Modelling in economic evaluation of mental health prevention: current status and quality of studies.

BACKGROUND: The present study aimed to identify and critically appraise the quality of model-based economic evaluation studies in mental health prevention. METHODS: A systematic search was performed on MEDLINE, EMBASE, EconLit, PsycINFO, and Web of Science. Two reviewers independently screened for eligible records using predefined criteria and extracted data using a pre-piloted data extraction form. The 61-item Philips Checklist was used to critically appraise the studies. Systematic review registration number: CRD42020184519. RESULTS: Forty-nine studies were eligible to be included. Thirty studies (61.2%) were published in 2015-2021. Forty-seven studies were conducted for higher-income countries. There were mainly cost-utility analyses (n = 31) with the dominant primary outcome of quality-adjusted life year. The most common model was Markov (n = 26). Most of the studies were conducted from a societal or health care perspective (n = 37). Only ten models used a 50-year time horizon (n = 2) or lifetime horizon (n = 8). A wide range of mental health prevention strategies was evaluated with the dominance of selective/indicate strategy and focusing on common mental health problems (e.g., depression, suicide). The percentage of the Philip checkilst's criteria fulfilled by included studies was 69.3% on average and ranged from 43.3 to 90%. Among three domains of the Philip checklist, criteria on the model structure were fulfilled the most (72.1% on average, ranging from 50.0% to 91.7%), followed by the data domain (69.5% on average, ranging from 28.9% to 94.0%) and the consistency domain (54.6% on average, ranging from 20.0% to 100%). The practice of identification of 'relevant' evidence to inform model structure and inputs was inadequately performed. The model validation practice was rarely reported. CONCLUSIONS: There is an increasing number of model-based economic evaluations of mental health prevention available to decision-makers, but evidence has been limited to the higher-income countries and the short-term horizon. Despite a high level of heterogeneity in study scope and model structure among included studies, almost all mental health prevention interventions were either cost-saving or cost-effective. Future models should make efforts to conduct in the low-resource context setting, expand the time horizon, improve the evidence identification to inform model structure and inputs, and promote the practice of model validation.

Comparison of the Cerumenolytic Activities of New and Currently Used Agents.

OBJECTIVES: This study compared the cerumen dissolution activities of 7.5% sodium bicarbonate, 5% potassium hydroxide, 10% lactic acid, 3% salicylic acid, 10% glycolic acid, and distilled water. METHODS: An in vitro study was conducted with 36 cerumen samples. The cerumenolytic activities of the 6 agents were assessed by recording the degree of cerumen disintegration using digital photography at 15 minutes, 30 minutes, 1 hour, 2 hours, and 12 hours. The undissolved cerumen that remained after 12 hours was removed from the solutions and weighed after drying. RESULTS: Potassium hydroxide showed the fastest cerumenolytic activity, dissolving a moderate amount of cerumen at 30 minutes, while glycolic acid and salicylic acid caused no visible changes in the cerumen samples. Samples treated with potassium hydroxide and sodium bicarbonate exhibited higher degrees of disintegration compared to samples treated with distilled water (odds ratio and 95% CI: 273.237 [0.203-367 470.4] and 1.129 [0.002-850.341], respectively). The greatest reduction in cerumen weight was associated with the use of sodium bicarbonate; however, this result did not reach statistical significance. CONCLUSIONS: Among the solutions tested, 5% potassium hydroxide showed the fastest dissolution activity, yielding moderate disintegration within only 30 minutes. In terms of residual cerumen weight within 12 hours, all solutions exhibited equivalent effectiveness in the disintegration of cerumen.

Health Insurance Reimbursement to Hosptials in Vietnam: Policy Implementation Results and Challenges.

In Vietnam, social health insurance (SHI) benefit package has been defined in a more explicit approach with the introduction of a regulation on the list of conditional reimbursed and non-reimbursed medical services. This paper aims to analyze the implementation results of this regulation from an economical perspective as well as the implementation challenges. Mix-method approach was employed. The quantitative component was employed to understand the implementation results. Desk study and qualitative components (2 inteviews with key informants from Ministry of Health; 6 discussions with key informants from provincial Social Security Offices and Departments of Health in Hanoi, Ho Chi Minh City, Hue, Tuyen Quang, Thai Binh and Soc Trang provinces; the other 23 discussions and 31 interviews with key informants from 23 selected hospitals) was employed to summarize the implementation challenges. The regulation seems to not able to mitigate the reimbursement of high-technology and expensive services in higher-level providers. There is a sign of increasing out-of-pocket payments for those regulated services in higher-level providers. It has also posed greater influence on lower-level providers in terms of the proportion of reimbursement amount rather than to higher-level hospitals. Applying World Health Organization's 6 building blocks of health system to analyze the implementation challenges, we provide policymakers evidence to improve the regulation, as well as point out the relating health system weakness need to be strengthened.

Reported handwashing practices of Vietnamese people during the COVID-19 pandemic and associated factors: a 2020 online survey.

COVID-19 pandemic currently affects nearly all countries and regions in the world. Washing hands, together with other preventive measures, to be considered one of the most important measures to prevent the disease. This study aimed to characterize reported handwashing practices of Vietnamese people during the COVID-19 pandemic and associated factors. Kobo Toolbox platform was used to design the online survey. There were 837 people participating in this survey. All independent variables were described by calculating frequencies and percentages. Univariate linear regression was used with a significant level of 0.05. Multiple linear regression was conducted to provide a theoretical model with collected predictors. Seventy-nine percent of the respondents used soap as the primary choice when washing their hands. Sixty percent of the participants washed their hands at all essential times, however, only 26.3% practiced washing their hands correctly, and only 28.4% washed their hands for at least 20 seconds. Although 92.1% washed hands after contacting with surfaces at public places (e.g., lifts, knob doors), only 66.3% practiced handwashing after removing masks. Females had better reported handwashing practices than male participants (OR = 1.88; 95% CI: 1.15-3.09). Better knowledge of handwashing contributed to improving reported handwashing practice (OR = 1.30; 95% CI: 1.20-1.41). Poorer handwashing practices were likely due, at least in part, to the COVID-19 pandemic information on the internet, social media, newspapers, and television. Although the number of people reported practicing their handwashing was rather high, only a quarter of them had corrected reported handwashing practices. Communication strategy on handwashing should emphasize on the minimum time required for handwashing as well as the six handwashing steps.

Access to Improved Water Sources and Sanitation in Minority Ethnic People in Vietnam and Some Sociodemographic Associations: A 2019 National Survey.

BACKGROUND: Achieving access to clean water and basic sanitation remains as major challenges in Vietnam, especially for vulnerable groups such as minority people, despite all the progress made by the Millennium Development Goal number 7.C. OBJECTIVES: The study aimed to describe the access to improved water sources and sanitation of the ethnic minority people in Vietnam based on a national survey and to identify associated factors. METHODS: A cross-sectional study was conducted in 2019 with a sample size of 1385 ethnic minority households in 12 provinces in Vietnam. Multivariate logistic regression modeling was performed to examine the probability of having access to improved water sources and sanitation and sociodemographic status at a significance level of P < .05. RESULTS: The access to improved water sources and sanitation was unequal among the ethnic minority people in Vietnam, with the lowest access rate in the northern midland and mountainous and Central Highland areas and the highest access rate in the Mekong Delta region. Some sociodemographic variables that were likely to increase the ethnic minority people's access to improved water sources and/or sanitation included older age, female household heads, household heads with high educational levels, religious households, and households in not poor status. CONCLUSION AND RECOMMENDATIONS: The study suggested more emphasis on religion for improving the ethnic minority's access to improved water sources and sanitation. Besides, persons of poor and near-poor status and with low educational levels should be of focus in future water and sanitation intervention programs.

Training need assessment for a master training program in Environmental Health program in Vietnam.

Vietnam is facing a shortage of skilled Environmental health workforce. A Training Needs Assessment was conducted to develop a list of environmental health tasks, a list of core competencies and assess the need for a Master of Environmental Health training program in Vietnam. To answer these questions, a cross-sectional study was conducted in Vietnam in 2017, using both qualitative and quantitative methods. The qualitative study involved a desk review, 29 in-depth interviews, two consultative workshops, and two expert meetings. For the quantitative component, 298 environmental health staff working at different levels completed a structured postal questionnaire. Results showed that different sectors were implementing various environmental health tasks but that there was currently no training program focusing on environmental health in Vietnam. Thirteen core competencies for a Master of Environmental Health were recommended. An urgent need to develop training programs to help building environmental health competencies at the Masters degree level was uniformly expressed. This could be achieved by developing a Master of Public Health with an Environmental Health stream in the short-term and a Master of Environmental Health program in the long-term.

Efficient Method for Preparation of Rutin Nanosuspension Using Chitosan and Sodium Tripolyphosphate Crosslinker.

High concentration of rutin nanosuspension (5%) in water was prepared by using high-speed and high-pressure homogenizer. Sodium tripolyphosphate (STPP) crosslinker and chitosan polymer were found to be an efficient encapsulating reagent and stabilizer to prepare rutin nanosuspension. In addition, the particle sizes and sedimentation rates of rutin nanosuspension were investigated under effects of several factors, including applied pressures of homogenization, the presence of co-solvent PEG 400 (polyethylene glycol 400), chitosan loading, STPP and chitosan mass ratio. Raw rutin material was characterized using powder X-ray diffraction (XRD) and high-performance liquid chromatography (HPLC). To evaluate the parameter of rutin nanosuspension, laser diffraction spectrometry (LDS) was employed to estimate the particle size distribution. Rutin nanosuspension prepared under optimal conditions was freezing dried/spray dried to form rutin powders. Properties of the rutin powders were evaluated using XRD analysis and re-dispersion into aqueous solutions of different pH values.

Meteorological factors associated with hand, foot and mouth disease in a Central Highlands province in Viet Nam: an ecological study.

BACKGROUND: Hand, foot and mouth disease (HFMD) is a public health problem in Viet Nam, and studies have reported seasonal fluctuation in the occurrence of HFMD. This study sought to describe the occurrence of HFMD and its associated meteorological factors in Dak Lak province, Viet Nam. METHODS: Monthly data on HFMD cases were collected from all commune health stations in Dak Lak province from 2012 through 2013. An HFMD case was defined as a brief febrile illness accompanied by a typical skin rash with or without mouth ulcers. Average temperature, maximum temperature, minimum temperature, humidity, rainfall, evaporation, sunshine duration and wind speed were recorded monthly at five local meteorological stations throughout Dak Lak.Data were aggregated at the district level, and the association between these meteorological factors and HFMD cases were examined by Poisson regression. RESULTS: In 2012 through 2013, there were 7128 HFMD patients in Dak Lak. The number of HFMD cases increased during the rainy season. An increased risk of HFMD was associated with higher average temperature (risk ratio and 95% confidence interval: 1.06; 1.03-1.08 per 1 °C increase), higher rainfall (1.19; 1.14-1.24 per 200 mm increase) and longer sunshine duration (1.14; 1.07-1.22 per 60 hours increase). The risk of HFMD was inversely associated with wind speed (0.77; 0.73-0.81 per 1 m/s increase). CONCLUSION: This study suggests that there is a significant association between HFMD occurrence and climate. Temperature, rainfall, wind speed and sunshine duration could be used as meteorological predictors of HFMD occurrence in Viet Nam's Central Highlands region. Intensified surveillance for HFMD during the rainy season is recommended.

Schizophrenia interventions in Vietnam: primary results from a cost-effectiveness study.

Schizophrenia is a highly disabling mental health disorder that imposes a considerable economic burden on a health care system. This paper aimed to examine the cost and effectiveness of alternative pharmaceutical interventions and the effects of family intervention (FI) for schizophrenia from the government perspective in order to introduce the most cost-effective intervention applicable to Vietnam. A Markov model was developed to estimate costs and health outcome over patients' lifetimes when using typical and atypical antipsychotic drugs, alone or in combination with family intervention. Health outcome was measured in terms of disability-adjusted life years averted. Monte Carlo simulation was used for uncertainty analysis. According to our findings, interventions using typical or atypical drugs combined with FI were found to be the most effective and least costly compared to a 'do-nothing' scenario. Interventions using atypical drugs alone were estimated to be much less favourable due to a considerably higher cost. This is a very first attempt on cost-effectiveness analysis of interventions for schizophrenia in Vietnam, and recommendations are made for future research to determine the most cost-effective intervention.