Protocol for a process evaluation of a cluster randomized controlled trial of the Learning Club intervention for women\u27s health, and infant\u27s health and development in rural Vietnam

Background: Learning Clubs is a multi-component intervention to address the eight common risk factors for women’s health, and infant’s health and development in resource-constrained settings. We are testing in a cluster randomized controlled trial in rural Vietnam whether this intervention improves cognitive development in children when they are aged two. There are few comprehensive process evaluations of complex interventions to optimise early childhood development. The aim is to conduct a planned process evaluation of the Learning Clubs intervention in Vietnam. Methods: The evaluation will be conducted alongside the Learning Clubs trial using both qualitative and quantitative methods. Four domains will be included in the evaluation: [1] Context – how contextual factors affect the implementation and outcomes; [2] Implementation – what aspects of the Learning Clubs intervention are actually delivered and how well the intervention is delivered; [3] Mechanism of impact – how the intervention produces changes in the primary and secondary outcomes; and [4] National integration – how the intervention can be scaled up for application nationally. Purposive sampling will be used to recruit project stakeholders from commune, provincial and national levels. Results of the process evaluation will be integrated with those of the outcome and economic evaluations to provide a comprehensive picture of the effectiveness of the Learning Clubs intervention for early childhood development in rural Vietnam. Discussion: Results of the evaluation will provide evidence about the implementation of the intervention and explanations for any differences in the outcomes between participants in intervention and control conditions. The evaluation will be integrated into each stage of the outcome assessments, but will be implemented by a bilingual team independent of the team implementing the intervention. It will therefore provide evidence which will not be influenced by or influence the intervention and will inform both generalisation to other settings and scalability in Vietnam

Early Purchaser Involvement in Open Innovation- the case of an advanced purchasing function triggering the absorption of external knowledge in the French automotive industry

International audienceThis paper investigates the mechanisms that trigger the absorption of external knowledge in an innovative French automotive firm. An ethnographic-inspired study conducted by an academic embedded within the Innovation Purchasing Department has enable us to present a rare and new function of Purchasing that plays an important role between potential new suppliers and Research and Development personnel

ベトナム国南部における稲遺伝資源の探索収集

Collaborative exploration between Japan and Vietnam was conducted in the Mekong Delta area of Southern Vietnam from November 17 to December 16, 1998. A total of 124 landraces and 12 wild relatives, including Oryza rufipogon and O. officinalis were collected. Land races which are adapted to deep water conditions, acid sulfurate soils, aluminum soil, or salinity were found in various locations. Some land races were grown for their high quality as aromatic rice and glutinous rice. Twelve accessions of wild relatives of rice, which include Oryza rufipogon and O. officinalis, were also collected near former fields. Oryza officinalis was collected in Ca Mau province, which is the first accession of that species from that province

Influence of Spray Rate on Structural and Optical Properties of Sprayed ZnO Films

In this report, the ZnO nanostructure films have been deposited by ultrasonic spray pyrolysis technique (USP) on fluorine doped tinoxide~(FTO) substrate using zinc acetate and aqueous 2-propanol as reactants. The effects of solution spray rate on structural, morphological and optical properties of ZnO nanostructure films were investigated by X-ray diffraction (XRD), atomic force microscopy (AFM) and UV-Vis measurements. ZnO films were crystallized in the hexagonal wurtzite phase and preferential orientation changed with changing of spray rate. Grain size and roughness of films depended on spray rate. Increasing spray rate made the films grown with bigger grain size and higher roughness. Band gap energy was determined from the UV-Vis. Its value was found to be of 3.25 eV and was almost independent on the spray rate

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Access to iodized salt in 11 low- and lower-middle-income countries: 2000 and 2010

drawing, reconstr. ceremonial bldg w/out dome (ext); section w/ dome, 200

Prevalence and determinants of symptoms of antenatal common mental disorders among women who had recently experienced an earthquake: a systematic review

Abstract Background Antenatal common mental disorders (CMDs) including anxiety, depressive, adjustment, and somatoform disorders are prevalent worldwide. There is emerging evidence that experiencing a natural disaster might increase the risk of antenatal CMDs. This study aimed to synthesise the evidence about the prevalence and determinants of clinically-significant symptoms of antenatal CMDs among women who had recently experienced an earthquake. Methods This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search included both electronic and manual components. Five major databases were searched. A data extraction table was used to summarise study characteristics and findings. Two authors examined the quality of studies independently using a quality assessment tool. A narrative synthesis of the findings reported. Results In total seven articles met inclusion criteria. Quality scores ranged from six to seven out of ten. All the studies were cross-sectional surveys and were conducted in high and middle-income countries. Sample sizes varied among studies. The prevalence of clinically-significant symptoms of antenatal CMD ranged from 4.6% (95% CI, 3.2; 6.5) experiencing ‘psychological stress’ in Japan to 40.8% (95% CI, 35.5; 46.4) ‘depression’ in China. While all studies were conducted in an earthquake context, only four examined some aspect of earthquake experiences as a risk factor for antenatal CMDs. In multivariable analyses, higher marital conflict, poor social support, multiparity, stresses of pregnancy and the personality characteristic of a negative coping style were identified as risks and a positive coping style as protective against antenatal CMDs. Conclusions This systematic review found that women who have recently experienced an earthquake are at heightened risk of antenatal mental health problems. It indicates that in addition to the establishment of services for safe birth which is recognised in post-disaster management strategies, pregnancy mental health should be a priority. The review also revealed that there is no evidence available from the world’s low-income nations where natural disasters might have more profound impacts because local infrastructure is more fragile and where it is already established that women experience a higher burden of antenatal CMDs. Trial registration PROSPERO-CRD42017056501

Attitudes towards Intimate Partner Violence against Women among Women and Men in 39 Low- and Middle-Income Countries

<div><p>Background</p><p>Violence against women perpetrated by an intimate partner (IPV) is prevalent in low- and middle-income countries (LAMIC). The aim was to describe the attitudes of women and men towards perpetration of physical violence to women by an intimate partner, in a large group of low- and middle-income countries.</p><p>Methods and Findings</p><p>We used data from Round Four of the UNICEF Multiple Indicator Cluster Surveys. Attitudes towards IPV against women were assessed by a study-specific scale asking if ‘wife beating’ is justified in any of five circumstances.</p><p>Overall, data from 39 countries (all had data from women and 13 countries also had data from men) were included in the analyses. The proportions of women who held attitudes that ‘wife-beating’ was justified in any of the five circumstances varied widely among countries from 2.0% (95% CI 1.7;2.3) in Argentina to 90.2% (95% CI 88.9;91.5) in Afghanistan. Similarly, among men it varied from 5.0% (95% CI 4.0;6.0) in Belarus to 74.5% (95% CI 72.5;76.4) in the Central African Republic. The belief that ‘wife-beating’ is acceptable was most common in Africa and South Asia, and least common in Central and Eastern Europe and Latin America and the Caribbean. In general this belief was more common among people in disadvantaged circumstances, including being a member of a family in the lowest household wealth quintile, living in a rural area and having limited formal education. Young adults were more likely to accept physical abuse by a man of his intimate partner than those who were older, but people who had never partnered were less likely to have these attitudes.</p><p>Conclusions</p><p>Violence against women is an international priority and requires a multicomponent response. These data provide evidence that strategies should include major public education programs to change attitudes about the acceptability of IPV against women, and that these should be addressed to women and girls as well as to boys and men.</p></div