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Barriers and facilitators for preventing motherto-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR)
Get PDF論文(Article)Background Mother-to-child transmission (MTCT) of Trypanosoma cruzi and hepatitis B virus (HBV) increases morbidity and disability in Latin America and the Caribbean. The tailormade comprehensive antenatal care based on the Framework for the elimination of MTCT of HIV, syphilis, hepatitis B virus (HBV), and Chagas disease (EMTCT Plus) has been implemented in the region since 2018 through a private-public partnership. This study aimed to estimate the effectiveness of the intervention in preparing MTCT of T. cruzi and hepatitis B. The study further attempted to identify the barriers to and facilitators for preventing MTCT of T. cruzi and HBV in the Gran Chaco region of Argentina and Paraguay.
Methods Data on T. cruzi and HBV screening and treatment among pregnant women and infants were collected from antenatal care (ANC) registries between June 2018 and December 2022. A cascade-of-care analysis was applied to assess the intervention’s effectiveness and identify bottlenecks. Additionally, key informant interviews were conducted for both implementors and service recipients to identify barriers to and facilitators for accessing screening and treatment using the Consolidated Framework for Implementation Research.
Results A total of 1,658 pregnant women were recruited, achieving 100% antenatal care coverage and screening for T. cruzi and HBV. The prevalence of T. cruzi among pregnant women was 3.3% (95%CI: 2.4-4.1%), while in newborns it was 14.0% (95% CI: 6.0–25.0). Treatment coverage for newborns infected with T. cruzi was 100%, whereas postdelivery treatment coverage among mothers was 67.3%. This achievement was likely attributed to strong community engagement, contributing to 100% ANC coverage. However, barriers such as a fragile local health system, long-term follow-up requirements, high mobile populations, cultural beliefs, and social trauma were identified in target areas.journal articl
Development of an Original Three-Dimensional Computed Tomography Scan Method and Imaging Process for Surgical Support of Anterior Cruciate Ligament
Get PDF論文(Article)Three-dimensional computed tomography (3D CT) scan images are useful as they can provide information essential for surgical support particularly in orthopedic surgery. In case of anterior cruciate ligament reconstruction, 3D CT scan is important in preoperative simulation. Further, it is associated with a reduced risk of revision surgery because the angle of the foramen magnum changes with the femoral muscle mass. However, the CT scan system geometry has several limitations. For example, the patient’s posture is limited during the procedure. Herein, we report an original CT scan method and 3D imaging process for surgical support of anterior cruciate ligament.journal articl
アイトラッキングシステムを用いた熟達投手コーチの「みえ」の顕在化
Get PDF論文(Article)本研究はアイトラッキングシステムを用いて，野球における熟達投手コーチの有する投手指導技術に関する「みえ」をその視点と発話により顕在化させることを目的とした．その結果，「熟達投手コーチに頻出の６つの発話が存在すること」や「熟達投手コーチは投球中“非投球腕”，“ピボット脚”，“骨盤”の順に視点を置く回数が多いこと」，「それらの視点を置く回数は投球局面によって，各身体部位で特徴があること」などが明らかになった．本研究では，先行研究とは異なる方法論で投手指導技術に関する「みえ」の顕在化を試みたが，先行研究が対象とした熟達指導者の「みえ」と共通する部分については，投手指導技術における基本的な着眼点となる可能性がある．指導者の投手育成能力の向上のためにも，様々な方法で投手指導に関する「みえ」を顕在化させ，投手指導の評価法を確立するための基礎資料を増やしていく必要がある．The current study aims to make manifest the skilled pitching coach’s “seeing” in the process of training a baseball pitcher using their gaze and utterance. The study has found that “there are six types of utterances frequently used by the skilled pitching coaches,” “the skilled pitching coaches often focus on ‘the non-pitching arm,’ ‘the pivoting leg,’ and ‘the pelvis,’ in this order, during pitching,” and “the frequency of focusing on different parts of the body depends on the phase in pitching.” This study differs from extant studies on manifestation the skilled pitching coach’s “seeing” in that it utilizes a different methodology. However, the present study is similar with previous studies in its perception of the skilled pitching coach’s “seeing” as the basis of pitcher training technique.
In order to improve the ability of instructors to develop pitchers, it is necessary to increase the number of basic data for establishing evaluation methods for pitching coaching by making the “seeing” of pitching coaching apparent in various ways.journal articl
Analysis of Speech Features in Alzheimer’s Disease with Machine Learning: A Case-Control Study
Get PDF論文(Article)Background: Changes in the speech and language of patients with Alzheimer’s disease (AD) have been reported. Using machine learning to characterize these irregularities may contribute to the early, non-invasive diagnosis of AD. Methods: We conducted cognitive function assessments, including the Mini-Mental State Examination, with 83 patients with AD and 75 healthy elderly participants, and recorded pre- and post-assessment conversations to evaluate participants’ speech. We analyzed the characteristics of the spectrum, intensity, fundamental frequency, and minute temporal variation (Δ) of the intensity and fundamental frequency of the speech and compared them between patients with AD and healthy participants. Additionally, we evaluated the performance of the speech features that differed between the two groups as single explanatory variables. Results: We found significant differences in almost all elements of the speech spectrum between the two groups. Regarding the intensity, we found significant differences in all the factors except for the standard deviation between the two groups. In the performance evaluation, the areas under the curve revealed by logistic regression analysis were higher for the center of gravity (0.908 ± 0.036), mean skewness (0.904 ± 0.023), kurtosis (0.932 ± 0.023), and standard deviation (0.977 ± 0.012) of the spectra. Conclusions: This study used machine learning to reveal speech features of patients diagnosed with AD in comparison with healthy elderly people. Significant differences were found between the two groups in all components of the spectrum, paving the way for early non-invasive diagnosis of AD in the future.journal articl
医療提供の地域格差解消に向けたオンライン診療（D to P with N）の可能性～新潟県粟島浦村におけるフィールドワークを通して～
Get PDF日本の社会課題である医師の不足や偏在に対する解決策の１ つとしてオンライン診療がある。新型コロナウイルス感染症の拡大を契機に、実施の条件が緩和され、へき地や離島以外でも活用されるようになった。しかし、認知度やサービス利用のハードルから、国内においては普及が進んでいない。本稿では、先行事例や新潟県粟島浦村でのフィールドワークを通して、オンライン診療の普及に向けた対策について検討を行う。結論として、看護師がオンライン診療に介在することがオンライン診療の普及に向けて重要である一方で、看護師の業務は多岐にわたるため負担が大きく継続的な医療サービスの提供には課題があることを確認した。departmental bulletin pape
Impact of the contraction of medial forearm muscles during grip tasks in different forearm positions on medial support at the elbow joint
Get PDF新潟医療福祉大学Niigata University of Health and Welfare博士(保健学)application/pdfJournal of Electromyography and Kinesiology. 2023, 71, p. 102783-.甲第103号doctoral thesi
Comparison of environment and attitudes toward childbirth and childcare of women living in the lowest and highest-TFR (total fertility rate) areas in Japan: synergy analyses of quantitative and qualitative data
Get PDF新潟医療福祉大学Niigata University of Health and Welfare博士(保健学)application/pdfNiigata Journal of Health and Welfare. 2024, 23(2), p. 45-64.甲第109号doctoral thesi
