Nutritional status of Vietnamese infants assessed by Fenton growth chart and related factors: A cross-sectional study.

Importance: Nutritional status of infants, measured by birth weight and length, is an essential factor in neonatal development. Malnutrition in newborns may lead to a higher risk of mortality, neurological and cognitive impairment, and poor language development. Objective: This study aims to assess the nutritional status of infants and related factors regarding maternal anthropometric characteristics and medical history. Methods: A cross-sectional study was conducted at the National Hospital of Obstetrics and Gynecology, Vietnam from May 2021 to May 2022 on 340 infants and mothers. Low birth weight was defined following the Intergrowth-21 standards. Stunting was evaluated using the Fenton growth chart when the length was below the 10% percentile line of the gestational week. Multivariate regression models were applied to identify factors associated with the nutritional status of infants. Results: We found that 12.4% and 14.1% of infants in our study fell into stunted and underweight categories, respectively. Infants of mothers over 35 years old, having a height lower than 150 cm or experiencing anemia during pregnancy were more likely to be stunted or have low birth weight. Serum albumin deficiency during pregnancy was strongly associated with the infant being underweight (odds ratio [OR] = 2.8, 95% confidence interval [95%CI] 1.1-7.3). Newborns were more likely to be stunted if their mothers had a history of preterm birth (OR = 3.3, 95%CI 1.1-10.2). Interpretation: Maternal nutritional status is closely related to infant malnutrition, particularly in preterm infants. Improving the understanding of mothers regarding prenatal care, reproductive healthcare, adequate nutritional diet, and multi-micronutrient supplements during pregnancy is therefore important.

Avoidance of healthcare service use and correlates among HIV-positive patients in Vietnam: a cross-sectional study.

OBJECTIVE: The prevention of HIV/AIDS is not making sufficient progress. The slow reduction of HIV/AIDS infections needs to prioritise hesitancy towards service utilisation, including treatment duration, social support and social stigma. This study investigates HIV-positive patients' avoidance of healthcare services and its correlates. DESIGN: A cross-sectional study. SETTING: The secondary data analysis used cross-sectional data from a randomised controlled intervention, examining the effectiveness of HIV-assisted smartphone applications in the treatment of HIV/AIDS patients in the Bach Mai and Ha Dong clinics in Hanoi. METHODS: Simple random sampling was used to identify 495 eligible patients. Two-tailed χ2, Mann-Whitney, multivariate logistic and ordered logistic regression models were performed. PRIMARY AND SECONDARY OUTCOME MEASURES: The main study outcome was the patients' healthcare avoidance and frequency of healthcare avoidance. The association of individual characteristics, social and behavioural determinants of HIV patients' usage of health services was also determined based on the collected data using structured questionnaires. RESULTS: Nearly half of the participants avoid health service use (47.3%), while 30.7% rarely avoid health service use. Duration of antiretroviral therapy and initial CD4 cell count were negatively associated with avoidance of health services and frequency of health service avoidance. Similarly, those with the middle and highest income were more likely to avoid health services compared with those with the lowest income. People having health problems avoided health service use more frequently (OR 1.47, 95% CI 1.35 to 1.61). CONCLUSIONS: Our study's findings identify characteristics of significance in relation to health service avoidance and utilisation among HIV-positive patients. The results highlighted the need to improve satisfaction, adherence and utilisation of treatment. Moreover, identifying ways to address or incorporate those social determinants in new policy may also help the treatment of HIV/AIDS and strategically allocate funding in the changing financial and political climate of Vietnam. TRIAL REGISTRATION NUMBER: Thai Clinical Trials Registry TCTR20220928003.

Sleep disorders among patients suffering from road traffic injuries in an urban setting of Vietnam: an exploratory study.

Sleep quality is an important indicator of treatment outcome for patients with traffic accident injuries. In Vietnam, the impacts of injury on sleep status are usually amplified in urban areas due to disproportionate distribution of mental care services between the city and less developed settings. Our study investigated deterioration in sleep quality and identified associated demographic factors among traffic injury patients in an small urban setting of Vietnam. A cross-sectional study was conducted among 408 patients in one provincial hospital and five district hospitals in Thai Binh, Vietnam from October to December 2018. A structured questionnaire was designed based on 3 standardized scales: Health-related Quality of Life, the Pittsburgh Sleep Quality Index and the Kessler Scale. Face-to-face interviews and medical records were conducted by trained health professionals on patients hospitalized in the Trauma-Orthopedic/Burn Department and Surgery and General Department. About 16.9% of respondents had sleep disturbances, and there was a statistically significant difference between age group (p < 0.01), education level (p < 0.01), and monthly household income (p < 0.01) between participants who with and without sleep disturbances. Furthermore, more than half (50.7%) of respondents sleep less than 5 h per day, while 18.7% of the sampled also reported that the habitual sleep efficiency was below 85%. Current results indicated that people being female, suffering from traumatic brain injury, being comatose at hospitalization, and having higher psychological distress scores were more likely to suffer from sleep problems. Our study is one of the first evidence in Vietnam to assess sleep disturbances in road traffic injury patients and their correlated factors. It is important to identify patients who are at risk of sleep disturbances based on socio-demographic and clinical characteristics, as well as psychological distress status. Therefore, a holistic approach should be taken to include sleep quality and psychological state in the treatment process and outcome assessment for road traffic injury patients.

Association of Individual and Neighborhood Characteristics to Problematic Internet Use among Youths and Adolescents: Evidence from Vietnam.

INTRODUCTION: This study aimed to determine latent profiles from the Problematic Internet Use Questionnaire Short Form-6 (PIUQ-SF-6) score of Vietnamese youths and adolescents, which supports the diagnosis of problematic internet use among a large sample size. Moreover, it also explored factors that affect each latent profile of the PIUQ-SF-6 score among participants. METHODS: A sample of 1477 Vietnamese people, aged 14 to 24, across five provinces participated in the study. Multinomial logistic regression determined factors related to the levels of the Problematic Internet Use Questionnaire Short Form-6 (PIUQ-SF-6) after using latent profile analysis. RESULTS: Participants were divided into three profiles, including those at low, moderate, and high risk of internet addiction. The high-risk latent profile was obtained for 23.1% of adolescents, and the remaining percentages were, respectively, 40.2% and 36.7% of adolescents belonging to the moderate and low-risk groups. Moreover, factors including age, living alone, high Kessler psychological distress scale, excessive time on the internet, living in central cities, and high neighborhood disorder scores were found to be related to moderate- and high-risk internet addiction profiles. CONCLUSIONS: Factors analyzed according to individual and social characteristics further explore the reasons underlying increasing internet addiction among Vietnamese youths and inform early interventions.

Plastic waste in sandy beaches and surface water in Thanh Hoa, Vietnam: abundance, characterization, and sources.

The occurrence and characterization of marine debris on beaches bring opportunities to track back the anthropogenic activities around shorelines as well as aid in waste management and control. In this study, the three largest beaches in Thanh Hoa (Vietnam) were examined for plastic waste, including macroplastics (≥ 5 mm) on sandy beaches and microplastics (MPs) (< 5 mm) in surface water. Among 3803 items collected on the beaches, plastic waste accounted for more than 98%. The majority of the plastic wastes found on these beaches were derived from fishing boats and food preservation foam packaging. The FT-IR data indicated that the macroplastics comprised 77% polystyrene, 17% polypropylene, and 6% high-density polyethylene, while MPs discovered in surface water included other forms of plastics such as polyethylene- acrylate, styrene/butadiene rubber gasket, ethylene/propylene copolymer, and zein purified. FT-IR data demonstrated that MPs might also be originated from automobile tire wear, the air, and skincare products, besides being degraded from macroplastics. The highest abundance of MPs was 44.1 items/m3 at Hai Tien beach, while the lowest was 15.5 items/m3 at Sam Son beach. The results showed that fragment form was the most frequent MP shape, accounting for 61.4 ± 14.3% of total MPs. MPs with a diameter smaller than 500 µm accounted for 70.2 ± 7.6% of all MPs. According to our research, MPs were transformed, transported, and accumulated due to anthropogenic activities and environmental processes. This study provided a comprehensive knowledge of plastic waste, essential in devising long-term development strategies in these locations.

Depressive symptoms are associated with immunological failure among HIV-positive patients in Vietnam.

As the lives of people living with HIV (PLWH) become increasingly normalized, more focus is being given to the associated comorbidities of HIV, including those related to mental health such as depression. This study aims to evaluate the correlation between depressive symptoms and HIV outcomes in Vietnam through the measurement of CD4 cell count. A mixed design was utilized, in which both a longitudinal assessment of CD4 cell counts and a cross-sectional survey of depressive symptoms were conducted on 481 patients in the Bach Mai and Ha Dong HIV clinics (Hanoi, Vietnam). CD4 cell count data was extracted from the medical records of participants, and depressive symptoms were screened using the Patient Health Questionnaire (PHQ-9). The results illustrate that the presence of moderately severe to severe depressive symptoms is associated with lower CD4 cell counts, indicating poorer HIV outcomes resulting from comorbid depression. This correlation was especially noticeable in the PHQ-9 items for psychomotor agitation/retardation (p < 0.05) and suicidal ideation (p < 0.05). Future policy and treatment options for HIV in Vietnam should consider the presence of comorbid mental health conditions in order to provide more suitable and effective treatment in the goal of providing a higher quality of life for PLWH.

Resource mobilization for tetanus vaccination in Vietnam: Uptake, demand and willingness to pay among women of reproductive age.

Introduction: Tetanus vaccine coverage in Vietnam has been declining in recent years due to a rapid population growth rate, shrinking budget, and inefficient resource mobilization strategy. This study examined the uptake, demand, and willingness to pay (WTP) for tetanus vaccines in Vietnamese women of reproductive age as well as determined associated factors and assessed the feasibility of the long-term tetanus vaccine resource mobilization scheme. Methods: Cross-sectional data were obtained on 807 women of childbearing age in Hanoi, Vietnam in 2016. Tetanus vaccine uptake, demand, and willingness to pay were collected by using a structured questionnaire. Multivariable logistic and interval regression models were used to examine associated factors with vaccine uptake, demand, and WTP. Results: Of 807 participants, 42.4 and 64.8% had sufficient tetanus vaccination (i.e., received at least three doses of vaccine) and were willing to pay for tetanus vaccination. The mean amount of WTP for one dose of tetanus was US$ 7.3 (95% CI = 6.7-7.9). Having children or being aware that the tetanus vaccine was free-of-charge were negatively associated with WTP for tetanus vaccine. Having a high school education, living in a rural area, and not being aware of vaccine prices or being aware that vaccines were provided freely reduced the amount of WTP. WTP increased among women receiving information from friends and relatives. Conclusion: Despite of exemption from the tetanus vaccination programs, this study indicated a low tetanus vaccination coverage and a moderate degree of WTP for tetanus vaccine among Vietnamese women of childbearing age. Target-specific educational and financial support interventions, along with efforts to reduce vaccination costs are critical to improving the vaccine uptake, demand, and WTP for tetanus immunization among women.

Classification of Southeast Asian mints (Mentha spp.) based on simple sequence repeat markers.

Mentha is a complex genus encompassing many species as a consequence of their interspecific hybridization and polyploidy. Southeast Asian mints have been poorly distinguished though they are widely used for culinary and medical purposes. In this study, we have analyzed Southeast Asian mints and known varieties as well as a related Lamiaceae species (Nepeta sp.) using simple sequence repeat (SSR) markers and leaf morphology. Two types of mints were clearly distinguished based on their venation pattern and leaf shape index. We developed 12 SSR markers that allowed good amplification in the Mentha and another Lamiaceae species. In the SSR-based phylogram, the Mentha lines could be delimited into groups I-VI. The Southeast Asian mints divided into groups I and II, and the phylogram separated most of the available species, with groups I and II containing the known species M. × cordifolia and M. arvensis, respectively. The separation of the two groups was supported by a population structure analysis. The SSR markers developed in this study enabled the simultaneous classification of mints and will help improve our understanding of the genetic composition of known mint varieties and as yet unclassified Southeast Asian mints.

The prevalence of self-reported anxiety, depression, and associated factors among Hanoi Medical University's students during the first wave of COVID-19 pandemic.

BACKGROUND: Medical students are known to have higher levels of these issues than the general population but in Vietnam the effects of the pandemic on medical student mental health was not documented. OBJECTIVES: To estimate the prevalence and identify factors associated with self-reported anxiety disorder, depression, and perception of worsening mental health among Vietnamese medical students during the COVID-19 pandemic. METHOD: A cross-sectional study was conducted from April 7th to 29th, 2020. All students in Doctor of General Medicine, Doctor of Preventive Medicine, and Bachelor of Nursing tracks at Hanoi Medical University (3672 students) were invited to participate. Data were collected using an online questionnaire including demographic characteristics, Generalized Anxiety Disorder 7 items, Patient Health Questionnaire 9 items, Fear of COVID-19 scale, and question about worsening mental health status. Robust Poisson regression was used to assess the association between mental health status and associated factors. RESULTS: Among 1583 students (43.1% response rate), the prevalence of students screened positive for anxiety disorder was 7.3%(95%C.I.:6.0-8.7), depression was 14.5%(95%C.I.:12.8-16.3), and perceiving worsening mental health was 6.9%(95%C.I.:5.7-8.3). In multivariable regression models, significant factors associated with self-reported anxiety disorder included being male (PR = 1.99,95%C.I.:1.35-2.92), difficulty in paying for healthcare services (PR = 2.05,95%C.I.:1.39-3.01), and high level of fear of COVID-19 (Q3:PR = 2.36,95%C.I.:1.38-4.02 and Q4:PR = 4.75,95%C.I.:2.65-8.49). Significant factors associated with self-reported depression were difficulty in paying for healthcare services (PR = 1.78,95%C.I.:1.37-2.30), and high level of fear of COVID-19 (Q3:PR = 1.41,95%C.I.:1.02-1.95 and Q4:PR = 2.23,95%C.I.:1.51-3.29). Significant factors associated with perceived worsening mental health status included having clinical experience (PR = 1.83,95%C.I.:1.17-2.88) and having atypical symptoms of COVID-19 (PR = 1.96,95%C.I.:1.31-2.94). CONCLUSION: The prevalence of self-reported depression, anxiety disorder, and worsening mental health among Vietnamese students during the first wave of COVID-19 was lower than in medical students in other countries. Further investigation is needed to confirm this finding.

Heavy metals in surface sediments of the intertidal Thai Binh Coast, Gulf of Tonkin, East Sea, Vietnam: distribution, accumulation, and contamination assessment.

Heavy metals contamination in sediments may endanger ecosystems and human health via the food chain. In fact, there is little to no understanding about heavy metal accumulation in surface sediment of one of the most economically important marine bodies for Vietnam, the Thai Binh Coast, where five large rivers co-discharge into the Gulf of Tonkin. Twenty-seven surface sediment samples were collected from the intertidal regions and analyzed for: arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), nickel (Ni), and zinc (Zn) using inductively coupled plasma mass spectroscopy (ICP-MS). The studied area exhibited a large spatial variation in the concentration of heavy metals, e.g., the dry sediment concentration of Cd was the least (0.05-0.49 mg.kg-1), whereas that of Zn was the greatest (45.4-252 mg.kg-1). Based on the geoaccumulation index ([Formula: see text]), most of the studied heavy metals were accumulated at low pollution levels, except four locations exhibited moderately and highly polluted levels of Hg with [Formula: see text] Hg values from 1.92 to 2.66. However, the high contamination factor value implicated that not only Hg but also all other detected heavy metals in this area resulted from anthropogenic activities along the coast and the river upstream. This implied the need for quick action from the government. In addition, numerous analytical methods were used to see the association between metals, total organic carbon (TOC), and particle size distribution, including Pearson correlation coefficient (P) and principal component analysis (PCA). Hg demonstrates lowest connection with TOC (PHg-TOC ~ 0) but individual heavy metal correlations are largely positive, with many reaching 1.0 (e.g., PNi-Cr = 0.89, PCd-As = 0.72, PNi-Cu = 0.76, and PCu-Cr = 0.72). From the PCA diagram, we can observe that those sampling points in the positive direction of PC1 were expected to have a high concentration of Cu, Zn, As, Ni while having extremely little sand content.

Tobacco smoking and nicotine dependence among patients with respiratory diseases in Vietnam: Status and correlated factors.

INTRODUCTION: Understanding nicotine dependence can support clinicians in enhancing the effectiveness of treatments for respiratory patients. Our research aimed to assess the severity of nicotine dependence among patients with respiratory diseases in Vietnam and accordingly suggest potential interventions for tobacco cessation. METHODS: A cross-sectional study was conducted at the Respiratory center of Bach Mai Hospital, Hanoi, for two months of 2016 (October and November). A total of 508 respondents participated in the study Data on socio-economic characteristics and smoking patterns were collected. The Euroqol-5 dimensions-5 levels (EQ-5D-5L) and Fagerström test for nicotine dependence (FTND) were used to evaluate patient's quality of life and the nicotine dependence level, respectively. Kruskal-Wallis and Chi-square tests were used to assess the differences between variables. We applied the multivariate logistic regression and Tobit regression to categorize the association between nicotine dependence level and other factors. RESULTS: A total of 508 patients enrolled in our study. Former smokers and current smokers accounted for 8.1% and 38.6% of the sample, respectively. Current smokers were more likely to be male, work as free lancers, and report anxiety/depression. Higher level of nicotine dependence among current smokers was associated with the employment status of the patient. The mean number of cigarettes per day was 15.7 (SD = 11.1). The mean score of the FTND was 5.1 (SD = 2.0). Freelancers were more likely to be a current smoker (OR = 2.65, 95% CI = 2.21; 5.79). People who experienced anxiety/depression had a higher likelihood of smoking (OR = 2.21, 95% CI = 1.04; 4.72). CONCLUSIONS: Current smokers demonstrated a moderate level of nicotine dependence, which predict a difficult quitting and suggest the development of specialized programs to support smoking cessation counseling. Furthermore, the capabilities of physicians in supporting and counseling patients in quitting smoking should be strengthened.

Income Inequalities in Hepatitis B Vaccination and Willingness to Pay Among Women of Reproductive Age in Hanoi, Vietnam.

BACKGROUND: Hepatitis B virus (HBV) infection is endemic in Vietnam and can be transmitted from mother to child. Vaccination of women of reproductive age (WRA) can reduce this transmission. Because adult HBV vaccination in Vietnam follows a fee-for-service model, research is needed to determine the effect of household income on willingness to pay (WTP) to ensure equitable access to the vaccine. METHODS: A cross-sectional study was performed in Hanoi, Vietnam, in April 2018, among WRA. Questionnaires were administered to assess household income, HBV history, vaccination status, vaccine awareness, and WTP for the vaccine. Multivariable logistic and interval regression were performed to assess the impact of household income on WTP for HBV vaccine. RESULTS: This study found that 62.3% of all participants were willing to pay for the HBV vaccine with no differences in WTP across income quintiles. There were significant differences among household income levels in awareness of HBV vaccination and WTP amount beyond US$4.50 with the lowest awareness and WTP amount among women from the lowest income quintiles. CONCLUSIONS: Our data suggest the need to subsidize HBV vaccination for low-income women to ensure more equitable access to HBV vaccination. We propose that a sliding-scale payment method may be an effective strategy in light of limited funding to support vaccination expansion. An education campaign focusing on lower-income households should also be implemented in conjunction with this program. Further research would be required to evaluate consumer acceptance of this payment scheme and to develop an appropriate sliding scale to maximize vaccine uptake.

A qualitative assessment in acceptability and barriers to use pre-exposure prophylaxis (PrEP) among men who have sex with men: implications for service delivery in Vietnam.

BACKGROUND: HIV Pre-exposure prophylaxis (PrEP) is being considered for implementation among MSM nationwide in Vietnam. However, there may be concerns about potential obstacles for PrEP adherence among Vietnamese MSM. This study aims to assess the acceptability to use PrEP, potential barriers and facilitators, and the preferences for PrEP service accessibility and delivery among Vietnamese MSM. METHODS: Four focus group discussions (FGDs) were conducted with 30 HIV-negative MSM in January 2018 in Hanoi, Vietnam. FGDs explored MSM's awareness regarding PrEP, perceived benefits and barriers of PrEP use, and willingness to use PrEP. FGDs were audio-recorded and transcribed verbatim. Content analysis was used. RESULTS: The mean age of participants was 23.9 years old. Most participants realized the advantages of PrEP given its efficacy in HIV risk reduction and expressed high motivation and interest to use PrEP in the future. PrEP was considered as a supplement alongside condoms. Common concerns about PrEP included side-effects, forgetting to take the pill daily, stigmatization due to using PrEP, negative attitudes toward PrEP from other MSM and accessibility of PrEP. Participants would prefer an injectable PrEP regime if available as it was seen as easier to adhere to. Concerns were also raised that PrEP usage could be interpreted as an indication of engaging in sexual risk behavior for HIV, potentially causing suspicion in love relationships or by family and friends. Participants preferred to receive PrEP in civil business organizations and MSM-friendly clinics, and recommended that pharmacy stores would not be suitable for PrEP implementation due to lack of trust and fear of fake drugs. CONCLUSION: This study indicated a high level of willingness to use PrEP among MSM in Vietnam in combination with condom. Strategies to raise awareness of PrEP, reduce stigma towards PrEP, and improve the accessibility among MSM in Vietnam is needed. Existing MSM-friendly clinics were recommended to implement PrEP programs in Vietnam.

Survival Outcomes of Vietnamese People with HIV after Initiating Antiretroviral Treatment: Role of Clinic-Related Factors.

Given the rapid development of HIV clinics in Vietnam, this study evaluates the infrastructure surrounding this expansion, identifying clinic-related factors that impact survival outcomes. A retrospective longitudinal study was conducted among people living with HIV (PLWH) who initiated antiretroviral therapy (ART) between 2011 and 2015 among 62 ART clinics in 15 provinces. The mortality rate during the 717674.1 person-years of observation (PYO) was 0.29/100 PYO. Location in rural areas (versus urban) and in Central Vietnam (versus Northern Vietnam) were associated with higher risk of mortality. The risk was lower among clinics that had peer-educators. As Vietnam's HIV/AIDS program continues to expand, this data supports increasing resource allocation for rural clinics, incorporation of ART with the community's existing healthcare infrastructure in its efforts to decentralize, and integration of services to reflect patients' anticipated needs.

An exploratory assessment of the preference for eHealth interventions to prevent HIV and sexually transmitted infections among men who have sex with men in Hanoi, Vietnam.

BACKGROUND: Electronic health (eHealth) interventions are promising in HIV and sexually transmitted infections (STIs) prevention among men who have sex with men (MSM), given a high rate of the Internet use in this population. This study determined the preferences for eHealth interventions to prevent HIV and STIs among MSM in Hanoi, Vietnam to guide the development of future eHealth interventions. METHODS: Five focus group discussions (FGD) were conducted with 35 MSM recruited by purposive sampling in January 2018 in Hanoi, Vietnam. The FGDs addressed attitudes towards the feasibility and uptake of HIV/STI interventions via online modalities such as smartphone applications (apps, social network sites, or emails); preferences and concerns regarding an online HIV/STI intervention. FGDs were audio-recorded and transcribed verbatim. Content analysis was used to determine themes. RESULTS: MSM reported that they commonly searched for information regarding HIV/STI and sexual health on Facebook and a variety of mobile apps. They perceived a lack of reliable online sources, a high need, and interest for an online intervention. Most of them preferred short and concise messages without perceived sensitive words such as "HIV" or "STI". Diversity of online modalities were preferred with information from credible sources about HIV/STI symptoms, testing and treatment, safe sex practices and testing locations with a focus on safe MSM-friendly clinics. Concerns about the need to trust the organization behind the online information and interventions, and the importance of confidentiality when participating in online interventions were raised. CONCLUSION: High acceptance and perceived need for an online HIV/STI intervention were reported. The importance of establishing trust within the MSM community as a reliable source of information was emphasized, as well as the importance of confidentiality.

The Status of First Aid and Its Associations with Health Outcomes among Patients with Traffic Accidents in Urban Areas of Vietnam.

While it is well-evident that proper first aid would significantly promote survival and later treatment outcomes, little attention has been paid to improving its capacity in Vietnam. Thus, we conducted this study to assess the status of first aid and its associations with health outcomes among patients in traffic accidents in urban areas of Vietnam. We conducted a cross-sectional study on 413 patients in traffic accidents from October to December 2018 at six hospitals in Thai Binh province. Socio-demographics, first aid characteristics, and health outcomes were collected via face-to-face interviews using a structured questionnaire. We used a chi-square test to determine the differences in health outcomes among those who received first aid and those without. In addition, a multivariable regression was performed to determine the factors associated with first aid. The results indicated that less than half of the patients received first aid (48.1%), and only one fourth received first aid within 10 min after an accident. The proportions of having problems with mobility, self-care, usual activities, and pain/discomfort were significantly lower among those who received first aid compared to those without it. The regression model showed that those with multiple injuries were less likely to receive first aid.

Investigation on the Epoxidation of Piperitenone, and Structure-activity Relationships of Piperitenone Oxide for Differentiation-inducing Activity.

Piperitenone oxide, a major chemical constituent of the essential oil of spearmint, Mentha spicata, induces differentiation in human colon cancer RCM-1 cells. In this study, piperitenone oxide and trans-piperitenone dioxide were prepared as racemic forms by epoxidation of piperitenone. The relative configuration between two epoxides in piperitenone dioxide was determined to be trans by 1H NMR analysis and nuclear Overhauser effect spectroscopy (NOESY) in conjunction with density functional theory (DFT) calculations. Optical resolution of (±)-piperitenone oxide by high-performance liquid chromatography (HPLC) using a chiral stationary phase (CSP) afforded both enantiomers with over 98% enantiomeric excess (ee). Evaluation of the differentiation-inducing activity of the synthetic compounds revealed that the epoxide at C-1 and C-6 in piperitenone oxide is important for the activity, and (+)-piperitenone oxide has stronger activity than (-)-piperitenone oxide. The results obtained in this study provide new information on the application of piperitenone oxide and spearmint for differentiation-inducing therapy. Furthermore, natural piperitenone oxide was isolated from M. spicata. The enantiomeric excess of the isolated natural piperitenone oxide was 66% ee. Epoxidation of piperitenone with hydrogen peroxide proceeded in a phosphate buffer under weak basic conditions to give (±)-piperitenone oxide. These results suggest that the nonenzymatic epoxidation of piperitenone, which causes a decrease in the enantiomeric excess of natural piperitenone oxide, is accompanied by an enzymatic epoxidation in the biosynthesis of piperitenone oxide.

Measuring satisfaction with health care services for Vietnamese patients with cardiovascular diseases.

Patient satisfaction is a useful predictor of adherence and outcomes of cardiovascular diseases (CVDs) treatment. This study explored the satisfaction of Vietnamese CVDs inpatients and outpatients using a scale specifically designed for CVDs patients and examined the factors associated with satisfaction towards CVDs treatment services. Interviews of 600 patients at the Hanoi Heart Hospital were conducted. We developed a measurement scale for both inpatient and outpatient services. Multivariate Tobit regression was used to determine the associated factors with patient satisfaction. For inpatients, Cronbach's alpha reported for the domains were in the range of 0.72-0.97, while for outpatients, Cronbach's alpha was within 0.61-0.97. Overall, patients were more satisfied with inpatient services (Mean = 81.8, SD = 5.8) than outpatient services (Mean = 79.7, SD = 5.2, p<0.05). In inpatients, the highest complete satisfaction was in "Attitude of Nurse" item (42.0%), the highest satisfaction score was in "Care and treatment" domain (Mean = 85.6, SD = 9.7) and the lowest in "Hospital facilities" domain (Mean = 78.3; SD = 9.2). Among outpatients, the highest complete satisfaction was in "Attitude of physicians when examining, guiding and explaining to the patient" item (19.7%), the highest satisfaction score was in "Attitude of medical staff" domain (Mean = 82.8; SD = 7.9) and the lowest in "Waiting time" domain (Mean = 76.6; SD = 8.2). People not having health insurances had significantly higher scores in "Waiting time", "Hospital facilities" and "Attitude of staff" domains (for outpatients) and in "Health service accessibility", "Hospital facilities" domains (for inpatients) as well as higher total satisfaction score than those having health insurance. Findings discovered through the application of the newly developed instrument showed low satisfaction regarding hospital facilities for inpatients and waiting time for outpatients, suggesting renovation efforts, while inferiority regarding patient satisfaction of health insurance covered patients compared to those without implied policy reform possibility. Further enhancement and validation of the developed instrument was required.

Psychological Distress of Patients Experiencing Different Types of Road Traffic Injuries in Vietnam.

Road-related injuries are often catastrophic, and the eighth leading cause of all-aged mortality. While psychological problems, including anxiety, driving phobia, and post-traumatic stress have been found to be common among injured survivors, the literature in this area is still limited. This study aimed to evaluate the prevalence of distress between different types of road injuries among 413 patients in Thai Binh hospitals from October to December 2018. The Kessler Psychological Distress Scale (K6) was used to assess mental health status. Sociodemographic and clinical characteristics were also collected. The results of Multiple Logistic and Tobit regression models were utilized. Psychological issues were found in 13.8% of the participants. In terms of K6 profile, nervous, restless/fidgety, and "everything was an effort" were the three most frequently endorsed aspects. Having soft-tissue injuries had a 0.32-time lower likelihood of psychological distress compared to those having other injuries. Additionally, patients who were diagnosed with fractures were 4.5-times more likely to report psychological distress. Our finding highlights the need for psychological screening to reduce disabilities associated with non-fatal injury related to road traffic crashes.