Determinants of antibiotic prescribing in primary care in Vietnam: a qualitative study using the Theoretical Domains Framework.

BACKGROUND: To formulate effective strategies for antimicrobial stewardship (AMS) in primary care, it is crucial to gain a thorough understanding of factors influencing prescribers' behavior within the context. This qualitative study utilizes the Theoretical Domains Framework (TDF) to uncover these influential factors. METHODS: We conducted a qualitative study using in-depth interviews and focus group discussions with primary care workers in two provinces in rural Vietnam. Data analysis employed a combined inductive and deductive approach, with the deductive aspect grounded in the TDF. RESULTS: Thirty-eight doctors, doctor associates, and pharmacists participated in twenty-two interviews and two focus group discussions. We identified sixteen themes, directly mapping onto seven TDF domains: knowledge, skills, behavioral regulation, environmental context and resources, social influences, social/professional role and identity, and optimism. Factors driving unnecessary prescription of antibiotics include low awareness of antimicrobial resistance (AMR), diagnostic uncertainty, prescription-based reimbursement policy, inadequate medication supplies, insufficient financing, patients' perception of health insurance medication as an entitlement, and maintaining doctor-patient relationships. Potential factors facilitating AMS activities include time availability for in-person patient consultation, experience in health communication, and willingness to take action against AMR. CONCLUSION: Utilizing the TDF to systematically analyze and present behavioral determinants offers a structured foundation for designing impactful AMS interventions in primary care. The findings underscore the importance of not only enhancing knowledge and skills but also implementing environmental restructuring, regulation, and enablement measures to effectively tackle unnecessary antibiotic prescribing in this context.

Renal tubular function and morphology revealed in kidney without labeling using three-dimensional dynamic optical coherence tomography.

Renal tubule has distinct metabolic features and functional activity that may be altered during kidney disease. In this paper, we present label-free functional activity imaging of renal tubule in normal and obstructed mouse kidney models using three-dimensional (3D) dynamic optical coherence tomography (OCT) ex vivo. To create an obstructed kidney model, we ligated the ureter of the left kidney for either 7 or 14 days. Two different dynamic OCT (DOCT) methods were implemented to access the slow and fast activity of the renal tubules: a logarithmic intensity variance (LIV) method and a complex-correlation-based method. Three-dimensional DOCT data were acquired with a 1.3 [Formula: see text]m swept-source OCT system and repeating raster scan protocols. In the normal kidney, the renal tubule appeared as a convoluted pipe-like structure in the DOCT projection image. Such pipe-like structures were not observed in the kidneys subjected to obstruction of the ureter for several days. Instead of any anatomical structures, a superficial high dynamics appearance was observed in the perirenal cortex region of the obstructed kidneys. These findings suggest that volumetric LIV can be used as a tool to investigate kidney function during kidney diseases.

The genus Vietbocap Lourenço & Pham, 2010 in the Thien Duong cave, Vietnam: A possible case of subterranean speciation in scorpions (Scorpiones: Pseudochactidae).

Two new species of scorpion belonging to the family Pseudochactidae and to the genus Vietbocap are described based on specimens collected in the Thien Duong cave, which belongs to the Vom cave system, in the Phong Nha-Ke Bang National Park, Quang Binh Province, Vietnam. The previously described species from this cave, Vietbocap thienduongensis Lourenço & Pham, 2012 was collected in the initial section of the cave (1500 to 1800m from the cave entrance) and proved to be a true troglobitic element. The diagnosis of this species, only known from males, is completed based on females collected at 750m from the cave entrance. The two new species described here were collected respectively at 3000 and 5000m from the cave entrance and are also true troglobitic elements, very similar to V. thienduongensis, but showing some clear morphological differences. This observed situation suggests a possible case of speciation within the cave system, the first one ever reported for scorpions. The population found at 5000m from the entrance of the cave is a total new record of distance from a cave entrance for scorpions.

Diversity and endemicity in the scorpion fauna of Vietnam. A preliminary synopsis.

A faunistic inventory is proposed for the known Vietnamese scorpion species. The aim of this contribution is to bring an up-to-date checklist of all known species in Vietnam, prior to a more detailed study of the Vietnamese fauna to be performed by one of the authors (T.-H.T.) in the context of the preparation of a doctoral degree. Final taxonomic decisions should be taken at the end of the doctoral dissertation.

Photoreactive polylactide nanoparticles by the terminal conjugation of biobased caffeic acid.

Photoreactive 3,4-diacetoxycinnamic acid- (DACA-) terminally conjugated poly(L-lactide) (PLLA) (DACA-PLLA) nanoparticles with different diameters were prepared by mixing acetonitrile as a good solvent and water as a poor solvent. The average diameters and morphologies of the nanoparticles prepared under various conditions were evaluated by dynamic light scattering (DLS) measurement and scanning electron microscopic (SEM) observation. The particle size was controllable from about 100 to 300 nm by altering the composition ratio of the mixed solvent, the concentration of the polymers, or the L-lactic acid (LLA) unit number. The particle size increased upon decreasing the LLA unit number or increasing the polymer concentration and water content in the mixed solution. Interestingly, the DACA-PLLA nanoparticles showed different size change properties following UV irradiation at lambda>280 nm before or after particle formation. When UV irradiation was performed after particle formation, only a few percent (ca. 3%) size decrement was observed, although a significant size decrement (ca. 30%) was detected after UV irradiation before particle formation. The DACA-PLLA nanoparticles showed weight decrement during accelerated hydrolysis experiments (pH=10.0, 37 degrees C) for 5 days, whereas the particle diameters were unchanged completely. DACA-PLLA nanoparticles have great potential as a photoreactive PLLA nanoparticles in the various applications.