Factors affecting the choice of delivery place in a rural area in Laos: A qualitative analysis

Background: Home delivery (HD) without skilled birth attendants (SBAs) are considered crucial risk factors increasing maternal and child mortality rates in Loa PDR. While a few studies in the literature discuss the choice of delivery in remote areas of minority ethnic groups; our work aims to identify factors that indicated their delivery place, at home or in the health facilities.Methods: A community-based qualitative study was conducted between February and March 2020. Three types of interviews were implemented, In-depth interviews with 16 women of eight rural villages who delivered in the last 12 months in Xepon District, Savannakhet Province, Lao PDR. Also, three focus group discussions (FGDs) with nine HCPs and key-informant interviews of ten VHVs were managed. Factors affecting the choice of the delivery place were categorized according to the social-ecological model.Results: Our sample included five Tri women and two Mangkong women in the HD group, while the FD group included three Tri women, two Mangkong women, one Phoutai woman, two Laolung women and one Vietnamese. Our investigation inside the targeted minority showed that both positive perceptions of home delivery (HD) and low-risk perception minorities were the main reasons for the choice of HD, on the individual level. On the other hand, fear of complication, the experience of stillbirth, and prolonged labour pain during HD were reasons for facility-based delivery (FD). Notably, the women in our minority reported no link between their preference and their language, while the HCPs dated the low knowledge to the language barrier. On the interpersonal level, the FD women had better communication with their families, and better preparation for delivery compared to the HD group. The FD family prepared cash and transportation using their social network. At the community level, the trend of the delivery place had shifted from HD to FD. Improved accessibility and increased knowledge through community health education were the factors of the trend. At the societal (national policy) level, the free delivery policy and limitation of HCPs’ assisted childbirth only in health facilities were the factors of increasing FD, while the absence of other incentives like transportation and food allowance was the factor of remaining of HD.Conclusions: Based on the main findings of this study, we urge the enhancement of family communication on birth preparedness and birthplace. Furthermore, our findings support the need to educate mothers, especially those of younger ages, about their best options regarding the place of delivery. We propose implementing secondary services of HD to minimize the emergency risks of HD. We encourage local authorities to be aware of the medical needs of the community especially those of pregnant females and their right for a free delivery policy

Seismic exploration at Fuji volcano with active sources : The outline of the experiment and the arrival time data

Fuji volcano (altitude 3,776m) is the largest basaltic stratovolcano in Japan. In late August and early September 2003, seismic exploration was conducted around Fuji volcano by the detonation of 500 kg charges of dynamite to investigate the seismic structure of that area. Seismographs with an eigenfrequency of 2 Hz were used for observation, positioned along a WSW-ENE line passing through the summit of the mountain. A total of 469 seismic stations were installed at intervals of 250-500 m. The data were stored in memory on-site using data loggers. The sampling interval was 4 ms. Charges were detonated at 5 points, one at each end of the observation line and 3 along its length. The first arrival times and the later-phase arrival times at each station for each detonation were recorded as data. P-wave velocities in the surface layer were estimated from the travel time curves near the explosion points, with results of 2.5 km/s obtained for the vicinity of Fuji volcano and 4.0 km5/s elsewhere

4-Amino-TEMPO-Immobilized Polymer Monolith: Preparations, and Recycling Performance of Catalyst for Alcohol Oxidation

Continuous flow reactors with immobilized catalysts are in great demand in various industries, to achieve easy separation, regeneration, and recycling of catalysts from products. Oxidation of alcohols with 4-amino-TEMPO-immobilized monolith catalyst was investigated in batch and continuous flow systems. The polymer monoliths were prepared by polymerization-induced phase separation using styrene derivatives, and 4-amino-TEMPO was immobilized on the polymer monolith with a flow reaction. The prepared 4-amino-TEMPO-immobilized monoliths showed high permeability, due to their high porosity. In batch oxidation, the reaction rate of 4-amino-TEMPO-immobilized monolith varied with stirring. In flow oxidation, the eluent permeated without clogging, and efficient flow oxidation was possible with residence times of 2–8 min. In the recycling test of the flow oxidation reaction, the catalyst could be used at least six times without catalyst deactivation

Medical and nursing interventions influence a caregiver’s willingness to continue home hemodialysis: a multicenter cross-sectional survey

Abstract Background In Japan, home hemodialysis (HHD) has several benefits, including a favorable prognosis, enhanced quality of life (QOL) of patients, and cost-effectiveness. However, the caregiver’s burden in assisting patients on HHD is significant, which influences their decision to continue HHD. This study focused on the relationship between medical and nursing interventions, caregiver resolve to continue HHD, and caregiver quality of life, aiming to create support strategies for caregivers. Methods A multicenter cross-sectional survey was conducted on caregivers of patients on HHD from 150 HHD facilities in Japan. The caregiver’s intent to continue HHD was assessed using a four-tier response scale that evaluated aspects such as caregiver–healthcare provider meetings, caregiver breaks, treatment discussions, difficulty in HHD initiation, and post-initiation medical support. Caregiver QOL was evaluated using the Short-form Health Survey, eight domains (SF-8). Statistical analysis involved χ-squared tests, independent t-tests, and propensity score matching. Results The study achieved a caregiver participation rate of 55.6%. Results indicated that caregivers who were inclined to continue HHD were significantly more likely to receive respite outpatient dialysis and had a better understanding of HHD mechanics as explained by healthcare professionals; however, propensity score matching revealed limited generalizability. There was no significant difference in the SF-8 scores before and after propensity score matching among the groups. Conclusions This study highlights that there are a small number of caregivers who have little motivation to continue HHD and emphasizes the crucial role of support from healthcare professionals. Comprehensive support, including respite dialysis and detailed HHD information, may affect HHD sustainability

Factors affecting the choice of delivery place in a rural area in Laos: A qualitative analysis

BACKGROUND: Home delivery (HD) without skilled birth attendants (SBAs) are considered crucial risk factors increasing maternal and child mortality rates in Loa PDR. While a few studies in the literature discuss the choice of delivery in remote areas of minority ethnic groups; our work aims to identify factors that indicated their delivery place, at home or in the health facilities. METHODS: A community-based qualitative study was conducted between February and March 2020. Three types of interviews were implemented, In-depth interviews with 16 women of eight rural villages who delivered in the last 12 months in Xepon District, Savannakhet Province, Lao PDR. Also, three focus group discussions (FGDs) with nine HCPs and key-informant interviews of ten VHVs were managed. Factors affecting the choice of the delivery place were categorized according to the social-ecological model. RESULTS: Our sample included five Tri women and two Mangkong women in the HD group, while the FD group included three Tri women, two Mangkong women, one Phoutai woman, two Laolung women and one Vietnamese. Our investigation inside the targeted minority showed that both positive perceptions of home delivery (HD) and low-risk perception minorities were the main reasons for the choice of HD, on the individual level. On the other hand, fear of complication, the experience of stillbirth, and prolonged labour pain during HD were reasons for facility-based delivery (FD). Notably, the women in our minority reported no link between their preference and their language, while the HCPs dated the low knowledge to the language barrier. On the interpersonal level, the FD women had better communication with their families, and better preparation for delivery compared to the HD group. The FD family prepared cash and transportation using their social network. At the community level, the trend of the delivery place had shifted from HD to FD. Improved accessibility and increased knowledge through community health education were the factors of the trend. At the societal (national policy) level, the free delivery policy and limitation of HCPs’ assisted childbirth only in health facilities were the factors of increasing FD, while the absence of other incentives like transportation and food allowance was the factor of remaining of HD. CONCLUSIONS: Based on the main findings of this study, we urge the enhancement of family communication on birth preparedness and birthplace. Furthermore, our findings support the need to educate mothers, especially those of younger ages, about their best options regarding the place of delivery. We propose implementing secondary services of HD to minimize the emergency risks of HD. We encourage local authorities to be aware of the medical needs of the community especially those of pregnant females and their right for a free delivery policy

川口順二教授退任記念論集

International audienceMélanges offerts au professeur Junji Kawaguchi (Université Keio) par ses élèves et ses amis à l'occasion de son départ à la retrait

Genome-Wide Association Study for Levels of Total Serum IgE Identifies <i>HLA-C</i> in a Japanese Population

<div><p>Most of the previously reported loci for total immunoglobulin E (IgE) levels are related to Th2 cell-dependent pathways. We undertook a genome-wide association study (GWAS) to identify genetic loci responsible for IgE regulation. A total of 479,940 single nucleotide polymorphisms (SNPs) were tested for association with total serum IgE levels in 1180 Japanese adults. Fine-mapping with SNP imputation demonstrated 6 candidate regions: the <i>PYHIN1/IFI16,</i> MHC classes I and II, <i>LEMD2, GRAMD1B,</i> and chr13∶60576338 regions. Replication of these candidate loci in each region was assessed in 2 independent Japanese cohorts (n = 1110 and 1364, respectively). SNP rs3130941 in the <i>HLA-C</i> region was consistently associated with total IgE levels in 3 independent populations, and the meta-analysis yielded genome-wide significance (<i>P = </i>1.07×10⁻¹⁰). Using our GWAS results, we also assessed the reproducibility of previously reported gene associations with total IgE levels. Nine of 32 candidate genes identified by a literature search were associated with total IgE levels after correction for multiple testing. Our findings demonstrate that SNPs in the <i>HLA-C</i> region are strongly associated with total serum IgE levels in the Japanese population and that some of the previously reported genetic associations are replicated across ethnic groups.</p></div

Top SNPs with the strongest statistical evidence of association with total serum IgE levels.

*<p>The significance level was corrected for multiple testing using the SNPSpD program <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0080941#pone.0080941-Nyholt1" target="_blank">[16]</a>.</p>‡<p>SNP previously reported for association with total serum IgE (the direction of the effect was the same).</p

Characteristics of the study cohorts.

<p>NA = not applicable; SD = standard deviation.</p

Replication studies and meta-analysis.

*<p>The direction of the effect was opposite to that of the Tsukuba cohort.</p><p>LD = linkage disequilibrium; MAF = minor allele frequency.</p