The establishment of a sustainable healthcare system based on residents’ needs is an urgent issue in a rural region. For this purpose, considering the structure of a healthcare system, such as the numbers of beds, doctors, and nurses is important. In addition, the study of healthcare utilization using the date gathered through geographic information systems (GIS) would be very helpful in building such a healthcare system. In Japan, however, there are few published studies available on how health services are utilized. The aim of this paper was to review articles of GIS research on healthcare utilization. We conducted a systematic search of published peer-reviewed literature on PubMed. We found 38 articles that satisfied our inclusions criteria for review. Of them, 12 articles had a map for understanding health needs or demands, 23 articles carried analyses of distance and time for health utilizations, and seven articles had a buffer or database for analyses of healthcare utilization. Most of these articles have dealt with pediatric care and emergency care. Given the aging population in a rural region, we concluded that a more evidence-based approach should be taken to rural health focussing on lifestyle-related diseases.

Workers and employers in the informal economy are often outside the scope of legal frameworks of occupational safety and health (OSH) service in South Asia. The present study aimed to find practical support measures to improve their safety and health. International Labour Organization’s participatory training activities in five selected informal economy workplaces comprising waste collection and recycling in India, sewage cleaning in Pakistan, home-based manufacturing in Nepal, small-scale construction in Nepal, and cotton farming in India were studied. The common steps taken in the training were collaboration with local trade unions and employer organizations to reach informal economy workplaces, collection of local good practices in OSH for designing participatory training contents, training worker and employer OSH trainers, assisting trained worker and employer trainers in conducting cascading training activities in their own workplaces, and follow-up visits for support and sustainability. It was found that working with local trade unions and employer organizations had the strong potential to reach various informal economy workplaces. Applying the easy-to-apply participatory training methodologies was vital in delivering practical OSH support.

Workers and employers in the informal economy are often outside the scope of legal frameworks of occupational safety and health (OSH) service in South Asia. The present study aimed to find practical support measures to improve their safety and health. International Labour Organization’s participatory training activities in five selected informal economy workplaces comprising waste collection and recycling in India, sewage cleaning in Pakistan, home-based manufacturing in Nepal, small-scale construction in Nepal, and cotton farming in India were studied. The common steps taken in the training were collaboration with local trade unions and employer organizations to reach informal economy workplaces, collection of local good practices in OSH for designing participatory training contents, training worker and employer OSH trainers, assisting trained worker and employer trainers in conducting cascading training activities in their own workplaces, and follow-up visits for support and sustainability. It was found that working with local trade unions and employer organizations had the strong potential to reach various informal economy workplaces. Applying the easy-to-apply participatory training methodologies was vital in delivering practical OSH support.

Workers and employers in the informal economy are often outside the scope of legal frameworks of occupational safety and health (OSH) service in South Asia. The present study aimed to find practical support measures to improve their safety and health. International Labour Organization’s participatory training activities in five selected informal economy workplaces comprising waste collection and recycling in India, sewage cleaning in Pakistan, home-based manufacturing in Nepal, small-scale construction in Nepal, and cotton farming in India were studied. The common steps taken in the training were collaboration with local trade unions and employer organizations to reach informal economy workplaces, collection of local good practices in OSH for designing participatory training contents, training worker and employer OSH trainers, assisting trained worker and employer trainers in conducting cascading training activities in their own workplaces, and follow-up visits for support and sustainability. It was found that working with local trade unions and employer organizations had the strong potential to reach various informal economy workplaces. Applying the easy-to-apply participatory training methodologies was vital in delivering practical OSH support.

Workers and employers in the informal economy are often outside the scope of legal frameworks of occupational safety and health (OSH) service in South Asia. The present study aimed to find practical support measures to improve their safety and health. International Labour Organization’s participatory training activities in five selected informal economy workplaces comprising waste collection and recycling in India, sewage cleaning in Pakistan, home-based manufacturing in Nepal, small-scale construction in Nepal, and cotton farming in India were studied. The common steps taken in the training were collaboration with local trade unions and employer organizations to reach informal economy workplaces, collection of local good practices in OSH for designing participatory training contents, training worker and employer OSH trainers, assisting trained worker and employer trainers in conducting cascading training activities in their own workplaces, and follow-up visits for support and sustainability. It was found that working with local trade unions and employer organizations had the strong potential to reach various informal economy workplaces. Applying the easy-to-apply participatory training methodologies was vital in delivering practical OSH support.

Workers and employers in the informal economy are often outside the scope of legal frameworks of occupational safety and health (OSH) service in South Asia. The present study aimed to find practical support measures to improve their safety and health. International Labour Organization’s participatory training activities in five selected informal economy workplaces comprising waste collection and recycling in India, sewage cleaning in Pakistan, home-based manufacturing in Nepal, small-scale construction in Nepal, and cotton farming in India were studied. The common steps taken in the training were collaboration with local trade unions and employer organizations to reach informal economy workplaces, collection of local good practices in OSH for designing participatory training contents, training worker and employer OSH trainers, assisting trained worker and employer trainers in conducting cascading training activities in their own workplaces, and follow-up visits for support and sustainability. It was found that working with local trade unions and employer organizations had the strong potential to reach various informal economy workplaces. Applying the easy-to-apply participatory training methodologies was vital in delivering practical OSH support.

BACKGROUND/AIMS: Although the risk of bleeding after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is low, the safety of EUS-FNA in patients prescribed antithrom-botic agents is unclear. Therefore, this study evaluated the incidence of bleeding after EUS-FNA in those patients. METHODS: Between September 2012 and September 2015, patients who were prescribed antithrombotic agents underwent EUS-FNA at 13 institutions in Japan were prospectively enrolled in the study. The antithrombotic agents were managed according to the guidelines of the Japanese Gastrointestinal Endoscopy Society. The rate of bleeding events, thromboembolic events and other complications within 2 weeks after EUS-FNA were analyzed. RESULTS: Of the 2,629 patients who underwent EUS-FNA during the study period, 85 (62 males; median age, 74 years) patients were included in this stduy. Two patients (2.4%; 95% confidence interval [CI], 0.6% to 8.3%) experienced bleeding events. One patient required surgical intervention for hemothorax 5 hours after EUS-FNA, and the other experienced melena 8 days after EUS-FNA and required red blood cell transfusions. No thromboembolic events occurred (0%; 95% CI, 0.0% to 4.4%). Three patients (3.5%; 95% CI, 1.2% to 10.0%) experienced peri-puncture abscess formation. CONCLUSIONS: The rate of bleeding after EUS-FNA in patients prescribed antithrombotic agents might be considerable.
Abscess ; Asian Continental Ancestry Group ; Endoscopic Ultrasound-Guided Fine Needle Aspiration* ; Endoscopy, Gastrointestinal ; Erythrocyte Transfusion ; Fibrinolytic Agents* ; Hemorrhage* ; Hemothorax ; Humans ; Incidence ; Japan ; Male ; Melena ; Prospective Studies*