Background: The lack of information regarding nonfatal agricultural injuries has been recognized as an obstacle for effective injury prevention. The aim of this study was to describe gender differences in the pattern of nonfatal agricultural injuries between the years 2008 and 2009.Methods: Farmers’ compensation injury claims were utilized to determine the mechanisms involved (machinery, non-machinery, and traffic), types of accident, sources of injury, kinds of injury, body parts affected place of injury, work being performed at the time of injury, and length of hospitalization. Agricultural injuries were identified using the International Classification of External Causes of Injury (ICECI). The Statistical Analysis System (SAS) software was used for all statistical analyses. Study variables were compared using the Mantel-Haenszel chi-square test.Results: A total of 2,729 (1,921 males) farmers’ compensation injury claims were analyzed. There were approximately 9 times as many nonfatal agricultural machinery injuries in males compared with females. The most common machinery injuries were cuts resulting from a rotary blade (31%) for males and injuries caused by being struck by a machine (24%) for females in the 65–89 years of age group. The male:female ratio of non-machinery injuries averaged 2:1 (actual numbers of 1,293 and 676, respectively), but the percentage was higher for females (83.7%) than males (67.3%). For both males and females in the 65–89 years of age group, the main source of non-machinery injuries was slopes, the main type of accident was falling/slipping, the leading kind of injury was fracture, and the main work being performed was harvesting. Female farmers had a greater risk of prolonged hospitalization (more than 30 days) compared with males (p < 0.05).Conclusions: Gender is an important factor to consider in the interpretation of nonfatal agricultural injuries. A greater number of males had machinery injuries than females; however, a higher percentage of females had non-machinery injuries than males. Further research will be needed to understand the role of differential job tasks within agriculture in explaining the difference in risk.

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Objective: This study aimed to examine changes in utilization of reproductive health services by wealth status from 2000 to 2011 in Vietnam.Methods: Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. The subjects were 550, 1023, and 1363 women, respectively, aged between 15 and 49 years who had given birth in the previous one or two years. The wealth index, a composite measure of a household’s ownership of selected assets, materials used for housing construction, and types of water access and sanitation facilities, was used as a measure of wealth status. Main utilization indicators were utilization of antenatal care services, receipt of a tetanus vaccine, receipt of blood pressure measurement, blood examination and urine examination during antenatal care, receipt of HIV testing, skilled birth attendance at delivery, health-facility-based delivery, and cesarean section delivery. Inequalities by wealth index were measured by prevalence ratios, concentration indices, and multivariable adjusted regression coefficients.Results: Significant increase in overall utilization was observed in all indicators (all p < 0.001). The concentration indices were 0.19 in 2000 and 0.06 in 2011 for antenatal care, 0.10 in 2000 and 0.06 in 2011 for tetanus vaccination, 0.23 in 2000 and 0.08 in 2011 for skilled birth attendance, 0.29 in 2006 and 0.12 in 2011 for blood examination, and 0.18 in 2006 and 0.09 in 2011 for health-facility-based delivery. The multivariable adjusted regression coefficients of reproductive health service utilization by wealth category were 0.06 in 2000 and 0.04 in 2011 for antenatal care, 0.07 in 2000 and 0.05 in 2011 for skilled birth attendance, and 0.07 in 2006 and 0.05 in 2011 for health-facility-based delivery.Conclusions: More women utilized reproductive health services in 2011 than in 2000. Inequality by wealth status in utilization of antenatal care, skilled birth attendance, and health-facility-based delivery had been reduced.

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Objective: Assistance from health professionals is very important to ensure medication adherence among older people. The present study aimed to assess the relationship between receipt of comprehensive medication management services by primary care physicians and medication adherence among community-dwelling older people in rural Japan.Methods: Data including medication adherence and whether or not a doctor knew all the kinds of medicines being taken were obtained from individuals aged 65 years or older who underwent an annual health checkup between February 2013 and March 2014 at a public clinic in Asakura. The subjects were divided into 2 groups: adherent (always) and non-adherent (not always). A logistic regression analysis was performed to assess the association between the presence of a doctor who was fully responsible for medication adherence and self-reported adherence. Predictors that exhibited significant association (p-value < 0.05) with medication adherence in a univariate analysis were entered in the model as possible confounding factors. The results were presented as odds ratios (OR) and 95% confidence intervals (CI).Results: Among four-hundred ninety-seven subjects in total, the adherent group included 430 subjects (86.5%), and its members were older than those of the non-adherent group. Significant predictors of good medication adherence included older age, no discomforting symptoms, eating regularly, diabetes mellitus and having a doctor who knew all the kinds of medicines being taken. After being adjusted for confounding variables, the subjects with a doctor who knew all the kinds of medicines they were taking were three times more likely to be adherent to medication (OR 3.01, 95% CI 1.44-6.99).Conclusion: Receipt of comprehensive medication management services for older people was associated with medication adherence.

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Cerebral amyloid angiopathy (CAA) is observed in most cases of nonhypertensive subcortical hemorrhage involving elderly patients. We herein describe the case of a female in whom a convexal subarachnoid hemorrhage was observed at 55 years of age. The cerebral hemorrhage occurred repeatedly; however, no obvious vascular lesions were observed on a cerebral angiography, and no signs of microbleeding or lesions in the deep white matter were identified on magnetic resonance imaging (MRI). Partial excision of the right frontal cortex and hematoma evacuation were performed, and histopathological examination showed deposition of an acidophilic substance with positive staining for Direct Fast Scarlet (DFS) in the cerebral vascular wall. Finally, brain hemorrhage due to CAA was diagnosed. This case suggests that CAA is an important differential diagnosis in patients with localized non-aneurysmal subarachnoid hemorrhage in the convexity sulcus.

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