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ObjectiveDoctor absenteeism is widespread in Bangladesh, and the perspectives of the actors involved are insufficiently understood. This paper sought to elicit preferences of doctors over aspects of jobs in rural areas in Bangladesh that can help to inform the development of packages of policy interventions that may persuade them to stay at their posts.MethodsWe conducted a discrete choice experiment with 308 doctors across four hospitals in Dhaka, Bangladesh. Four attributes of rural postings were included based on a literature review, qualitative research and a consensus-building workshop with policymakers and key health-system stakeholders: relationship with the community, security measures, attendance-based policies and incentive payments. Respondents’ choices were analysed with mixed multinomial logistic and latent class models and were used to simulate the likely uptake of jobs under different policy packages.ResultsAll attributes significantly impacted doctor choices (p<0.01). Doctors strongly preferred jobs at rural facilities where there was a supportive relationship with the community (β=0.93), considered good attendance in education and training (0.77) or promotion decisions (0.67), with functional security (0.67) and higher incentive payments (0.5 per 10% increase of base salary). Jobs with disciplinary action for poor attendance were disliked by respondents (−0.63). Latent class analysis identified three groups of doctors who differed in their uptake of jobs. Scenario modelling identified intervention packages that differentially impacted doctor behaviour and combinations that could feasibly improve doctors’ attendance.ConclusionBangladeshi doctors have strong but varied preferences over interventions to overcome absenteeism. We generated evidence suggesting that interventions considering the perspective of the doctors themselves could result in substantial reductions in absenteeism. Designing policy packages that take account of the different situations facing doctors could begin to improve their ability and motivation to be present at their job and generate sustainable solutions to absenteeism in rural Bangladesh.

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Bread is a food that is commonly recognized as a very convenient type of food, but it is also easily prone to microbial attack. As a result of bread spoilage, a significant economic loss occurs to both consumers and producers. For years, the bakery industry has sought to identify treatments that make bread safe and with an extended shelf-life to address this economic and safety concern, including replacing harmful chemical preservatives. New frontiers, on the other hand, have recently been explored. Alternative methods of bread preservation, such as microbial fermentation, utilization of plant and animal derivatives, nanofibers, and other innovative technologies, have yielded promising results. This review summarizes numerous research findings regarding the bio-preservation of bread and suggests potential applications of these techniques. Among these techniques, microbial fermentation using lactic acid bacteria strains and yeast has drawn significant interest nowadays because of their outstanding antifungal activity and shelf-life extending capacity. For example, bread slices with Lactobacillus plantarum LB1 and Lactobacillus rossiae LB5 inhibited fungal development for up to 21 days with the lowest contamination score. Moreover, various essential oils and plant extracts, such as lemongrass oil and garlic extracts, demonstrated promising results in reducing fungal growth on bread and other bakery products. In addition, different emerging bio-preservation strategies such as the utilization of whey, nanofibers, active packaging, and modified atmospheric packaging have gained considerable interest in recent days.