Asia-Pacific consensus on long-term and sequential therapy for osteoporosis.

Objectives: This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition. The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach. Methods: A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and antiresorptive agents in sequential therapy approaches. Results: The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to antiresorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for individuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment. Conclusions: This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.

The Influence of 6-Month Interdisciplinary Accompaniment on Family Caregivers' Knowledge and Self-Efficacy Regarding Diabetic Wound Care.

Introduction: Diabetes mellitus (DM) is a global health issue. Diabetic wounds have become a severe health complication. Interdisciplinary education and the use of homecare have led to improvements in the health of patients with chronic disease. The family caregiver's knowledge and self-efficacy positively impact the DM patient's self-care in the physical and psychological dimensions. There is still a need for interdisciplinary education to enhance family caregivers' knowledge and self-efficacy regarding diabetic wound care. Objective: To determine the effect of 6 months of interdisciplinary education on family caregivers' knowledge and self-efficacy regarding diabetic wound care. Methods: A quantitative longitudinal study with a quasi-experimental, one-group, pretest-posttest design was conducted. Family caregivers received 6 months of interdisciplinary education regarding diabetic wound care. The Foot Care Confidence Scale (FCCS) was used to measure the family caregivers' knowledge and self-efficacy regarding diabetic wound care. The dependent samples t test and the Wilcoxon signed-rank test were used for statistical analysis. Results: Sixteen caregivers of patients with diabetic ulcer wounds in the homecare unit participated in this intervention with a 6-month follow-up. Six months of interdisciplinary education significantly increased the family caregivers' knowledge (p = 0.001) and self-efficacy (p = 0.001). However, there was no significant correlation between self-efficacy and gender, age, education level, or duration of wound care (p = 0.91; 0.93; 0.38; 0.40, respectively). Long-term interdisciplinary education improved caregiver performance across genders, ages, education levels, and wound care experience durations. Conclusion: Long-term interdisciplinary education of family caregivers is recommended as one method to enhance the family support system with respect to diabetic ulcer care management. In addition, interprofessional collaboration could be performed to enhance the understanding of healthcare, especially diabetic ulcer care.

MXene Hybrid Nanosheet of WS2/Ti3C2 for Electrocatalytic Hydrogen Evolution Reaction.

Designing low-cost hybrid electrocatalysts for hydrogen production is of significant importance. Recently, MXene-based materials are being increasingly employed in energy storage devices owing to their layered structure and high electrical conductivity. In this study, we propose a facile hydrothermal strategy for producing WS2/Ti3C2 nanosheets that function as electrocatalysts in the hydrogen evolution reaction (HER). WS2 provides a high surface area and active sites for electrocatalytic activity, whereas MXene Ti3C2 facilitates charge transfer. As a result, the synthesized WS2/Ti3C2 offers an increased surface area and exhibits an enhanced electrocatalytic activity in acidic media. The WS2/Ti3C2 (10%) catalyst exhibited a low onset potential of -150 mV versus RHE for the HER and a low Tafel slope of ∼62 mV dec-1. Moreover, WS2/Ti3C2 (10%) exhibited a double-layer capacitance of 1.2 mF/cm-2, which is 3 and 6 times greater than those of bare WS2 and Ti3C2, respectively. This catalyst also maintained a steady catalytic activity for the HER for over 1000 cycles.

Using the WHO Self-Reporting Questionnaire-20 (SRQ-20) to Detect Symptoms of Common Mental Disorders among Pregnant Women in Vietnam: a Validation Study.

Purpose: Detection of antenatal common mental disorders in low-resource settings like Vietnam is important and requires a reliable, valid and practical screening tool. Currently, there is no such tool validated for use among pregnant women in Vietnam. This study aims to assess the validity of the Vietnamese version of the 20-item Self Reporting Questionnaire (SRQ-20) by evaluating its reliability, factorial structure, and performance in detecting common mental disorder (CMD) symptoms, thereby identifying the optimum cut-off score for CMD screening among pregnant women in Vietnam. Participants and Methods: A total of 210 pregnant women from four rural communes participated in a face-to-face interview using the Vietnamese version of the SRQ-20, followed by a clinical diagnostic interview based on ICD-10 diagnostic criteria of CMDs. The reliability of the SRQ-20 was assessed by calculating the scale's Cronbach's alpha to measure internal consistency. Factor analyses were undertaken to examine the factor structure of the instrument. The Receiver Operating Characteristic (ROC) curve analysis was performed to assess the performance of the SRQ-20 against the clinical diagnosis and to identify the optimum cut-off score. Results: Internal consistency was good, with a Cronbach's alpha of 0.87. Factor analyses resulted in a 4-factor solution. The area under the ROC curve (AUC) for detection of CMDs was 0.90. The optimum cut-off score of the SRQ-20 for detection of CMD symptoms among Vietnamese pregnant women was 5/6. Conclusion: The Vietnamese version of the SRQ-20 has the capacity to detect CMDs among pregnant women effectively and is recommended for use as a screening tool for CMDs in antenatal care settings in Vietnam.

High Prevalence of Post-Traumatic Stress Disorder and Psychological Distress Among Healthcare Workers in COVID-19 Field Hospitals: A Cross-Sectional Study from Vietnam.

Objective: To evaluate the prevalence of post-traumatic stress disorder (PTSD) and other psychological disturbances in the Vietnamese healthcare workers (HCWs) at COVID-19 field hospitals. Methods: A cross-sectional study was conducted using the Impact of Event Scale-Revised (IES-R) to measure PTSD and the Depression Anxiety Stress scale (DASS) to measure other psychological disturbances. The anxiety about COVID-19 was evaluated by the fear of COVID-19 (FOC) scale. A self-developed questionnaire was used to assess work conditions and HCW's major concerns and preparedness. Ordinal logistic regression was used to identify factors associated with the severity of PTSD. A structural modeling equation (SEM) model was fitted to examine the correlation between PTSD and other psychological disturbances. Results: A total of 542 HCWs participated in this study. The prevalence of PTSD was 21.2%, most cases were mild. In the ordinal logistic regression analysis, a history of mental illness, poor preparedness, working in a condition with poor resources, a greater number of concerns, and greater fear of COVID-19 were independently associated with higher severity of PTSD. The prevalence of depression, anxiety, and stress was 46.8%, 38.3%, and 60.2, respectively. In the SEM model, PTSD and psychological disturbances had a strong correlation (standardized covariance 0.86). Conclusion: The prevalence of PTSD and other psychological disturbances was alarmingly high among HCWs who worked at COVID-19 field hospitals. The reported associated factors can be useful for policymakers and health authorities in the preparation for future pandemics.

Palliative Care: A Concept Analysis Review.

Introduction: Palliative care is critically important for the world's aging population and can change illness trajectories and promote advances in health care technologies. As health care team members, nurses have the most contact with palliative care patients. However, misconceptions about which patients need to receive palliative care may be an obstacle to meeting patients' needs for palliative care. Objectives: This study aimed to describe preceding events, characteristics and outcomes of patients in palliative care according to current concept analysis studies. Methods: A literature review was conducted. Inclusion criteria were: (1) concept analysis studies, (2) use of the term palliative care or palliative nursing care, (3) palliative care explanation including antecedents, attributes, and consequences, and (4) articles written in English published between 2004 and 2021. Results: Four concept analysis studies on palliative care were included in this review. Palliative care was described as an approach to alleviating physical and psychological suffering and improving patients' and families' quality of life in the early stages of diagnosed illness. Terminal illnesses, acute or chronic diseases, and actual or potentially life-threatening illnesses were confirmed as the events preceding palliative care. Characteristics of palliative care include holistic care, interdisciplinary teamwork, and compassionate, patient- and family-centered care. Improved patient and family quality of life, enhanced human dignity, improved self-care, and strengthened coping abilities are outcomes of palliative care. Conclusions/Implications for Practice: Palliative care is a concept that is related to the early stage of an illness, the timing of illness diagnosis, and the onset of symptoms. Including palliative care terms in nursing education and training and developing palliative care models in clinical practice are recommended to ensure nurses understand the services of the palliative care needs of patients and their families. Future reviews, including grounded qualitative studies on the concept of palliative care, are recommended.

The Vietnamese version of the nursing critical thinking in clinical practice questionnaire: Translation and psychometric evaluation.

AIMS: This study translated and evaluated the validity and reliability of the Vietnamese version of the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice (V-v)). DESIGN: Forward- and back-translation approach developed by Sousa and Rojjanasrirat (2011). METHODS: 545 nurses were recruited based on convenience sampling and asked to complete the N-CT-4 Practice (V-v) questionnaire for psychometric testing. Data were collected during June 2019 in three public hospitals located in Southwestern Vietnam. We evaluated translation equivalence, the item content validity index, floor/ceiling effects, construct validity, internal consistency reliability and test-retest reliability. RESULTS: The N-CT-4 Practice (V-v) questionnaire retained the meaning of the original English version and was clear, explicit and easy for nurses to understand. The item content validity index was 1.0. There were no floor/ceiling effects. The Cronbach's alpha was 0.98. The intraclass correlation coefficient was 0.81. Confirmatory factor analysis indicated that this Vietnamese version fit the proposed model.

Vietnamese Version of the Geriatric Depression Scale (30 Items): Translation, Cross-Cultural Adaptation, and Validation.

The proportion of geriatric depression recorded in Vietnam was 66.9%. Depression in older people is a risk factor for problems related to dementia, poor quality of life, and suicide. To have a good Vietnamese questionnaire for assessing geriatric depression, we conducted the study to translate and cross-culturally adapt the Geriatric Depression Scale-long-form with 30 items (GDS-30). The study has two steps. Step 1 is a translation of the GDS-30 scale. We followed the guideline by Beaton et al., (2000 & 2007). Firstly, two translators (informed and uninformed) translated the questionnaires. Secondly, the translations were synthesized. Thirdly, back translation was performed by two translators fluent in both Vietnamese and English but completely unknown of the original version of the scale and did not have medical expertise. Finally, seven experts reached a consensus on the pre-final Vietnamese version (GDS-30). Step 2 is a field test of the questionnaires on people 60 years or older. Then, we determined the internal consistency and test-retest reliability of the questionnaire in 55 Vietnamese inpatients in a geriatric department. Construct validity was determined by examining the relationship between depressive scores and patient characteristics. The Vietnamese version of GDS-30 was built with the agreement of all experts on the semantic, idiomatic, experiential, and conceptual equivalences between the original and pre-final Vietnamese versions of the GDS-30. The Cronbach's alpha coefficient value was 0.928, indicating the items' adequate internal consistency. Spearman's correlation coefficient value of total scores between the first and second interviews showed medium correlation (0.479, p < 0.001), and the stability is acceptable. The GDS-30 scale reached the construct validity because the proportion of geriatric depression according to GDS-30 was significantly different between characteristics groups, such as gender, employment, level of education, economic status, and sleep disturbance. The Vietnamese version of the GDS-30 scale had high consistency, satisfactory reliability, and understanding and can be used as a screening tool for depression in elderly patients in primary healthcare centers. This is the first depression rating scale for the elderly in Vietnam to be translated and validated. Non-psychiatric health professionals or patients can quickly self-assess and screen for the illness.