The determinants of vaccination in a semi-rural area of Vientiane City, Lao People's Democratic Republic: a qualitative study.

BACKGROUND: Immunisation is a cost-effective and highly efficacious public health intervention, saving over 20 million lives in the last two decades due to decreases in childhood bacterial infections. In the Lao People's Democratic Republic, significant gaps in childhood immunisation coverage rates remain, which are a cause for concern and a barrier to the country reaching its Sustainable Development Goal targets for child health. Efforts to increase coverage have had limited success, with widening inequities being observed between urban and remote and rural areas. METHODS: The objectives of this study were two-fold; firstly, to describe the knowledge, attitudes and practices of mothers regarding their children's immunisation status; and, secondly, to identify individual and health system determinants of access to immunisation in five rural villages within a rural district in Lao People's Democratic Republic. This qualitative research used observation and interviews with healthcare workers (n = 10) and mothers (n = 10) with at least one child aged 12-23 months. RESULTS: The study identified several health system barriers that lower community demand for immunisation. These included the use of multiple providers, inconsistent record keeping and an inadequate health information system. At the individual and household level, there was a lack of understanding of the role of immunisation and the role of the different services provided. CONCLUSIONS: The study suggests that increasing immunisation coverage in Lao People's Democratic Republic requires clearer immunisation pathways, an integrated or unified information recording system across the different levels of the health system, and strategies to increase demand, including increasing individual and household understanding of the role of immunisation in child health.

Molecular interaction and partitioning in α-keratin using 1H NMR spin-lattice (T1) relaxation times.

The interactions between small molecules and keratins are poorly understood. In this paper, a nuclear magnetic resonance method is presented to measure changes in the 1H T1 relaxation times of small molecules in human hair keratin to quantify their interaction with the fibre. Two populations of small-molecule compounds were identified with distinct relaxation times, demonstrating the partitioning of the compounds into different keratin environments. The changes in relaxation time for solvent in hair compared with bulk solvent were shown to be related to the molecular weight (MW) and the partition coefficient, LogP, of the solvent investigated. Compounds with low MWs and high hydrophilicities had greater reductions in their T1 relaxation times and therefore experienced increased interactions with the hair fibre. The relative population sizes were also calculated. This is a significant step towards modelling the behaviour of small molecules in keratinous materials and other large insoluble fibrous proteins.

17O NMR spectroscopy as a tool to study hydrogen bonding of cholesterol in lipid bilayers.

Cholesterol is a crucial component of biological membranes and can interact with other membrane components through hydrogen bonding. NMR spectroscopy has been used previously to investigate this bonding, however this study represents the first 17O NMR spectroscopy study of isotopically enriched cholesterol. We demonstrate the 17O chemical shift is dependent on hydrogen bonding, providing a novel method for the study of cholesterol in bilayers.