The Project for Improving Maternal and Newborn Care through Midwifery Capacity Development by Japan International Cooperation Agency (JICA) was initiated for capacity building through pre-and post-service midwifery training.
  Firstly, we have shared the concept of ideal midwifery care based on the definition of evidence-based medicine (EBM) with our counterparts, which involves the integration of the best research evidence with clinical expertise and patient values. In addition to evidence-based midwifery care, we tried to provide individualized woman-centered care.
  After sharing these concepts in our project sites, we tried to modify the lectures on the basic concepts of midwifery care in the Health Center Midwifery Training program, and care providers’ attitudes based on EBM in the Basic Emergency Obstetric and Neonatal Care Training program.
  Our trial is an essential first step towards the further reduction of maternal mortality in Cambodia.

Physicians expect nurses to be able to understand electrocardiographic (ECG) findings.However, many nurses have difficulty learning how to interpret ECGs.We suspect that the reason for such difficulty might be the nurses'mental responses to ECGs, rather than improper teaching methods.
1) We performed a questionnaire survey to investigate the mental responses to ECGs based on the responses of 197 experienced nurses and 43 new nurses and on an additional survey of 37 nurses who took ECG evaluation tests.
2) Almost all nurses recognized the necessity and importance of understanding ECG findings, and most wished to master ECGs.On the other hand, many nurses said that they disliked ECGs and did not feel competent interpreting ECGs.In particular, their perceived lack of competence in interpreting ECGs was greater than their dislike of ECGs.
3) The nurses'perceived lack of competence interpreting ECGs tended to result from feelings that developed during nursing school.Many nurses continued to have such feelings even after they began working.
4) Nurses with a poor understanding of ECGs reported many factors as being associated with their perceived lack of competence.In addition, such negative feelings toward ECGs (such as fear of making a mistake) made these nurses avoid ECGs.We believe that these feelings were likely a factor in why many nurses had difficulty mastering ECGs.
5) Nurses should be provided with appropriate ECG training that carefully considers the perceived incompetence and fear of many nurses regarding ECGs.

The aim of the present study is to clarify the improvement of peripheral muscle oxygen consumption after successful renal transplantation. We investigated change of forearm (brachioradial muscle) muscular oxygen consumption in chronic renal failure children before and after renal transplantation. by using near-infrared spectroscopy.Oxygen consumption of brachioradial muscle was increased significantly after succesful renal transplantation. And half recovery time of brachioradial muscle oxygenation in arterial occlusion and exercise were decreased after renal transplantation.These results suggest that increased muscular blood flow and increased oxidative generation of ATP might contribute to the increased oxygen turn over after renal transplantation.

Methods: We evaluated the translation and back translation of the EOSQ-24 and made the required revisions as per the analysis performed by the expert committee and an international guideline to adapt it for use in this study. Thereafter, we recruited 100 EOS patients in order to evaluate its reliability and validity. The reliability was assessed with internal consistency. Convergent validity was assessed by comparing the scores of the EOSQ-24 and the 22-item Scoliosis Research Society Questionnaire (SRS-22r). Finally, the known groups validity was assessed as per patient’s sex, curve magnitude, and treatment type. Results: The Persian EOSQ-24 demonstrated very good internal consistency (Cronbach’s α=0.88). All the items had an acceptable corrected item-total correlation (>0.3). Further, the EOSQ-24 and the SRS-22r scores (p <0.001) were significantly correlated. The EOSQ-24 could discriminate patients with different curve magnitudes. Conclusions The Persian EOSQ-24 can serve as a disease-specific instrument with strong validity and reliability in the evaluation of EOS patients. Its applicability in other Persian-speaking countries and regions of the world needs to be investigated further.

Early detection of third-generation cephalosporin-resistant bacteria in blood culture tests influences the choice of antimicrobial agents. We report on our hospital’s system for early reporting of third-generation cephalosporin-resistant bacteria and its utility. The hospital operates a 24-h simple cefpodoxime (CPDX) testing system, where the content of a sample container with a positive blood culture result is smeared on a CA Sheep Blood Agar/VCM Chocolate EX II fractionation medium, and an antibiotic susceptibility test (AST) disk (Sensi-Disk CPDX) is placed at the center of the medium and incubated. The presence or absence of third-generation cephalosporin-resistant bacteria is estimated from the diameter of the growth inhibition zone. The physician in charge of AST makes comments on the chart based on the simple CPDX test results. The sensitivity of the simple CPDX test for detecting third-generation cephalosporin-resistant bacteria, based on AST results, was 95.5%. Among patients with failed antimicrobial therapy, the rate of switching antimicrobials before the AST results were known was 57.9% in cases where there were comments made by the physicians in charge of AST, compared with 42.9% in cases without comments. These results suggest that the simple CPDX test enables early and accurate detection of third-generation cephalosporin-resistant bacteria, facilitating early switching of antimicrobial agents through collaboration with physicians in charge of AST.