Challenges faced by community health nurses to achieve universal health coverage in Myanmar: A mixed methods study.

OBJECTIVE: This study aimed to identify the challenges of community health nurses (CHNs) in delivering effective community health care to achieve universal health coverage (UHC) in Myanmar. METHODS: A total of 30 CHNs from township health centers in the northeastern, southern, and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews. Quantitative data were processed using Microsoft Excel software, and qualitative data were analyzed using thematic analysis. This study is registered with researchregistry6201. RESULTS: Around the country, 30 CHNs uncovered their hardships in implementing primary health care to achieve UHC. Over 90% of the participants agreed to the problem of inadequate health infrastructure, while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion. Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services. Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidence-based practices. Insecure work and living conditions, unsupportive community relationships, and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC. Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs. CONCLUSION: Myanmar's CHNs face many challenges in achieving UHC. These challenges are not confined to the health sector. Some situations, such as geographical barriers and transportation problems, remain persistent challenges for healthcare providers. This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure. Meanwhile, public empowerment plays a critical role in promoting health development.

Psychometric Properties of the Death Anxiety Scale-Extended among Patients with End-Stage Renal Disease.

This study aimed to evaluate the validity and reliability of the Persian version of Death Anxiety Scale-Extended (DAS-E). A total of 507 patients with end-stage renal disease completed the DAS-E. The factor structure of the scale was evaluated using exploratory factor analysis with an oblique rotation and confirmatory factor analysis. The content and construct validity of the DAS-E were assessed. Average variance extracted, maximum shared squared variance, and average shared squared variance were estimated to assess discriminant and convergent validity. Reliability was assessed using Cronbach's alpha coefficient (α = .839 and .831), composite reliability (CR = .845 and .832), Theta (θ = .893 and .867), and McDonald Omega (Ω = .796 and .743). The analysis indicated a two-factor solution. Reliability and discriminant validity of the factors was established. Findings revealed that the present scale was a valid and reliable instrument that can be used in assessment of death anxiety in Iranian patients with end-stage renal disease.

Morphological and molecular features of some freshwater prawn species under genus Macrobrachium Spence Bate, 1868 (Crustacea: Decapoda: Palaemonidae) from Myanmar.

Myanmar is abundant in lakes and rivers, yet only a few investigations on the fauna of shrimps and prawns have been conducted and no molecular characteristics of prawn species have been described. This study reveals the morphologically identification of five freshwater prawn species under the genus Macrobrachium, including M. cavernicola, M. australiense, M. johnsoni, M. josephi and Macrobrachium sp.WMY-2017. As there was no previous record and information concerning with M. australiense, M. johnsoni, M. josephi and Macrobrachium sp. WMY-2017, they were regarded as the first record from Myanmar. A fragment of Mitochondrial Cytochrome Oxidase I Gene (COI) was amplified successfully from three studied species: M. australiense, M. josephi, and Macrobrachium sp.WMY-2017. The interspecific divergences of studied species varied from 0.01 to 0.15. The phylogenetic tree based on COI fragment sequences showed that M. australiense was closely related to M. rosenbergii, while Macrobrachium sp. WMY-2017 was closest to M. josephi. The results of molecular phylogeny has clarified the relationship within the genus Macrobrachium and represents the first step toward understanding the pattern of speciation base on molecular approach in Myanmar.

Hydrogel-Templated Solid Base Catalysts for Transesterification of Soybean Oil.

A new method for utilization of hydrogel is proposed here for the preparation of solid base catalysts for the transesterification of vegetable oil. When a solution of KF is mixed with a solution of Ca(NO3)2, CaF2 is obtained and inactive as a catalyst in the transesterification of vegetable oils. The catalysts were synthesized by the sequential incorporation of KF and/or Ca(NO3)2 solutions into the hydrogel upon microwave irradiation and then the as-obtained hydrogel was calcined at 800°C for 5 hours to eliminate the template and yield catalysts for the biodiesel productions. The prepared catalysts obtained by the different ways in the incorporation of ions into the hydrogel showed different physical properties and catalytic activities in the transesterification of soybean oil. All catalysts, except the low concentration of Ca(NO3)2, exhibiting the high activity yielding more than 90% FAME after 1 hour at 65°C, using oil to methanol molar ratio of 1:15 and 10 wt% of catalyst amounts.

History and Perspectives of Nuclear Medicine in Myanmar.

Nuclear Medicine was established in Myanmar in 1963 by Dr Soe Myint and International Atomic Energy expert Dr R. Hochel at Yangon General Hospital. Nuclear medicine diagnostic and therapeutic services started with Probe Scintillation Detector Systems and rectilinear scanner. In the early stage, many Nuclear Medicine specialists from the International Atomic Energy Agency (IAEA) spent some time in Myanmar and made significant contributions to the development of Nuclear Medicine in our country. The department participated in various IAEA technical cooperation projects and regional cooperation projects. By the late 1990s, new centers were established in Mandalay, Naypyidaw, and North Okkalapa Teaching Hospital of University of Medicine 11, Yangon. The training program related to Nuclear Medicine includes a postgraduate master's degree (three years) at the University of Medicine. Currently, all centers are equipped with SPECT, SPECT-CT, PET-CT, and cyclotron in Yangon General Hospital. Up until now, the International Atomic Energy Agency has been playing a crucial role in the growth and development of Nuclear Medicine in Myanmar. Our vision is to provide a wide spectrum of nuclear medicine services at a level compatible with the international standards to become a Center of Excellence.

On a new species of freshwater crab, Indochinamonkhinpyae, from northern Myanmar (Crustacea, Brachyura, Potamidae).

A new species of freshwater crab of the genus Indochinamon Yeo & Ng, 2007 (family Potamidae), is described from highlands north of Myitkyina in Kachin State, Myanmar. Indochinamonkhinpyae sp. n. is distinguished from congeners by its very rugose carapace, broad male pleon and distinctively structured male first gonopod; and is the first potamid species recorded from northern Myanmar.

Influenza A(H9N2) Virus, Myanmar, 2014-2015.

Routine surveillance of influenza A virus was conducted in Myanmar during 2014-2015. Influenza A(H9N2) virus was isolated in Shan State, upper Myanmar. Whole-genome sequencing showed that H9N2 virus from Myanmar was closely related to H9N2 virus of clade 4.2.5 from China.

Esterification of fatty acid catalyzed by hydrothermally stable propylsulfonic acid-functionalized mesoporous silica SBA-15.

Propylsulfonic acid-functionalized mesoporous silica SBA-15 has been synthesized via one-step strategy at 130°C based on the co-condensation of TEOS and MPTMS in the presence of Pluronic 123 polymer and H2O2 in HCl aqueous solution. The synthesized solid exhibited hydrothermal stability in boiling water without significant change in textural properties. The catalytic performance of the synthesized solid was studied in the esterification of oleic acid with methanol. The experimental results revealed that the large mesopore structures of SBA-15-PrSO3H solid synthesized at 130°C could favor a facile access of oleic acid to the acid sites, making the comparable activity to that of phenyl ethyl sulfonic acid functionalized silica and higher than that of dry amberlyst-15.

Genotyping of rotavirus isolates collected from children less than 5 years of age admitted for diarrhoea at the Yangon Children's Hospital, Myanmar.

Rotavirus positive stool specimens collected from children less than 5-year-old admitted to Yangon Children's Hospital for diarrhoea were analysed for their G and P genotypes. In 2004, rotavirus was detected in 57% of 1004 samples tested with G3 and P[8] being the most common genotypes identified. Corresponding figures in 2005, were 55% of 1175 samples positive for rotavirus with G3 and P[4] genotypes being most common. The most common G and P combinations were G3P[8] and G1P[8], with some unusual combinations (G1P[4], G1P[6] and G3P[4]) also being identified. In Myanmar, ongoing rotavirus surveillance to understand the distribution of G and P genotypes will be important for monitoring the impact of rotavirus vaccines following their introduction into the infant immunization schedule.

Drug-resistant tuberculosis in Yangon, Myanmar.

The extent of drug resistant tuberculosis (TB) in the capital city of Myanmar, Yangon has not yet been reported. This study aimed to determine the proportion and pattern of drug resistance to first-line anti-TB drugs, among Mycobacterium tuberculosis complex isolates from sputum smear positive TB patients who attended National TB Programme Yangon centres in April-August and October-December 2002. Drug susceptibility was determined by the Mycobacteria Growth Indicator Tube manual system (Becton Dickinson, MD, USA). Of the 567 patients, sputum specimens from 447 (79%) had a positive culture. Of these, 357 isolates (80%) had a susceptibility test result. Isolates from 76 of 259 (29.3%) new patients and from 45 of 98 (45.9%) previously treated patients were resistant to at least 1 of the anti-TB drugs. Resistance to isoniazid (INH) (22.0% vs 40.8%: new vs previously treated patients) and to > or =2 drugs (17.8% vs 29.6%: new vs previously treated patients) was common. Multidrug- resistant TB (MDR-TB) among new and previously treated patients was 4.2% and 18.4%, respectively. INH-resistant (adjusted OR: 2.0, 95% CI 1.1-3.6) and MDR-TB (adjusted OR: 3.4, 95% CI 1.4-8.3) cases were more likely to have taken anti-TB drugs > or =1 month previously. Collectively, prevalence of MDR-TB and TB resistance to > or =2 drugs are not rare in Yangon.