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% 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% did not receive any care during pregnancy, delivery, and after birth. The highest discontinuation rate was at the postnatal care stage (73.6%). Not receiving any perinatal care was associated with neonatal complications at 6 weeks after birth (adjusted odds ratio [AOR]: 3.075; 95% 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% 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.
To investigate the impact of overtime work, sleep duration, and perceived job characteristics on physical and mental status, a cross-sectional study was conducted on 377 workers (average age; 28 years old) in an information-technology (IT) company, engaged in consultation, system integration solution, and data management relevant to IT system. The psychophysical outcomes of overtime work were assessed using the Hamilton Depression Scale (HDS), Profile of Mood Status (POMS), major physical symptoms, and overtime work data for the preceding three-months. Sleep duration was directly asked by a physician. A job strain index was defined as the ratio of job-demands to jobcontrol scores evaluated using the Job Content Questionnaire (JCQ). In a univariate analysis, overtime work was significantly related with HDS scores, POMS anger-hostility scores, and the total physical symptom count in both sexes (all p<0.05), but not in multiple regression models, after controlling for sleep duration and the job strain index. Sleep duration was negatively related to the symptom count in men and to POMS tension-anxiety scores in women (both p<0.05); the job strain index was positively related to POMS anger-hostility scores in both sexes and to HDS scores and POMS tension-anxiety scores in men (all p<0.05). Although overtime work was associated with physical and mental complaints, sleep duration and the job strain index seemed to be better indicators for physical and mental distress in overloaded workers.
This study examined the relationship between arterial stiffness and autonomic nervous function in a young population. A cross-sectional study was conducted on 382 Japanese males, aged 24 to 39 years, who worked at the same information service company. Brachial-ankle pulse wave velocity (baPWV) was measured using an automatic waveform analyzer, and the spectral power of heart rate variability in the low frequency (LF: 0.04-0.15 Hz) and the high frequency (HF: 0.15-0.40 Hz) band was evaluated by the maximum entropy method. LF/HF and HF were used as the indicators of sympathetic and parasympathetic nervous activity, respectively. Psycho-hormonal responses were examined by the Profile of Mood State (tension-anxiety and anger-hostility scales) and Hamilton's Depression Scale with serum cortisol and catecholamine levels. In a univariate analysis, baPWV was positively associated with the following variables (all p <0.05): LF/HF, age, body mass index, systolic and diastolic blood pressures, heart rate, serum total cholesterol and triglycerides, blood glucose, and plasma cortisol and noradrenaline. Multiple regression analysis indicated that LF/HF was an independent predictor of baPWV (p <0.05), after controlling for significant effects of age, systolic blood pressure, and plasma noradrenaline levels. There was no significant effect of HF on baPWV in this multivariate analysis. Neither mood state nor health-related lifestyle factors such as smoking were significant. It was suggested that baPWV is closely associated with sympathetic nervous activity in young men.
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