stretches out its wings so that it can be component-video sun strålar.Sammetssnäckan is another animal that utnytjar sun as an energy source. It stretches out and catches the sun's rays. Since sunlight is converted into energy. All plants also live on solar energy through photosynthesis. The sun can power airplanes. Solar powered aircraft can fly at a height of 1000 meters. A solar-powered aircraft has flown over the English Channel. There Ochs solar-powered cars. Cars that run on solar power can achieve high hastigheter.Solenergin also used for ventilation systems in cars. The solar panel sits on the roof. Some mini-sufficient modern, refrigerators, irrigation and lights out at sea are also driven by solar energy. Japan has developed a tandem bicycle with solar panels on a roof over their riders. The energy generated from solar cells will drive an auxiliary engine that helps in the hills. It also planned to build a spacecraft that will be driven in part by using solar power.
The future of clean energy
In the near future we will be able to heat our houses, using energy from space. The energy should be obtained with energisatelliter.Dessa satellites are large, oblong plates, which circulates around the earth in a fixed orbit, and takes up the sun's energy out of rymden.Solens energy is converted to electricity, which in turn is converted to mikrovågor.Mikrovågorna is then sent down to a receiving antenna on Earth. The antenna is converted energy from the microwaves to electricity, which is sent out to consumers. To build an energy satellite will be very expensive, but you will then be able to generate energy for up to one hundred år.Byggandet of an energy satellite will make a comparison to be the largest engineering project the world has ever uppleft.Satelliterna will be constructed out of synkronbanan, 36,000 km above ekvartorn . In this court's orbital period is 24 hours and that means that the satellite always remains stationary over the same point on jorden.En energy satellite will be very much normal about six miles long and five kilometers wide. It will take 500 men and a year to build satelliten.Man begins to mount an aluminum skeleton and then substantiate this skeleton with solar cells.
I think that solar power is good in both environmentally and economically in the future. It is therefore necessary to invest a lot of research for future use. Research is already now possible in future to have the solar cells in space, where they do not take up any space. A new cheaper and better solar cells, the researchers have also come on. I believe that solar energy will mean more in the future. Perhaps the next Nobel Prize research in solar energy.based on 34 ratings Solar power,


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Washington, DC -- (ReleaseWire) -- 07/18/2016 --Last week began with Independence Day, America's celebration of freedom and the shared values that bind us together as a nation and a people. By the end of the week, though, we bore witness to what I can best describe as a reality TV version of American Horror Story, watching senseless violence wash across our screens in increasing disbelief and shock. First, 37 year old father of five Alton Sterling was fatally shot by police outside a Baton Rouge convenience store. Then, Philando Castile was shot during a traffic stop in Minnesota, with his partner live-streaming the aftermath from the passenger seat as her four year old daughter looked on from the back. Protests took place all around the country, and the horror climaxed when military veteran Micah Xavier Johnson killed five police officers and injured seven more at what started as a peaceful protest in Dallas, the deadliest single incident for U.S. law enforcement since September 11, 2001.
Media "analyzed" and politicians speechified, and we as Americans were left with the terrible sinking feeling in the pits of our stomachs that our republic is slipping into a malaise, that things continue to change for the worse and not the better. As the Irish poet John Yeats famously wrote in a poem full of despair for post-WWI Europe, "Things fall apart; the centre cannot hold; mere anarchy is loosed upon the world..." Our weaknesses as a society were revealed yet again in grainy cell phone footage and paroxysms of violence last week, and it is so difficult in the midst of that to respond by finding our strengths and applying them. As Yeats concludes his poem, "The best lack all conviction, while the worst are full of passionate intensity."
I believe there is a connection between this societal volatility and our increasingly hollow economy. I don't often quote the Reverend Al Sharpton, but he has a point when he says, "When people wake up in the morning trying to figure out how they're going to pay their bills or how they're going to put food on the table for their family, it leads to an anxiety that then leads to bad judgment and bad choices." Wage stagnation, income inequality, economic insecurity... all of these play a part in creating the current combustible atmosphere.
Analysts, even those from major financial institutions that are traditionally bullish, are beginning to throw in the towel on the markets in greater and greater numbers. Statements from Bank of America and Deutsche Bank in the last week show pessimism about the earnings to be reported beginning this week and reach the conclusion that the S&P 500 has never been more disjointed from other asset classes than it is now. Even the Federal Reserve has recently admitted that the stock market is effectively in bubble territory, saying that forward price to earnings ratios for equities have increased to a level well above their median of the past three decades. Of course, the Fed is doing nothing about that fact, and likely won't until the bubble bursts.
By so many measures, the United States is already in a recession. Labor market conditions are recessionary, the corporate bond market is recessionary, inventory accumulation is recessionary, ISM and many other factors—everything is crying out that we're in recession. Corporations are more leveraged even than they were in 2007, and earnings have sunk back to 2011/2012 levels, but the stock market continues to hover around and all-time high, with the Dow and S&P 500 up 4% for the year, and the Russell 2000 up 3%. At the same time, "safe-haven" investments are also rising, indicating an essential division in the way markets are being viewed. Gold has gone from $1060 in January to more than $1360. Silver moved from $13.90 to $20. That's a 45.8% gain for silver and a 28.64% gain for gold through last Friday.
Zero or negative interest rates, combined with huge amounts of cash being pumped into the markets, led us into an extreme fantasy land, causing a speculative frenzy. However, the central bank tide that has raised all the boats of our markets feels not only like it's about to recede, but even completely dry up and leave the boats sitting on sand. The mismatch of economic cheerleading from the Fed and the White House with the reality of poor job security and prospects, underfunded pensions, and mandated health care that's simply not working can only contribute to social unrest. We have to wonder how President Obama feels about the statement from his final State of the Union address that "anyone claiming that the America's economy is in decline is peddling fiction" today.
It is only human nature for us to look for someone to blame for all of the bad things, to point a finger at some villain that either caused this fraught social and economic situation, or a sham hero that failed to prevent or remedy it. This explains some of the great appeal of Donald Trump's unimaginably successful insurgency: he is speaking directly to our economic, social and personal fears. He is agreeing with our darkest thoughts, raising his voice to say that "America is falling apart!"
In the end, though, who do we need to blame? Who are the real villains? The first people we should point fingers at is... us. We claim to be victims, saying that we had no part in landing ourselves in this quagmire, but we need to accept personal responsibility, analyze our own role. If we made better choices in life and the voting booth, if we paid better attention, were more rational and wise and prudent and thoughtful, we wouldn't be in this mess. We put the leaders there, and we allow them to do what they're doing.
In our lives—personal, social, financial—we can no longer afford to play the damsel in distress, waiting for a knight in shining armor to save us. As we consider our portfolios, our financial security, our futures and the core of our society, we need to stop hoping for a knight and become self-rescuing princesses. In the end, we cannot rely on Yellen, Obama, Clinton, Trump, or anyone else. Only we can make the changes in our lives and government that must be made if we are to once again look forward to a bright American future.
For over a quarter century, Dawn Bennett has been successfully guiding clients through the complexities of wealth management. Her unique vision and insight into market trends makes Bennett a much sought after expert resource with regular appearances on Fox News Channel, CNBC, Bloomberg TV, and MSNBC as well as being featured in Business Week, Fortune, The NY Times, The NY Sun, Washington Business Journal in addition to her highly regarded weekly talk radio program - Financial Mythbusting. Through prudent and thoughtful advice, Dawn Bennett has strived to consistently provide the highest quality of guidance.
About Dawn Bennett
Dawn Bennett is CEO and Founder of Bennett Group Financial Services. She hosts a national radio program called Financial Myth Busting http://www.financialmythbusting.com.
She discusses educational topics and events in the financial news, along with her thoughts on the economy, financial markets, investments, and more with her live guests, who have included rock legend Ted Nugent, as well as Steve Forbes and Grover Norquist. Listeners can call 855-884-DAWN a as well as take podcasts on the road and forums for interaction.
She can be reached on Twitter @DawnBennettFMB or on Facebook Financial Myth Busting with Dawn Bennett.


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Warship made of plastic bottles created in Cornwall
A 30ft warship made of plastic found on beaches around the UK has been built on Marazion Beach in Cornwall.
Charity, Surfers Against Sewage (SAS) says the creation highlights the threat single-use plastics pose to our oceans.
20 Jul 2017
- From the section Cornwall


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Now showing items 1-1 of 1
Monitoring wheat varieties grown in irrigated Baluchistan
(CIMMYT; PARC, 1988)
This study was undertaken to assess farmers' use of different wheat varieties in two major growing environments of Baluchistan. Overall, farmers planted wheat on 39% of their cultivated area. Overall, 41 percent of the ...


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Highly Recommended **** Back in the 1960’s, there was a dark comedy horror film about a plant that is about to take over the world. This film was the basis for the doo-wop musical, “Little Shop of Horrors”, now on the stage at the Drury Lane Theatre in Oakbrook. Over the years, many productions of this fun little show have graced our stages, but for the most part, on smaller stages, and far more intimate. Seeing it larger than life on the Drury Lane stage was a rare and special experience. The book by Howard Ashman tells us the story of a flower shop that is on skid row , its owner, Mr. Mushnik ( Ron E. Rains, stepping away from his usual roles to show his true dexterity is a riot) and his workers. His helper is Seymour ( a breakout role for Will Lidke), a young man who he took in as a youth, nerdy and not too bright and his clerk, the adorable Audry (the lovely Kelly Felthous) a beauty who is looking for love in all the wrong places.
It turns out that Seymour bought a small plant at the yard that he has been nurturing. He names it Audrey II in honor of the woman he adores and loves. One even wonders why the shop even exists, as Skid Row is not exactly filled with customers purchasing flowers and plants. But the story needs to take place in the most unlikely place, with a female chorus ( like the Supremes) to help guide us through. These three ladies are terrific. They are Chiffon ( Melanie Loren), Crystal (Candace C. Edwards- what a set of pipes) and Ronnette (Melanie Brezill). These three could easily put on “Dream Girls”. There is one more actor to help make this story come to life. Steven Strafford plays a multitude of roles , male and female, bum and high-brow and does so with great speed. He also plays the bad boyfriend, dentist Orin Scrivello. Bravo.
The story is of Seymour being offered an opportunity to get the girl of his dreams, Mushnik, to be the father he never had, success and happiness. All of this is from a plant that needs something just a bit unusual in the way of plant food. The music is very R & B and this show will certainly keep you at a high interest level. Many of you know that this has become a “cult-type” of play with a following, so be prepared for audience members to shout and shriek at specific numbers. The puppeteer for “Little Shop of Horrors” is Matthew Stitz and the voice of Audrey II, the incredible ( and need I say perfect)Lorenzo Rush , Jr.
Smoothly directed and choreographed by Scott Calcagno, the show grabs you in the first few minutes and locks you in for the entire two hours ( including 15 minute intermission). Kevin Depinet’s flower shop is divine and very realistic as is his Skid Row. Lynda Myers does great costumes of the period and some extreme numbers for the ladies ( take that Supremes). The sound ( Ray Nardelli) and lighting ( Ryan O’Gara) along with the props (Cassie Schillo) are all perfect as are the musicians under the leadership of Chris Sargent at the Keyboard. As usual, the music direction is handled to perfection by Roberta Duchak. The show is suggested for ages 13 and up due to some strong language and a situation or two.
“Little Shop of Horrors” will continue at Drury Lane Theatre Oakbrook thru October 28th with performances as follows:
Thursdays 1:30 p.m. and 8 p.m.
Fridays 8 p.m.
Saturdays 5 and 8:30 p.m.
Sundays 2 p.m. and 6 p.m.
Call 1-630-530-0111 or visit www.DruryLaneTheatre.com
The theater is located at 100 Drury Lane in Oakbrook Terrace ( just north of the Oakbrook Center)
Plenty of free parking

domain: entertainment


text:
Try Rakhi Block Collapse and relive the memories you have made with your brother in your childhood with this raksha Bandhan video game
Play Rakhi Block Game free at crazy games online
The love and importance for the Raksha Bandhan are dominant to all the other events since, on this day, the sisters tie a knot of protecting against the wrist of their beloved brothers. An amulat_Rakhi in India and south Asia_is gifted by the sisters to their brother as a sign of evil protectors and strengthen their bonds with them. The developer has mold all the love of this beautiful Indian event into a puzzle game. This online puzzle game for free is a type of block game. You have to tap on the blocks assembled in a group having the same rakhi designs on them. On tapping similar designed blocks in this new game online, those blocks will vanish. Try to disappear all the obstruction in the form of a group. If any blocks leave at the end of this block puzzle game, you will have to spend 200 to vanish them up. Utilize all the power-ups wisely in these online puzzle games unblocked and vanish all the blocks to finish around. Have fun! Also, try The Draw climbing OMR games to have more enjoyment of online running games.
Release date: 24 November 2021 , Platform: Web browser (Desktop and Mobile)
585 played times

domain: hobby


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Several years ago my brother came to visit me and while I was making dinner he announced he had gone vegetarian. Ummm….ok. (I am just saying a little advanced warning can be helpful in these situations.)
I am embarrassed to admit that that particular night I was a little stumped on what to make for dinner based on what I had on the on hand. That weekend was the first time I actually thought about making meals that were intentionally meatless.
Fast forward a few years and my family now happily enjoys delicious and interesting vegetarian meals sprinkled in among our usual meat-ful routine. There are so many tasty meatless choices out there if you know where to look.
My meatless recipe for today is for Creamy Tortilla Soup. It was inspired by a recipe for Creamy Tortilla Soup with Chickpeas and Corn that I found on the Veggie Converter 365. I changed up the spices and a few other ingredients. The results was a velvety, slightly spicy and deliciously satisfying soup. You can enjoy it as is or garnish away with a dollop of sour cream, chopped cilantro or tortilla strips.
Beside the taste, the other great thing about this soup is it freezes beautifully. To freeze, cool soup completely, portion in to zip top bags (or other container), push out the extra air and freeze. Hope you enjoy!
Creamy Tortilla Soup
Prep time: 10 minutes - Cook time: 30 minutes - Makes: 4-6 servings
- 3 tablespoons olive oil
- 1 medium yellow onion, chopped
- 6 cloves garlic, minced or pressed
- 2 chipotle peppers in adobo, minced
- 4 corn tortillas, ripped into small pieces
- 1 teaspoon ground smoked paprika
- 1 teaspoon dried thyme
- 1 teaspoon turmeric
- 14.5 ounces diced fire roasted tomatoes
- 4 cups vegetable broth
- 2 cans chickpeas, drained and rinsed
- 1 cup frozen corn, thawed
- 1/2 cup heavy cream
- 1/2 cup Mexican blend cheese, shredded
- cilantro, chopped
- sour cream
- corn tortillas, cut into strips and fried (or pre-made tortilla strips)
- lime wedges
- Mexican blend cheese shreds
Place olive oil in a medium stock pot and heat on medium heat. Add onions and saute for 5 minutes stirring occasionally. Add garlic to onions and saute for 2 minutes. Add tortilla pieces, chipotle pepper, paprika, thyme and turmeric. Stir well and saute for 2 more minutes.
Add vegetable broth, tomatoes with juice, chickpeas and corn to the pot with the onion mixture. Bring the mixture to a boil and simmer for 10 minutes.
Remove from heat and let cool for a few minutes. Use a blender to puree the soup in batches. (Always be careful when pureeing hot ingredients. After you put the top on the bender, put a dish towel over the top and hold it with your hand to make sure the top doesn’t pop off while you are blending hot liquid. )
Return pureed soup to the pot on medium heat. Heat soup until it simmers then remove from heat. Stir in the cream and cheese. Season with salt and pepper if desired. Serve and enjoy!
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domain: food


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India has sealed its maritime boundary to prevent Rohingya refugees from entering into the country.
Indian navy and coastguards sealed the maritime border on Tuesday, following a warning issued by the intelligence agencies.
The agencies warned that the Rohingya refugees who are fleeing the conflict in Myanmar would try to sneak into Indian territory using sea routes, reports the India Today.
Wishing anonymity, a senior government source said: "Maritime surveillance aircraft including Dorniers, hovercraft and patrolling ships of the border guarding forces have been activated in the entire region to prevent the influx of
Rohingya, who are seen as a major threat to national security by the Centre."
The spy agencies also fear that the Rohingya would try to reach Bengal in view of the pro-Rohingya stand taken by the state government under Mamata Banerjee.
Besides, International traffickers are also getting involved in the racket and occupying uninhabited islands in Andaman and Nicobar.
On Monday, the Indian government told the country’s top court that the Muslim Rohingya who have fled Myanmar are a serious security threat as it sought to justify moves to deport up to 40,000 of the refugees.
While talking to media, BJP General Secretary Ram Madhav said the decision to let Rohingya refugees stay in India or not is in the executive's domain and the latter will take an appropriate decision.
"We will handle on the basis of national security and deal in appropriate manner," he said.
Dismissing those challenging the secular credentials of the government in insisting on deporting Rohingya refugees, Madhav said there was nothing communal about the decision.
Bangladesh struggles with more than 410,000 Rohingya who have flooded across the border since August 25 when the military in Buddhist-dominated Myanmar launched a crackdown on the minority Muslim group.
Currently 40,000 Rohingya have taken refuge in India after facing persecution back home. The Indian government has told the Supreme Court the refugees will have to go back, due to links with terror outfits like Islamic State.

domain: law