Background: The poor coverage of essential maternal services, such as antenatal care (ANC) and skilled delivery care utilization, accounts for higher maternal and infant mortality in low- and middle-income countries (LMICs). Although mobile health (mHealth) interventions could potentially improve the service utilization in resource-limited settings, their effectiveness remains unclear. Objective: This review aimed to summarize the effect of mHealth interventions on improving the uptake of ANC visits, skilled birth attendance at the time of delivery, and facility delivery among pregnant women in LMICs. Methods: We conducted a comprehensive search on 9 electronic databases and other resources from inception to October 2020. We included individual randomized controlled trials and cluster randomized controlled trials that assessed the effectiveness of mHealth interventions for improving perinatal health care utilization among healthy pregnant women in LMICs. We performed a random-effects meta-analysis and estimated the pooled effect size by using risk ratios (RRs) with 95% CIs. In addition, 2 reviewers independently assessed the risk of bias of the included studies by using the Cochrane risk of bias tool and the certainty of the evidence by using the Grading of Recommendation, Assessment, Development and Evaluation approach. Results: A total of 9 studies (10 articles) that randomized 10,348 pregnant women (n=6254, 60.44% in the intervention group; n=4094, 39.56% in the control group) were included in this synthesis. The pooled estimates showed a positive effect of mHealth interventions on improving 4 or more ANC visit utilizations among pregnant women in LMICs, irrespective of the direction of interventions (1-way communications: RR 2.14, 95% CI 1.76-2.60, I2=36%, 2 studies, moderate certainty; 2-way communications: RR 1.17, 95% CI 1.08-1.27, I2=59%, 3 studies, low certainty). Only 2-way mHealth interventions were effective in improving the use of skilled birth attendance during delivery (RR 1.23, 95% CI 1.14-1.33, I2=0%, 2 studies, moderate certainty), but the effects were unclear for 1-way mHealth interventions (RR 1.04, 95% CI 0.97-1.10, I2=73%, 3 studies, very low certainty) when compared with standard care. For facility delivery, the interventions were effective in settings where fewer pregnant women used facility delivery (RR 1.68, 95% CI 1.30-2.19, I2=36%, 2 studies, moderate certainty); however, the effects were unclear in settings where most pregnant women already used facility delivery (RR 1.01, 95% CI 0.97-1.04, I2=0%, 1 study, low certainty). Conclusions: mHealth interventions may contribute to improving ANC and skilled delivery care utilization among pregnant women in LMICs. However, more studies are required to improve their reproducibility and efficiency or strengthen the evidence of different forms of mHealth interventions because of the considerable heterogeneity observed in the meta-analyses. Trial Registration: PROSPERO CRD42020210813; https://tinyurl.com/2n7ny9a7

Background: Ensuring good health of immigrants is a serious issue across countries, including Japan. This study focused on the health of middle-aged female immigrants in Japan who experienced changes to their health as well as an increased risk of non-communicable diseases. Specifically, the study aimed to clarify the risks and perceptions of non-communicable diseases and health promotion behavior of middle-aged female immigrants in Japan. Methods: This investigation used an exploratory design. The participants were a purposive sample of 35 middle-aged female immigrants (age ≥ 40 years) living in urban and rural areas of Japan. Data were generated using mixed methods. A quantitative approach provided data of their risks of non-communicable diseases. Focus group discussions provided insights to identify their health promotion perceptions. Results: Blood pressure measurement revealed that 29% of the immigrants had hypertension, 29% had a body mass index of > 30, and 71% had an abdominal girth of > 80 cm. About 31% had a history of chronic disease and 34% had regular medication. There were 80% who received regular health check-up, 49% who received breast cancer screening, and 34% who received cervical cancer screening. The focus group discussions indicated that the middle-aged female immigrants recognized the threat of non-communicable diseases. However, they lacked knowledge about the prevention of non-communicable diseases, and they felt that non-communicable diseases were unavoidable. They also failed to understand the benefits of health promotion behavior. The study revealed that the monolingual Japanese health service prevented immigrant women from understanding their health check-up and cancer screening results, and how to utilize the health service system. Conclusions: Middle-aged female immigrants in Japan had potential risks of non-communicable diseases, and recognized their threat. These settled immigrant women received health check-ups and cancer screenings with the support of their family, and consequently attained the same level of adherence as that of Japanese women. However, lack of knowledge about health promotion and its benefits and the absence of a culturally sensitive health service system for immigrants in Japan constrained their health-promotion behavior. Sociocultural multilingual-tailored interventions including interpretation services by care providers with cultural sensitivities must be developed.

Previous studies have indicated that people with malignant pleural mesothelioma (MPM) have a poor quality of life (QOL); however, information about the QOL of people with MPM in Japan is anecdotal. The aims of this study were to investigate the QOL of survivors of MPM in Japan and to determine the factors that correlate with their QOL. This was a cross sectional study. The included patients were those diagnosed with MPM in Japan. We created a self-administered questionnaire consisting of 64 questions. The questionnaires were sent to hospitals and patient advocacy groups, distributed to the patients, completed, and sent back to the researchers by postal mail. QOL was assessed with the European Organization for Research and Treatment of Cancer 16 questionnaire (QLQ) and the short version of the core domains of the Comprehensive Quality of Life Outcome questionnaire (CoQoLo). In total, 133 questionnaires were collected. The QLQ assessments demonstrated that the survivors of MPM most frequently complained of fatigue, pain, sleep disturbances, and dyspnea. The symptom scales were acceptable, but the functional scales were significantly poorer for the patients with poor performance statuses (PSs). The short CoQoLo assessment was very unfavorable for ‘Being free from physical pain.’ Being a long-term survivor and a survivor with a poor PS were significantly correlated with poor global health status. Survivors of MPM have impaired function, a variety of symptoms, and lower QOL. Survivors of MPM, even those in good physical condition, need broad support.

Purpose: In japan nursing care lags behind the growing population of patients with malignant pleural mesothelioma. This study evaluated an educational program for nurses about caring for patients with malignant pleural mesothelioma in Japan. Method: In this randomized controlled study relative to care for malignant pleural mesothelioma, Knowledge, Difficulties and Attitude were measured at baseline, at post-test and at follow-up one month later. The two-day program with a half-day follow-up program included lectures, group work, role-playing and group discussion. 188 participants were randomly assigned to the intervention group (program, n = 96) and control group (n = 92; self-study by a similar content handbook). At baseline the groups showed no statistical differences in Knowledge (p = 0.921), Difficulty (p = 0.458) and Attitude (p = 0.922). Completing the study were 177 participants yielding 88 in the intervention group and 89 in the control group. Human rights and privacy of participants were protected. Results: The Knowledge score was significantly higher in the intervention post-test (t = 14.03, p = 0.000) and follow-up test (t = 8.98, p = 0.000). Difficulty score was significantly lower in the intervention at post-test (t = -3.41, p = 0.001) and follow-up test (t = -3.70, p = 0.000). The Attitude score was significantly higher in the intervention post-test (t = 7.11, p = 0.000) and follow-up test (t = 4.54, p = 0.000). The two-way analysis of variance with repeated measures on time showed an interaction between time and group; the subsequent simple main effect test found significant differences (p = 0.000-0.001) between groups for after-program and at follow-up and a significant difference (p = 0.000) in time only within the intervention group. Conclusion: The educational program was effective in improving the nurses' knowledge and attitude toward malignant pleural mesothelioma care and decreasing the difficulty in MPM care, therefore this program has potential for nurses' in-service education throughout japan. (C) 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-SA license (http://creativecommons.org/licenses/by-nc-sa/3.0/).

Objectives: we investigated the prevalence and associated factors of depression and complicated grief (CG) among bereaved family members of malignant pleural mesothelioma (MPM) patients in Japan. Methods: Bereaved family members of MPM patients (n = 72) were surveyed. The Japanese version of the Patient Health Questionnaire-9 (PHQ-9) and the Japanese version of the Brief Grief Questionnaire (BGQ) were used to assess depression and complicated grief (CG), respectively. Socio-economic factors, anger toward asbestos, care satisfaction, achievement of good death, and quality of end-of-life care were assessed in relation to depression and CG. Results: In the family members of MPM patients, the frequencies of depression and CG were 19.4% and 15.3%, respectively. The bereaved family members who were not compensated by the asbestos-related health-damage relief system (p = 0.018) and who felt the financial impacts of the patient’s MPM on the family (p = 0.006) had a higher likelihood of depression. The bereaved family members who were not satisfied with the care given when the patient became critical (p = 0.034), who were not compensated by the asbestos-related health-damage relief system (p = 0.020), who felt the financial impact of the patient’s MPM on the family (p = 0.016), and whose deceased relative underwent surgery (p = 0.030) had a higher likelihood of CG. Conclusions: For bereaved family members of MPM patients, routine screening for depression and CG and the provision of grief care are suggested. In addition, for family members of MPM patients, financial support, including the promotion of the asbestos-related health-damage relief system, and improved care for patients who undergo surgery and when patients become critical, are recommended.

Malignant pleural mesothelioma (MPM) is a fatal and rare disease that is caused by the inhalation of asbestos. Treatment and care requests made by MPM patients to their physicians were collected and analyzed. This cross-sectional survey was part of a larger study (N = 133) regarding the quality of life of MPM patients. Specific responses to two open-ended questions related to patients’ requests regarding treatment and care were quantified, analyzed and divided into categories based on content. Responses (N = 217) from MPM patients (N = 73) were categorized into 24 subcategories and then abstracted into 6 categories. The majority of requests were related to patient-physician communication. Patients wanted clear and understandable explanations about MPM and wanted their physician to deliver treatment based on the patient’s perspective by accepting and empathizing with their anxiety and pain. Patients expected physicians to be dedicated to their care and establish an improved medical support system for MPM patients. Patients with MPM had a variety of unmet needs from their physicians. Physicians who provide care to MPM patients should receive training in both communication skills and stress management. A multidisciplinary care system that includes respiratory and palliative care for MPM patients should be established.