Objectives: In developing countries, measuring household income is difficult. The Wealth Index is an alternative to household income; however, it contains too many items making its use in a healt-related study difficult. Thus, we developed a shorter version of the index appropriate for rural areas in Cambodia and analyzed the relationship between economic status and maternal health knowledge and behavior using the index.
Methods: We conducted the study in four health center areas in Kampong Cham Province. We administered structured questionnaires to 640 women who had delivered babies within a year prior to the study. The development of the Cambodian Wealth Index-Rural version (CWI-R) followed the procedures of the Demographic and Health Survey (DHS) Wealth Index. Out of 69 items in the Cambodian DHS, we selected 18 items by assessing the distribution and correlation between the items and then performed principal component analysis. Those items that had principal component scores (PCS) below 0.4 were removed. As a result, we created an 11-item wealth index weighted by PCS; Cronbach’s α was 0.81. We tabulated economic status using quintiles and calculated health behavior and the women’s healt-related knowledge for each quintile.
Results: The mean age (SD) of the women was 27.0 (6.4) years. The rate of antenatal and postnatal care and skilled birth attendant increased as economic status improved. Knowledge of risk factors during pregnancy and delivery varied according to item. For prolonged labor and edema, knowledge increased as economic status improved; however, we observed no significant differences for vaginal bleeding. More women who had a higher economic status knew the benefits of Vitamin A and the causes of intestinal parasitic infections.
Conclusion: The pattern of maternal knowledge and behavior analyzed with the CWI-R was parallel to the original wealth index, indicating its usefulness as an alternative to the original wealth index.

Objective: To assess the characteristics and influencing factors of sleep during a prehospitalization period in liver cancer survivors with frequent recurrences. Methods: A sleep pattern and mental health were analyzed in 12 patients who had recurrences of hepatocellular carcinoma during a pre-hospitalization period. Subjective sleep quality was assessed by PSQI-J, and objective sleep quality was measured with a actigraphic method. Results: The mean age of the subjects was 74.1 years and the mean number of recurrence episodes was 3.7. The mean PSQI total score was 6.7. The subjective assessment showed that 50% of the patients had a poor sleep pattern, required more time to fall asleep, had a shorter duration of sleep, and had poor sleep quality. The objective assessment showed that 50% of the patients slept for less than 360 minutes and that the patients did not have disturbance of sleep induction with a sleep latency of 3 to 29 minutes. The mean time of awakening episodes was 3.3. The hypnotic agent, severe fatigue, and poor mental health were identified as factors of the poor sleep pattern, as assessed by the subjective measures, and the hypnotic agent shortened and influenced the time spent awake after falling asleep. The subjective evaluation of sleep demonstrated inconsistency with the objective evaluation of sleep. Namely the patients with poor sleep pattern had higher sleep efficiency and significant short awakening times. Conclusion: The sleep pattern in liver cancer survivors was influenced by the hypnotic agent, mental health, and fatigue.