Language：Japanese   Publisher：Japanese Society for the Science of Design  

<p>We propose a maternity roadmap as a tool to sustain attendance in home-based antenatal and postnatal care in rural Bangladesh. Through preliminary and on-site surveys, we identified that immediate access to necessary information, understanding the entirety of maternal care, and personal engagement are crucial for continuous attendance. Therefore, we adopted a roadmap easily displayed on walls to alleviate concerns of misplacement and created a prototype. Moving forward, we will refine based on local evaluations to extract necessary elements for sustainability.</p>

DOI： 10.11247/jssd.71.0_268

CiNii Research

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Studies in Health Technology and Informatics  

Portable medical sensors play an important role in healthcare services, especially in rural communities. Many telehealth systems use these devices for providing patients' vital information from a distance to remote doctors. Erroneous data will not only mislead the remote doctor for correct diagnosis but it will cause health threats to these unreached community people. Therefore, it is very important to identify good sensors with an acceptable level of accuracy but within the affordable price of the available sensors in the market. This study aims to identify quality portable cholesterol sensors with high accuracy with the reference of the Japanese clinical pathology laboratory as a gold standard. We have considered cholesterol sensors that measure total cholesterol for this study that are commonly used in the developing countries of Asia. We found that out of four, three of them were very much erroneous and cannot be recommended even for primary healthcare.

DOI： 10.3233/SHTI230977

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

Background and Objective: One of the primary challenges faced by telehealth systems is the accurate transmission of patient information to remote doctors. In this context, portable medical sensors deployed at the remote patients' end play a crucial role in measuring vital information. There are many sensors available in the market. However, the accuracy of the sensors has been always a concern. The objective of this study is to verify different sensors and create awareness for using accurate sensors to avoid misdiagnosis for the patients’ safety. Methods: This study considered the test result of a Japanese clinical pathology laboratory as the reference gold standard. The clinical pathology laboratory uses 1) Hexokinase UV method for blood glucose, 2) Enzymatic Determination method for cholesterol, 3) Automatic Analyzer (EDTA-2 K) of Hemoglobin, and 4) Uricase POD method for uric acid. To assess the performance of a medical sensor, its test results were compared to the gold standard test results obtained from the laboratory using the same sample. A Normalized Root Mean Square Error (NRMSE) threshold of less than 0.2 was established as the criterion for determining whether the medical sensor's performance fell within an acceptable range. Results: Among the eight most commonly used blood glucose devices in the Asian market, only one device was deemed acceptable with NRMSE less than 0.2. However, all four devices found in the Japanese market showed their acceptability. In the case of cholesterol, hemoglobin, and uric acid devices, only a limited number of items were available in Asian markets. Some of the hemoglobin and uric acid devices were found to be somewhat acceptable, while all the cholesterol sensors were found erroneous. Conclusions: This study has clearly shown the issues with the portable medical sensors and recommends the device approval authority of each country to approve sales of the quality sensors only for patients’ safety.

DOI： 10.1016/j.cmpbup.2024.100147

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Academy of Midwifery  

<p><b>Objectives</b></p><p>This study aimed to reveal the current status and factors related to preconception care (PCC) health literacy among men visiting an infertility clinic in Japan.</p><p><b>Methods</b></p><p>This cross-sectional study was conducted between September and November 2022 at a clinic specializing in infertility treatment in Fukuoka Prefecture, Japan. Three hundred leaflets with website addresses and QR codes linked to a web-based questionnaire were placed in the waiting rooms of the research facility. The participants were asked to complete a web-based questionnaire and participate in the study. The PCC Health Literacy Scale was used to measure PCC health literacy in men. A multiple logistic regression analysis was performed to identify factors related to PCC health literacy.</p><p><b>Results</b></p><p>Seventy-seven men completed the questionnaire. The mean PCC health literacy score was 38.8 ± 6.5 points. This mean score was used as the cut-off value according to which the participants were divided into two groups: high and low PCC health literacy. The men who visited the infertility outpatient clinic for the first time and who identified “kind of being tiresome” as a reason for not visiting an infertility clinic had a significant risk of low PCC health literacy.</p><p><b>Conclusion</b></p><p>This study revealed factors related to PCC health literacy among men seeking care at an infertility clinic for the first time. Future research should expand the targets of the survey, such as medical facilities specializing in infertility nationwide, and include men in the pre-perinatal period rather than solely including men who visit infertility clinics.</p>

DOI： 10.3418/jjam.jjam-2024-0017

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Language：English   Publisher：Springer  

Background: / Sleep problems and irritable temperaments are common among infants with autism spectrum disorder (ASD). The prospective association between such sleep problems and irritable temperaments and ASDs needs to be determined for elucidating the mechanism and exploring the future intervention study. Thus, in this study, we investigated whether sleep quality and temperament in 1-month-old infants are associated with the onset of ASD in 3-year-old children. We also assessed its sex-stratified associations. / Methods: / We conducted a longitudinal study using data from 69,751 mothers and infants from a large-cohort study, the Japan Environment and Children’s Study. We examined the prospective association between infant sleep quality and temperament at 1 month of age and ASD diagnosis by 3 years of age. / Results: / Here we show infants with longer daytime sleep have a higher risk of later ASD than those with shorter daytime sleep (risk ratio [RR]: 1.33, 95% confidence interval [CI]: 1.01–1.75). Infants who experienced intense crying have a higher risk of ASD than those who did not (RR: 1.31, 95% CI: 1.00–1.72). There is a difference in sex in the association between a bad mood and later ASD. In particular, female infants experiencing bad moods have a higher risk of ASD than others (RR: 3.59, 95% CI: 1.91–6.75). / Conclusions: / The study findings provide important information for future intervention to reduce the risk of future ASD.

CiNii Research

Authorship：Lead author  

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Language：English   Publisher：The Asahi Glass Foundation  

DOI： 10.50867/afreport.2023_086

CiNii Research

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2196/41586

Language：English   Publishing type：Research paper (scientific journal)   Publisher：PLoS ONE  

This study aimed to examine the association between infant sleep quality and temperament in one-month-old infants using a large cohort study data. We used data from the Japan Environment and Children's Study, a cohort study which follows around 100,000 women from pregnancy until their children's development. The mothers were asked about their infants' sleep and temperament using a structured questionnaire. Frequent crying (adjusted odds ratio [AOR]: 1.05, 95% confidence interval [CI]: 1.00-1.10) and intense crying (AOR: 1.19, 95% CI: 1.13-1.25) were positively associated with longer sleep periods during the day than at night. Female infants with longer daytime sleep periods than that at nighttime were more likely to cry frequently (AOR: 1.11, 95% CI: 1.04-1.20). Parous women with infants who had frequent night awakening believed their infants cried more intensely (AOR: 1.17, 95% CI: 1.03-1.31). The study demonstrated a specific association between sleep quality and temperament in one-month-old infants. Based on the results of this study, further sleep intervention studies are required to improve infant temperament.

DOI： 10.1371/journal.pone.0274610

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Other Link： https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274610

Publishing type：Part of collection (book)   Publisher：Springer International Publishing  

DOI： 10.1007/978-3-030-91237-6_43

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Language：English   Publishing type：Research paper (scientific journal)  

Other Link： https://doi.org/10.1016/j.cmpbup.2022.100061

Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Studies in Health Technology and Informatics  

A personal health record (PHR) is not only a collection of personal health data but also a personal healthcare and disease management tool for individual patients. Recently, PHRs have been considered indispensable tools for patient engagement in the area of noncommunicable diseases (NCDs) and have gained a special importance. Unfortunately, similar to several other developing countries, Bangladesh remains far behind in establishing a standard PHR system for the country despite the fact that the growth of NCDs is extremely high and accounts for approximately 70% of the total diseases experienced in the country. The Portable Health Clinic system, which has a PHR feature, was established in Bangladesh in 2010. This PHR system requires standardization for each country. The objective of this research is to standardize this PHR system with reference to the PHR system proposed by the Japanese Clinical Societies, which is a pioneer of work in this field in Asia.

DOI： 10.3233/SHTI220053

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Other Link： https://ebooks.iospress.nl/doi/10.3233/SHTI220053

Language：English   Publishing type：Research paper (international conference proceedings)  

DOI： 10.3233/SHTI220700

Other Link： https://ebooks.iospress.nl/doi/10.3233/SHTI220700

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：PLoS ONE  

The coronavirus disease (COVID-19) pandemic has widely spread worldwide since 2020. Several countries have imposed lockdown or stay-at-home policies to prevent the infection. Bangladesh experienced a lockdown from March 2020 to May 2020, and internal travel was restricted. Such long and strict confinement may impact women's health. Herein, we aimed to assess the impact of the COVID-19 pandemic on women's health by comparing their health status before and during the pandemic. We conducted a prospective longitudinal study in two zones in the Chhaygaon union, rural district Shariatpur, Bangladesh. The study population comprised non-pregnant women aged 15-49 years. We visited the household of all eligible women and invited them for health checkups. The survey staff examined their health status at the checkup camps and conducted questionnaire interviews. In total, 121 non-pregnant women received health checkups both from June 2019 to July 2019 and in October 2020, before and during the COVID-19 pandemic, respectively. Compared with those during the 2019 health checkup, the medians of body mass index, systolic blood pressure, and diastolic blood pressure were significantly higher (22.7 kg/m2 to 23.6 kg/m2; 110.0 mmHg to 111.0 mmHg; and 73.0 mmHg to 75.0 mmHg, respectively, p<0.05) during the 2020 health checkup. In contrast, urine glucose levels were significantly lower (10.1% to 3.4%, p = 0.021). The lack of physical activity and other inconvenience accumulation caused by the prolonged confinement might have affected their health status. This necessitates local health workers to promote physical activity to prevent health deterioration during the pandemic.

DOI： 10.1371/journal.pone.0266141

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Language：English   Publishing type：Research paper (international conference proceedings)  

DOI： 10.3233/SHTI210684. PMID: 34920489.

Other Link： https://ebooks.iospress.nl/doi/10.3233/SHTI210684

Language：English   Publishing type：Research paper (scientific journal)  

Background
In low- and middle-income countries (LMICs), the continuum of care (CoC) for maternal, newborn, and child health (MNCH) is not always complete. This study aimed to evaluate the effectiveness of an integrated package of CoC interventions on the CoC completion, morbidity, and mortality outcomes of woman–child pairs in Ghana.

Methods and findings
This cluster-randomized controlled trial (ISRCTN: 90618993) was conducted at 3 Health and Demographic Surveillance System (HDSS) sites in Ghana. The primary outcome was CoC completion by a woman–child pair, defined as receiving antenatal care (ANC) 4 times or more, delivery assistance from a skilled birth attendant (SBA), and postnatal care (PNC) 3 times or more. Other outcomes were the morbidity and mortality of women and children. Women received a package of interventions and routine services at health facilities (October 2014 to December 2015). The package comprised providing a CoC card for women, CoC orientation for health workers, and offering women with 24-hour stay at a health facility or a home visit within 48 hours after delivery. In the control arm, women received routine services only. Eligibility criteria were as follows: women who gave birth or had a stillbirth from September 1, 2012 to September 30, 2014 (before the trial period), from October 1, 2014 to December 31, 2015 (during the trial period), or from January 1, 2016 to December 31, 2016 (after the trial period). Health service and morbidity outcomes were assessed before and during the trial periods through face-to-face interviews. Mortality was assessed using demographic surveillance data for the 3 periods above. Mixed-effects logistic regression models were used to evaluate the effectiveness as difference in differences (DiD). For health service and morbidity outcomes, 2,970 woman–child pairs were assessed: 1,480 from the baseline survey and 1,490 from the follow-up survey. Additionally, 33,819 cases were assessed for perinatal mortality, 33,322 for neonatal mortality, and 39,205 for maternal mortality. The intervention arm had higher proportions of completed CoC (410/870 [47.1%]) than the control arm (246/620 [39.7%]; adjusted odds ratio [AOR] for DiD = 1.77; 95% confidence interval [CI]: 1.08 to 2.92; p = 0.024). Maternal complications that required hospitalization during pregnancy were lower in the intervention (95/870 [10.9%]) than in the control arm (83/620 [13.4%]) (AOR for DiD = 0.49; 95% CI: 0.29 to 0.83; p = 0.008). Maternal mortality was 8/6,163 live births (intervention arm) and 4/4,068 live births during the trial period (AOR for DiD = 1.60; 95% CI: 0.40 to 6.34; p = 0.507) and 1/4,626 (intervention arm) and 9/3,937 (control arm) after the trial period (AOR for DiD = 0.11; 95% CI: 0.11 to 1.00; p = 0.050). Perinatal and neonatal mortality was not significantly reduced. As this study was conducted in a real-world setting, possible limitations included differences in the type and scale of health facilities and the size of subdistricts, contamination for intervention effectiveness due to the geographic proximity of the arms, and insufficient number of cases for the mortality assessment.

Conclusions
This study found that an integrated package of CoC interventions increased CoC completion and decreased maternal complications requiring hospitalization during pregnancy and maternal mortality after the trial period. It did not find evidence of reduced perinatal and neonatal mortality.

DOI： https://doi.org/10.1371/journal.pmed.1003663

Other Link： https://doi.org/10.1371/journal.pmed.1003663

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Repository Public URL： http://hdl.handle.net/2324/4400020

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Other Link： https://doi.org/10.1016/j.cmpb.2021.106156

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1136/ bmjpo-2020-000992

Other Link： https://bmjpaedsopen.bmj.com/content/5/1/e000992

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Repository Public URL： http://hdl.handle.net/2324/4400022

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Repository Public URL： http://hdl.handle.net/2324/4400023

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Repository Public URL： http://hdl.handle.net/2324/4400024

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Repository Public URL： http://hdl.handle.net/2324/4400025

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HIV-positive children are at high risk for oral mucosal disorders. Additionally, their low immune status is associated with dental caries. However, little is known about how their dental caries and related risk factors, such as salivary flow, salivary pH level and oral health-related quality of life, differ from those of HIV-negative children. The study aimed to assess (1) dental caries and related risk factors in HIV-positive compared with HIV-negative children and (2) the association between these factors and HIV seropositive status in Phnom Penh, Cambodia.

Other Link： https://doi.org/10.1186/s12903-021-01441-2

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Nurse-led mobile phone voice call reminder and on-time antiretroviral pills pick-up in Nepal: a randomized controlled trial

Other Link： https://doi.org/10.1007/s10461-020-03122-7

Language：Others   Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s12889-020-09238-8

Other Link： https://doi.org/10.1186/s12889-020-09238-8

Language：English   Publishing type：Research paper (international conference proceedings)  

Comparisons of anthropometric indices for predicting type 2 diabetes among participants in telemedicine and health checkups in Bangladesh

Language：English   Publishing type：Research paper (international conference proceedings)  

Effects of renal dysfunction on the improvement of anemia in Bangladesh: an epidemiological analysis of health checkup data with ICT intervention

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Medical staff carry an inordinate risk of infection from patients, and many doctors, nurses, and other healthcare workers are affected by COVID-19 worldwide. The unreached communities with noncommunicable diseases (NCDs) such as chronic cardiovascular, respiratory, endocrine, digestive, or renal diseases became more vulnerable during this pandemic situation. In both cases, Remote Healthcare Systems (RHS) may help minimize the risk of SARS-CoV-2 transmission. This study used the WHO guidelines and Design Science Research (DSR) framework to redesign the Portable Health Clinic (PHC), an RHS, for the containment of the spread of COVID-19 as well as proposed corona logic (C-Logic) for the main symptoms of COVID-19. Using the distributed service platform of PHC, a trained healthcare worker with appropriate testing kits can screen high-risk individuals and can help optimize triage to medical services. PHC with its new triage algorithm (C-Logic) classifies the patients according to whether the patient needs to move to a clinic for a PCR test. Through modified PHC service, we can help people to boost their knowledge, attitude (feelings/beliefs), and self-efficacy to execute preventing measures. Our initial examination of the suitability of the PHC and its associated technologies as a key contributor to public health responses is designed to “flatten the curve”, particularly among unreached high-risk NCD populations in developing countries. Theoretically, this study contributes to design science research by introducing a modified healthcare providing model.

DOI： 10.3390/ijerph17134709

Language：Japanese   Publishing type：Research paper (scientific journal)  

Other Link： https://doi.org/10.15017/4400006

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This study examined the association between the decayed, missing and filled teeth (DMFT) score and CD4+ cell counts in 142 children living with HIV aged 8–15 years (male, 51%) from Phnom Penh, Cambodia.

DOI： 10.1038/s41598-019-51077-0

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: To evaluate the effect of a continuum-of-care intervention package on adequate contacts of women and newborn with healthcare providers and their reception of high-quality care. DESIGN: Cluster randomised controlled trial. SETTING: 32 subdistricts in 3 rural sites in Ghana. PARTICIPANTS: The baseline survey involved 1480 women who delivered before the trial, and the follow-up survey involved 1490 women who received maternal and newborn care during the trial. INTERVENTIONS: The intervention package included training healthcare providers, using an educational and recording tool named 'continuum-of-care card', providing the first postnatal care (PNC) by retaining women and newborns at healthcare facility or home visit by healthcare providers. OUTCOME MEASURES: Adequate contacts were defined as at least four contacts during pregnancy, delivery with assistance of skilled healthcare providers at a healthcare facility and three timely contacts within 6 weeks postpartum. High-quality care was defined as receiving 6 care items for antenatal care (ANC), 3 for peripartum care (PPC) and 14 for PNC. RESULTS: The difference-in-difference method was used to assess the effects of the intervention on the study outcome. The percentage of adequate contacts with high-quality care in the intervention group in the follow-up survey and the adjusted difference-in-difference estimators were 12.6&#37; and 2.2 (p=0.61) at ANC, 31.5&#37; and 1.9 (p=0.73) at PPC and 33.7&#37; and 12.3 (p=0.13) at PNC in the intention-to-treat design, whereas 13.0&#37; and 2.8 (p=0.54) at ANC, 34.2&#37; and 2.7 (p=0.66) at PPC and 38.1&#37; and 18.1 (p=0.02) at PNC in the per-protocol design that assigned the study sample by possession of the continuum-of-care card. CONCLUSIONS: The interventions improved contacts with healthcare providers and quality of care during PNC. However, having adequate contact did not guarantee high-quality care. Maternal and newborn care in Ghana needs to improve its continuity and quality. TRIAL REGISTRATION NUMBER: ISRCTN90618993. .

DOI： 10.1136/bmjopen-2018-025347

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s41182-019-0172-7

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1080/09540121.2019.1622634

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DOI： 10.1186/s13063-018-3047-z

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Lessons learned from the co-design and co-production on a portable health clinic research project in Jaipur district, India (2016-2018)

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s12889-018-6123-0

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1136/bmjgh-2018-000786

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In South-East Asia, the maternal and child mortality rate has declined over the past decades
however, it varies among and within the countries in the region, including Cambodia. The continuum of care is an integrated series of care that women and children are required to avail continuously from pregnancy to the child/motherhood period. This study aimed to assess the completion rate of the continuum of care and examine the factors associated with the continuum of care in Ratanakiri, Cambodia. A cross-sectional study was conducted in Ratanakiri. Overall, 377 women were included, and data were collected via face-to-face interviews using a semi-structured questionnaire. Among them, 5.0&#37; completed the continuum of care (antenatal care at least four times, delivery by skilled birth attendant, and postnatal care at least once). Meanwhile, 18.8&#37; did not receive any care during pregnancy, delivery, and after birth. The highest discontinuation rate was at the postnatal care stage (73.6&#37;). Not receiving any perinatal care was associated with neonatal complications at 6 weeks after birth (adjusted odds ratio [AOR]: 3.075
95&#37; confidence interval [CI]: 1.310–7.215). Furthermore, a long distance to the health center was negatively associated with completion of the continuum of care (AOR: 0.877
95&#37; CI: 0.791–0.972). This study indicates the need for efforts to reduce the number of women who discontinue from the continuum of care, as well as who do not receive any care to avoid neonatal complications. Since the discontinuation rate was highest at the postnatal care, postnatal care needs to be promoted more through the antenatal care and delivery services. Furthermore, given that long distance to health facilities was a barrier for receiving the care continuously, our findings suggest the need for a village-based health care system that can provide the basic continuum of care in remote areas.

DOI： 10.1371/journal.pone.0198829

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Physical and psychosocial changes during adolescence could influence the psychological well-being and adherence to antiretroviral therapy (ART) of adolescents living with HIV. However, few studies have assessed these two important issues in Zambia. This study aimed at addressing this gap by examining adolescents' depressive symptoms and ART adherence. This was a mixed-methods study conducted from April to July 2014. We recruited 200 adolescents, ages 15 to 19, who were already aware of their HIV status. We measured depressive symptoms using the short form of the Center for Epidemiologic Studies Depression Scale, and self-reported three-day adherence to ART. We performed logistic regression analysis to identify factors associated with depressive symptoms and non-adherence to ART. For qualitative data, we examined challenges over ART adherence using thematic analysis. Out of 190 adolescents, 25.3&#37; showed high scores of depressive symptoms. Factors associated with depressive symptoms were unsatisfactory relationships with family (Adjusted Odds Ratio [AOR] 3.01; 95&#37; Confidence Interval [CI] 1.20-7.56); unsatisfactory relationships with health workers (AOR 2.68; 95&#37; CI 1.04-6.93); and experience of stigma (AOR 2.99; 95&#37; CI 1.07-8.41). Of all participants, 94.2&#37; were taking ART, but 28.3&#37; were non-adherent. Factors associated with non-adherence to ART were loss of a mother (AOR 3.00; 95&#37; CI 1.05-8.58) and lack of basic knowledge about HIV (AOR 3.25; 95&#37; CI 1.43-7.40). Qualitative data identified the following challenges to ART adherence: management of medication, physical reactions to medicine, and psychosocial distress. The evidence suggests that depressive symptoms and non-adherence to ART were priority issues in late adolescence in Zambia. Health workers should be aware of these issues, and the care and treatment services should be tailored to respond to age-specific needs.

DOI： 10.1080/09540121.2018.1425364

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Adolescents living with HIV face challenges, such as disclosure of HIV status, adherence to antiretroviral therapy, mental health, and sexual and reproductive health (SRH). These challenges affect their future quality of life. However, little evidence is available on their sexual behaviors and SRH needs in Zambia. This study aimed at assessing their sexual behaviors and SRH needs and identifying factors associated with marriage concerns and a desire to have children. METHODS: This cross-sectional study was conducted at the University Teaching Hospital from April to July 2014. We recruited 200 adolescents aged 15-19 years who were aware of their HIV-positive status. We collected data on their first and recent sexual behavior, concerns about marriage, and desire to have children. We used the Generalized Linear Model to identify factors associated with having concerns about marriage and desire to have children. We performed thematic analysis with open-ended data to determine their perceptions about marriage and having children in the future. RESULTS: Out of 175 studied adolescents, 20.6&#37; had experienced sexual intercourse, and only 44.4&#37; used condoms during the first intercourse. Forty-eight percent had concerns about marriage, and 87.4&#37; desired to have children. Marriage-related concerns were high among those who desired to have children (adjusted relative risk [ARR] = 2.51, 95&#37; CI = 1.02 to 6.14). Adolescents who had completed secondary school were more likely to desire to have children (ARR = 1.35, 95&#37; CI = 1.07 to 1.71). Adolescents who had lost both parents were less likely to want children (ARR = 0.80, 95&#37; CI = 0.68 to 0.95). Thematic analysis identified that major concerns about future marriage were fear of disclosing HIV status to partners and risk of infecting partners and/or children. The reasons for their willingness to have children were the desire to be a parent, having children as family assets, a human right, and a source of love and happiness. CONCLUSIONS: Zambian adolescents living with HIV are at risk of engaging in risky sexual relationships and have difficulties in meeting needs of SRH. HIV care service must respond to a wide range of needs.

DOI： 10.1186/s12978-018-0493-8

Other Link： https://doi.org/10.1186/s12978-018-0493-8

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Background Maternal morbidity and mortality is still a major public health issue in low- and middle-income countries such as Cambodia. Improving access to antenatal care (ANC) services for pregnant women has been widely recognized as one of the most effective means of reducing maternal mortality and morbidity. As such, this study examined the barriers for pregnant women living in rural, agricultural villages to accessing ANC based on data collected in the Ratanakiri province, one of the least developed provinces in Cambodia, using a combination of a community-based cross-sectional survey and a geographic information system (GIS). Methods A community-based cross-sectional survey was conducted among 377 mothers with children under the age of two living in 62 villages in the Ratanakiri province, Cambodia, in December 2015. Face-to-face interviews were conducted to ask mothers about their ANC service use, knowledge of ANC, barriers to accessing health facilities, and complications they experienced during the most recent pregnancy. At the same time, GIS data were also collected using a Global Positioning System (GPS) to accurately measure actual travel distance of pregnant women to access health facilities and to examine geographical and environmental barriers in greater detail. Results Only a third of the mothers met the recommendations made by the World Health Organization (WHO) of receiving ANC four times or more (achieved ANC4+), and a quarter of the mothers had never received ANC during their most recent pregnancy. Factors positively associated with achieving ANC4+ were mother’s secondary or higher education (adjusted odds ratio [AOR] = 5.50, 95&#37; confidence interval [CI]: 1.74, 17.37), being aware that receiving ANC is recommended (AOR = 2.74, 95&#37; CI: 1.25, 6.00), and knowledge about the recommended frequency for ANC (AOR = 2.26, 95&#37; CI: 7.22). Actual travel distance was negatively associated with achieving ANC4+. Mothers who had to travel 10.0–14.9 km were 68&#37; less likely (AOR = 0.32, 95&#37; CI: 0.10, 0.99), and those who had to travel 15.0 km or longer were 79&#37; less likely (AOR = 0.21, 95&#37; CI: 0.07, 0.62) to have achieved ANC 4+, both compared to those who travelled 5.0 km or less. While most previous studies have used a straight-line to measure distance traveled, this study much more accurately measured the actual distance traveled by using a GIS. As a result, there was a statistically significant discrepancy between actual travel distance and straight-line distance. Conclusions This study revealed promoting factors and barriers for ANC use among pregnant women living in remote, agricultural villages in Cambodia. Furthermore, this study highlights the importance of measuring travel distances accurately to ensure that targeted interventions for ANC are not misguided by straight-line distances. The methodology used in this study can be applied widely to other developing countries, especially in remote areas with limited road networks where there may be a large discrepancy between actual and straight-line distances.

DOI： 10.1371/journal.pone.0194103

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Other Link： http://www.ijmrhs.com/abstract/the-relationships-and-risk-factors-associated-with-hypertension-diabetes-and-proteinuria-among-adults-from-bheramara-upa-14609.html

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DOI： 10.5582/bst.2018.01070

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DOI： 10.1080/09540121.2017.1307917

Other Link： https://doi.org/10.1080/09540121.2017.1307917

Language：English   Publishing type：Research paper (scientific journal)  

Background: How does the gap in preferences between married couples affect their happiness after childbirth? Are couples that share similar preferences happier? In recent years, gender, marriage, and happiness have been considered to be key issues in public health research. Although much research has examined the happiness status of married couples, practically no study has explored the gender gap in relation to happiness and the preferences of married couples after childbirth. Therefore, our study was conducted to assess the association between the preference gap and the happiness status among married couples in the afterbirth period.
Methods: We conducted a field experiment in rural communities in the Brong-Ahafo region of Ghana. Participants were 80 married couples who had experienced childbirth within 2 years prior to the survey. As preference indicators, we measured trust, reciprocity, altruism, and risk lovingness through an economic experiment. Then, we assessed how, for a couple, the gap between these preferences affected their happiness.
Results: Wives' happiness was positively associated with the absolute value of the gap in risk lovingness between a couple (OR= 4.83, p = 0.08), while husbands' happiness was negatively associated with the gap in trust (OR = -3.58, p = 0.04) or altruism (OR = -3.33, p = 0.02). Within a couple, wives felt greater happiness than their husbands if there was a wider gap in trust (OR = 6.22, p = 0.01), reciprocity (OR = 2.80, p = 0.01), or risk lovingness (OR = 3.81, p = 0.07).
Conclusions: The gender gaps in the preference indicators were found to be closely associated with the happiness levels between married couples after childbirth. For the further improvement of maternal and child health, we must consider the gender gaps between couples in relation to happiness and preferences.

DOI： 10.1186/s41043-017-0084-2

Other Link： https://doi.org/10.1186/s41043-017-0084-2

Language：English   Publishing type：Research paper (international conference proceedings)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s12913-017-2068-8

Other Link： https://doi.org/10.1186/s12913-017-2068-8

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.3389/fpubh.2017.00326

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1080/16549716.2017.1291879

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1371/journal.pone.0164965

Language：English   Publishing type：Research paper (scientific journal)  

Background: Health worker shortage in rural areas is one of the biggest problems of the health sector in Ghana and many developing countries. This may be due to fewer incentives and support systems available to attract and retain health workers at the rural level. This study explored the willingness of community health officers (CHOs) to accept and hold rural and community job postings in Ghana.Methods: A discrete choice experiment was used to estimate the motivation and incentive preferences of CHOs in Ghana. All CHOs working in three Health and Demographic Surveillance System sites in Ghana, 200 in total, were interviewed between December 2012 and January 2013. Respondents were asked to choose from choice sets of job preferences. Four mixed logit models were used for the estimation. The first model considered (a) only the main effect. The other models included interaction terms for (b) gender, (c) number of children under 5 in the household, and (d) years worked at the same community. Moreover, a choice probability simulation was performed.Results: Mixed logit analyses of the data project a shorter time frame before study leave as the most important motivation for most CHOs (beta 2.03; 95 &#37; CI 1.69 to 2.36). This is also confirmed by the largest simulated choice probability (29.1 &#37;). The interaction effect of the number of children was significant for education allowance for children (beta 0.58; 95 &#37; CI 0.24 to 0.93), salary increase (beta 0.35; 95 &#37; CI 0.03 to 0.67), and housing provision (beta 0.16; 95 &#37; CI -0.02 to 0.60). Male CHOs had a high affinity for early opportunity to go on study leave (beta 0.78; 95 &#37; CI -0. 06 to 1.62). CHOs who had worked at the same place for a long time greatly valued salary increase (beta 0.28; 95 &#37; CI 0.09 to 0.47).Conclusions: To reduce health worker shortage in rural settings, policymakers could provide "needs-specific" motivational packages. They should include career development opportunities such as shorter period of work before study leave and financial policy in the form of salary increase to recruit and retain them.

DOI： 10.1186/s12960-016-0148-1

Other Link： http://www.ncbi.nlm.nih.gov/pubmed/27549208

Language：English   Publishing type：Research paper (scientific journal)  

Introduction
HIV-positive people's clinic attendance for medication pick-up is critical for successful HIV treatment. However, limited evidence exists on it especially in low-income settings such as Nepal. Moreover, the role of family support in clinic attendance remains under-explored. Therefore, this study was conducted to examine the association between perceived family support and regular clinic attendance and to assess factors associated with regular clinic attendance for antiretroviral pills pick-up among HIV-positive individuals in Nepal.
Methods
A cross-sectional study was conducted among 423 HIV-positive people in three districts of Nepal. Clinic attendance was assessed retrospectively for the period of 12 months. To assess the factors associated, an interview survey was conducted using a semi-structured questionnaire from July to August, 2015. Multiple logistic regression models were used to assess the factors associated with regular clinic attendance.
Results
Of 423 HIV-positive people, only 32.6&#37; attended the clinics regularly. They were more likely to attend them regularly when they received high family support (AOR = 3.98, 95&#37; CI = 2.29, 6.92), participated in support programs (AOR = 1.68, 95&#37; CI = 1.00, 2.82), and had knowledge on the benefits of antiretroviral therapy (AOR = 2.62, 95&#37; CI = 1.15, 5.99). In contrast, they were less likely to attend them regularly when they commuted more than 60 minutes to the clinics (AOR = 0.53, 95&#37; CI = 0.30, 0.93), when they self-rated their health status as being very good (AOR = 0.13, 95&#37; CI = 0.04, 0.44), good (AOR = 0.14, 95&#37; CI = 0.04, 0.46), and fair (AOR = 0.21, 95&#37; CI = 0.06, 0.70).
Conclusion
HIV-positive individuals are more likely to attend the clinics regularly when they receive high family support, know the benefits of antiretroviral therapy, and participate in support programs. To improve clinic attendance, family support should be incorporated with HIV care programs in resource limited settings. Service providers should also consider educating them about the benefits of antiretroviral therapy.

DOI： 10.1371/journal.pone.0159382

Other Link： http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159382

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1371/journal.pone.0152235

Other Link： http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0152235

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1371/journal.pone.0139288

Language：English   Publishing type：Research paper (scientific journal)  

AimBeing homebound is regarded as a negative condition for social participation in Japan. However, little is known about the possibility of psychological resilience to prevent being homebound among older adults with urinary incontinence. The present study aimed to examine the association between sense of coherence as a measure of psychological resilience and being homebound among older adults with urinary incontinence.
MethodsA cross-sectional study was carried out in Chiba, Japan. We trained 95 care managers as interviewers, and they collected the data from 411 community-dwelling frail older adults using a pretested structured questionnaire. Logistic regression analysis was run to identify factors associated with being homebound among the participants with urinary incontinence.
ResultsOf the participants, 158 (38.4&#37;) had urinary incontinence. Among the participants with urinary incontinence, 52 (32.9&#37;) were homebound. As a result of logistic regression analysis adjusting for age, sex, living status, hobby, types of prevalent diseases, walking ability, perceived social support and subjective social capital, lower meaningfulness in their lives, which is a component of a sense of coherence, remained positively associated with being homebound (adjusted odds ratio 0.79, 95&#37; confidence interval 0.65-0.96).
ConclusionsBeing homebound is less prevalent among those who feel challenges, or worthy of investment or engagement in daily life. By improving a sense of meaningfulness, homebound status might be improved among older adults with urinary incontinence. To encourage active social participation of the target population, their psychological resilience (particularly meaningfulness) should be addressed more. Geriatr Gerontol Int 2015; 15: 910-917.

DOI： 10.1111/ggi.12353

Other Link： http://www.ncbi.nlm.nih.gov/pubmed/25257847

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1080/13607863.2015.1065792

Other Link： http://www.tandfonline.com/doi/abs/10.1080/13607863.2015.1065792?journalCode=camh20

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Ghana's Ensure Mothers and Babies Regular Access to Care (EMBRACE) program: study protocol for a cluster randomized controlled trial.
BACKGROUND: The United Nations' Millennium Development Goals call for improving maternal and child health status. Their progress, however, has been minimal and uneven across countries. The continuum of care is a key to strengthening maternal, newborn, and child health. In this context, the Japanese government launched the Ghana Ensure Mothers and Babies Regular Access to Care (EMBRACE) Implementation Research Project in collaboration with the Ghanaian government. This study aims to evaluate the implementation process and effects of an intervention to increase the continuum of care for maternal, newborn, and child health status in Ghana. METHODS/DESIGN: We will conduct a cluster randomized controlled trial using an effectiveness-implementation hybrid design in Dodowa, Kintampo, and Navrongo, Ghana. We will provide an intervention package to women living in randomly allocated intervention clusters. The study population is women of reproductive age between the ages of 15 and 49 years. The package includes: 1) use of a new continuum of care card, 2) continuum of care orientation for health workers, 3) 24-hour health facility retention of mothers and newborns after delivery, and 4) postnatal care by home visits. We will measure maternal, newborn, and child health outcomes for both intervention and implementation impacts. The intervention outcomes are continuum of care completion rate, rate of postnatal care within 48 hours, complication rate requiring mothers' and newborns' hospitalizations, and perinatal and neonatal mortality. The implementation outcomes are intervention coverage of the target population, intervention adoption and fidelity, implementation cost, and sustainability. DISCUSSION: In this trial, we will investigate how successful continuum of care can contribute to improving maternal, newborn, and child health outcomes. If successful, this model will then be implemented further in Ghana and other neighboring countries. TRIAL REGISTRATION: Current Controlled Trials ISRCTN90618993 . Registered on 3 September 2014.

DOI： 10.1186/s13063-014-0539-3

Other Link： http://trialsjournal.biomedcentral.com/articles/10.1186/s13063-014-0539-3

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1371/journal.pone.0130712

Other Link： http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0130712

Language：English   Publishing type：Research paper (scientific journal)  

Introduction: Every year, approximately 260,000 children are infected with HIV in low-and middle-income countries. The timely initiation and high level of maintenance of antiretroviral therapy (ART) are crucial to reducing the suffering of HIV-positive children. We need to develop a better understanding of the background of children's ART non-adherence because it is not well understood. The purpose of this study is to explore the background related to ART non-adherence, specifically in relation to the orphan status of children in Kigali, Rwanda.
Methods: We conducted 19 focus group discussions with a total of 121 caregivers of HIV-positive children in Kigali. The primary data for analysis were verbatim transcripts and socio-demographic data. A content analysis was performed for qualitative data analysis and interpretation.
Results: The study found several contextual factors that influenced non-adherence: among double orphans, there was psychological distance between the caregivers and children, whereas economic burden was the primary issue among paternal orphans. The factors promoting adherence also were unique to each orphan status, such as the positive attitude about disclosing serostatus to the child by double orphans' caregivers, and feelings of guilt about the child's condition among non-orphaned caregivers.
Conclusions: Knowledge of orphan status is essential to elucidate the factors influencing ART adherence among HIV-positive children. In this qualitative study, we identified the orphan-related contextual factors that influenced ART adherence. Understanding the social context is important in dealing with the challenges to ART adherence among HIV-positive children.

DOI： 10.7448/IAS.17.1.19310

Other Link： http://www.jiasociety.org/index.php/jias/article/view/19310

Language：Japanese   Publishing type：Research paper (scientific journal)  

Other Link： http://jglobal.jst.go.jp/search/#%7B%22keyword%22%3A%5B%22%5C%22L8268A%5C%22%22%5D%2C%22category%22%3A%222%22%7D

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1136/bmjopen-2012-002340

Other Link： http://bmjopen.bmj.com/content/3/2/e002340.full

Language：English   Publishing type：Research paper (scientific journal)  

Background: To reduce HIV/AIDS related mortality of children, adherence to antiretroviral treatment (ART) is critical in the treatment of HIV positive children. However, little is known about the association between ART adherence and different orphan status. The aims of this study were to assess the ART adherence and identify whether different orphan status was associated with the child's adherence.
Methods: A total of 717 HIV positive children and the same number of caregivers participated in this cross-sectional study. Children's adherence rate was measured using a pill count method and those who took 85&#37; or more of the prescribed doses were defined as adherent. To collect data about adherence related factors, we also interviewed caregivers using a structured questionnaire.
Results: Of all children (N = 717), participants from each orphan category (double orphan, maternal orphan, paternal orphan, non-orphan) were 346, 89, 169, and 113, respectively. ART non-adherence rate of each orphan category was 59.3&#37;, 44.9&#37;, 46.7&#37;, and 49.7&#37;, respectively. The multivariate analysis indicated that maternal orphans (AOR 0.31, 95&#37; CI 0.12-0.80), paternal orphans (AOR 0.35, 95&#37; CI 0.14-0.89), and non-orphans (AOR 0.45, 95&#37; CI 0.21-0.99) were less likely to be non-adherent compared to double orphans. Double orphans who had a sibling as a caregiver were more likely to be non-adherent. The first mean CD4 count prior to initiating treatment was 520, 601, 599, and 844 (cells/ml), respectively (p<0.001). Their mean age at sero-status detection was 5.9, 5.3, 4.8, and 3.9 (year old), respectively (p<0.001).
Conclusions: Double orphans were at highest risk of ART non-adherence and especially those who had a sibling as a caregiver had high risk. They were also in danger of initiating ART at an older age and at a later stage of HIV/AIDS compared with other orphan categories. Double orphans need more attention to the promote child's adherence to ART.

DOI： 10.1371/journal.pone.0041998

Other Link： http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0041998

Language：English   Publishing type：Research paper (scientific journal)  

Background: In tropical settings, malaria education at school is potentially useful, but textbook content related to malaria education has so far received little attention. This study aimed to examine whether school textbooks contain sufficient knowledge and skills to help children in primary and lower secondary schools and their family members to cope with malaria.
Methodology/Principal Findings: This was a descriptive, cross-country study. We collected textbooks that were used by children in grades one to nine from nine countries endemic for malaria: Laos, Cambodia, Nepal, Bangladesh, Sri Lanka, Zambia, Niger, Benin, and Ghana. Two reviewers per country identified descriptions about malaria by seeking the term "malaria" or a local word that corresponds to malaria in languages other than English. The authors categorized the identified descriptions according to the content of the descriptions. Additionally, the authors examined whether the identified contents addressed life skill messages. Of a total of 474 textbooks collected, 35 contained descriptions about malaria. The most commonly included content was transmission mode/vector (77.1&#37;), followed by preventive measures (60.0&#37;), epidemiology (57.1&#37;), cause/agent (54.3&#37;), signs/symptoms (37.1&#37;) and treatment (22.9&#37;). Treatment-related content was not included in any textbooks from four countries and textbooks failed to recommend the use of insecticide-treated bed nets in five countries. Very few textbooks included content that facilitated prompt treatment, protection of risk groups, and use of recommended therapy.
Conclusion/Significance: Textbooks rarely included knowledge and skills that are crucial to protect schoolchildren and their families from malaria. This study identified the need for improvement to textbook contents regarding malaria.

DOI： 10.1371/journal.pone.0036629

Other Link： http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0036629

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.5582/bst.2011.v5.6.255

Responsible for pages：pp. 145-163   Language：English   Book type：General book, introductory book for general audience

Event date： 2022.12

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Venue：オンライン   Country：Colombia  

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Venue：Taiwan   Country：Taiwan, Province of China  

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Event date： 2022.9

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Venue：福岡   Country：Japan  

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Event date： 2022.3

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Venue：オンライン   Country：Japan  

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Venue：オンライン   Country：Japan  

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Venue：オンライン   Country：United States  

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Event date： 2021.12

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Venue：オンライン   Country：Japan  

Event date： 2021.12

Language：English   Presentation type：Oral presentation (general)  

Venue：オンライン   Country：Japan  

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性感染症に関する化学反応を利用した体験型ワーク後の海外の医療研修者の意識調査

Language：Japanese  

国際ネットワーク構築に関する経験の紹介

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Type：Peer review 

Number of peer-reviewed articles in foreign language journals：11

Number of peer-reviewed articles in Japanese journals：1

Proceedings of International Conference Number of peer-reviewed papers：1

Proceedings of domestic conference Number of peer-reviewed papers：6

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Number of participants：790

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Number of peer-reviewed articles in foreign language journals：18

Proceedings of International Conference Number of peer-reviewed papers：2

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Type：Competition, symposium, etc. 

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Number of peer-reviewed articles in foreign language journals：7

Number of peer-reviewed articles in Japanese journals：1

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Type：Academic society, research group, etc. 

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Type：Peer review 

Number of peer-reviewed articles in foreign language journals：13

Proceedings of International Conference Number of peer-reviewed papers：7

Type：Competition, symposium, etc. 

Type：Competition, symposium, etc. 

Type：Peer review 

Number of peer-reviewed articles in foreign language journals：5

Proceedings of International Conference Number of peer-reviewed papers：35

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Type：Competition, symposium, etc. 

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Type：Competition, symposium, etc. 

Type：Peer review 

Number of peer-reviewed articles in foreign language journals：7

Number of peer-reviewed articles in Japanese journals：7

Proceedings of International Conference Number of peer-reviewed papers：12

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Portable Health Clinic

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