Awareness, Perceptions, Gaps, and Uptake of Maternity Protection among Formally Employed Women in Vietnam.

Maternity protection is a normative fundamental human right that enables women to combine their productive and reproductive roles, including breastfeeding. The aim of this study is to examine the uptake of Vietnam's maternity protection policy in terms of entitlements and awareness, perceptions, and gaps in implementation through the lens of formally employed women. In this mixed methods study, we interviewed 494 formally employed female workers, among whom 107 were pregnant and 387 were mothers of infants and conducted in-depth interviews with a subset of these women (n = 39). Of the 494 women interviewed, 268 (54.3%) were working in blue-collar jobs and more than 90% were contributing to the public social insurance fund. Among the 387 mothers on paid maternity leave, 51 (13.2%) did not receive cash entitlements during their leave. Among the 182 mothers with infants aged 6-11 months, 30 (16.5%) returned to work before accruing 180 days of maternity leave. Of 121 women who had returned to work, 26 (21.5%) did not receive a one-hour paid break every day to express breastmilk, relax, or breastfeed, and 46 (38.0%) worked the same or more hours per day than before maternity leave. Although most women perceived maternity leave as beneficial for the child's health (92.5%), mother's health (91.5%), family (86.2%), and society (90.7%), fewer women perceived it as beneficial for their income (59.5%), career (46.4%), and employers (30.4%). Not all formally employed women were aware of their maternity protection rights: women were more likely to mention the six-month paid maternity leave (78.7%) and one-hour nursing break (62.3%) than the other nine entitlements (2.0-35.0%). In-depth interviews with pregnant women and mothers of infants supported findings from the quantitative survey. In conclusion, although Vietnam's maternity protection policy helps protect the rights of women and children, our study identified implementation gaps that limit its effectiveness. To ensure that all women and their families can fully benefit from maternity protection, there is a need to increase awareness of the full set of maternity entitlements, strengthen enforcement of existing policies, and expand entitlements to the informal sector.

First Pass Recanalization Rates of Solitaire vs Trevo vs Primary Aspiration: The Kaiser Southern California Experience.

CONTEXT: New stroke thrombectomy devices have significantly improved recanalization rates in patients with large vessel occlusion. The first pass effect, or complete or near complete recanalization after a single pass of a device, is associated with better outcome. However, it remains unclear whether one technique is superior to the others at first pass recanalization. OBJECTIVE: The successful recanalization rates of three common techniques: 1) Stent-retriever with the Solitaire or 2) Trevo device, or 3) primary aspiration (PA) with a distal aspiration catheter, were compared across three Kaiser Permanente Southern California Medical Centers over a 5-year period. DESIGN: Retrospective review of cases between October 2013 and May 2018. MAIN OUTCOME MEASURE: Successful recanalization after a single pass of a device. RESULTS: Forty-five percent of Solitaire thrombectomies resulted in first pass success, compared with 31% of Trevo and 39% of PA, not statistically significant (p = 0.26). Adjusted for age, gender, and National Institutes of Health Stroke Scale score, the odds of successful recanalization were 1.90 ± 0.72 (CI 0.90-3.99, p = 0.09) for Solitaire compared with Trevo, and 1.41 ± 0.50 (CI 0.70-2.84, p = 0.33) for aspiration compared with Trevo. CONCLUSION: In this multi-center cohort, there was no statistical difference in successful first pass recanalization between Solitaire, Trevo, and PA. However, there was a trend towards improved efficacy with the Solitaire device compared to Trevo (OR 1.90, p = 0.09). Additional data are needed to determine the conditions under which design differences may favor one technique over another.

Susceptibility-weighted imaging for differential diagnosis of cerebral vascular pathology: a pictorial review.

Susceptibility-weighted imaging (SWI) is a high-spatial resolution, three-dimensional, gradient-echo (GRE) magnetic resonance (MR) technique. This fully velocity-compensated pulse sequence utilizes the magnetic susceptibility differences of various tissues or substances, such as blood products, iron, and calcification. By postprocessing the magnitude images using a phase mask, it emphasizes the magnetic properties of different susceptibility effects. Generated minimal intensity projection (minIP) images can further demonstrate tortuous vasculature and the continuity of vessels or abnormalities across slices. SWI has been used to improve the diagnosis of neurological trauma, brain neoplasm, neurodegenerative disorders, and cerebrovascular disease because of its ability to demonstrate microbleeds and conspicuity of the veins and other sources with susceptibility effects. We have used SWI to identify cerebrovascular lesions which may be obscured on other MR sequences to aid in the differential diagnosis. We present a review with selected cases to demonstrate the usefulness of this new neuroimaging technique in improving the diagnosis of cerebral vascular pathology.