Peer Texting to Promote Quitline Use and Smoking Cessation Among Rural Participants in Vietnam: Randomized Clinical Trial.

Objectives: We tested an adapted version of an effective U.S.-based peer-texting intervention to promote Quitline use and smoking cessation among rural participants in Vietnam. Methods: We conducted a two-arm randomized trial with participants recruited at four rural community centers. The intervention included peer messages sent for six months that promoted Quitline use and smoking cessation. Additionally, biweekly two-way text messages assessed participants' interest in Quitline referral and current smoking status. Comparison participants received only the bi-weekly text message assessment of their current smoking status. At six months, we assessed Quitline use and smoking cessation. Smoking cessation was assessed using the 7-day point prevalence question and verified with a carbon monoxide breath monitor (<=6 ppm). Results: Among 750 participants, the intervention had higher Quitline verified use (18%, 95% CI 0.14, 0.22) than comparison (1%, 95% CI .2, 2, p < 0.0001). Carbon-monoxide-verified smoking cessation did not differ between the two groups. However, intervention (28.3%, 95% CI) and comparison (28.1%, 95% CI) participants had substantial rates of carbon monoxide cessation at 6 months (both 28%). Conclusion: Our study highlighted the promise of texting interventions to extend tobacco control efforts in Vietnam.

Wild and cultivated allele effects on rice phenotypic traits in reciprocal backcross populations between Oryza rufipogon and two cultivars, O. sativa Nipponbare and IR36.

A total of four populations of reciprocal backcross recombinant inbred lines were produced from a cross between a wild accession of Oryza rufipogon W630 and two major cultivars, O. sativa Japonica Nipponbare and Indica IR36. Using these populations, quantitative trait locus (QTL) analysis for eight morphological traits (culm length, panicle length, days to heading, panicle shape, pericarp color, hull color, seed shattering and seed awning) was carried out, and the putative QTL regions were compared among the populations. The QTLs with strong allele effects were commonly detected for culm length, panicle shape, pericarp color and hull color in all four populations, and their peak locations were close to the major genes of sd1, Spr3, Rc and Bh4, respectively. For panicle length and days to heading, some QTL regions overlapped between two or three populations. In the case of seed shattering and seed awning, strong wild allele effects at major loci were observed only in the populations with cultivated backgrounds. Since the wild and cultivated alleles have never been evaluated in the reciprocal genetic backgrounds, the present results provide new information on gene effects in breeding and domestication studies.

A visible-light photodetector based on heterojunctions between CuO nanoparticles and ZnO nanorods.

Optoelectronic devices have various applications in medical equipment, sensors, and communication systems. Photodetectors, which convert light into electrical signals, have gained much attention from many research teams. This study describes a low-cost photodetector based on CuO nanoparticles and ZnO nanorods operating in a wide range of light wavelengths (395, 464, 532, and 640 nm). Particularly, under 395 nm excitation, the heterostructure device exhibits high responsivity, photoconductive gain, detectivity, and sensitivity with maximum values of 1.38 A·W-1, 4.33, 2.58 × 1011 Jones, and 1934.5% at a bias of 2 V, respectively. The sensing mechanism of the p-n heterojunction of CuO/ZnO is also explored. Overall, this study indicates that the heterostructure of CuO nanoparticles and ZnO nanorods obtained via a simple and cost-effective synthesis process has great potential for optoelectronic applications.

Liquidity creation and bank risk-taking: Evidence from a transition market.

This study contributes to the banking literature by examining the effect of bank liquidity creation on bank risk-taking behaviors in Vietnam - a transition economy. Our data sample comprises 367 observations of 33 Vietnamese commercial banks from 2009 to 2020. We employ the Bias-corrected Least-Squares with Dummy Variables (LSDVC) estimation, which performs better than other dynamic estimators in small and unbalanced panel samples. In this research, bank risk primarily represents non-performing loans (NPLs). Empirical results show that bank liquidity creation significantly reduces NPLs. Otherwise, bank funding diversification significantly increases NPLs in Vietnamese commercial banks. Our findings are robust to alternative measurements of liquidity creation and bank risk. Additionally, we show the moderating role of bank scale in the effects of liquidity creation and funding diversification on bank risk-taking in Vietnamese banks. Our paper is the first research investigating the influence of liquidity creation on bank risk-taking in the specified situation of a transition economy. Besides, it provides empirical evidence to fill the existing research gap. Further, this study provides a list of implications for bank managers and policymakers to manage credit risks and improve the stability of the Vietnamese banking system.

Comprehensive transcriptomic analysis of age-, dark-, and salt-induced senescence reveals underlying mechanisms and key regulators of leaf senescence in Zoysia japonica.

The lawn grass Zoysia japonica is widely cultivated for its ornamental and recreational value. However, its green period is subject to shortening, which significantly decreases the economic value of Z. japonica, especially for large cultivations. Leaf senescence is a crucial biological and developmental process that significantly influences the lifespan of plants. Moreover, manipulation of this process can improve the economic value of Z. japonica by extending its greening period. In this study, we conducted a comparative transcriptomic analysis using high-throughput RNA sequencing (RNA-seq) to investigate early senescence responses triggered by age, dark, and salt. Gene set enrichment analysis results indicated that while distinct biological processes were involved in each type of senescence response, common processes were also enriched across all senescence responses. The identification and validation of differentially expressed genes (DEGs) via RNA-seq and quantitative real-time PCR provided up- and down-regulated senescence markers for each senescence and putative senescence regulators that trigger common senescence pathways. Our findings revealed that the NAC, WRKY, bHLH, and ARF transcription factor (TF) groups are major senescence-associated TF families that may be required for the transcriptional regulation of DEGs during leaf senescence. In addition, we experimentally validated the senescence regulatory function of seven TFs including ZjNAP, ZjWRKY75, ZjARF2, ZjNAC1, ZjNAC083, ZjARF1, and ZjPIL5 using a protoplast-based senescence assay. This study provides new insight into the molecular mechanisms underlying Z. japonica leaf senescence and identifies potential genetic resources for enhancing its economic value by prolonging its green period.

Current Insights into m6A RNA Methylation and Its Emerging Role in Plant Circadian Clock.

N6-adenosine methylation (m6A) is a prevalent form of RNA modification found in the expressed transcripts of many eukaryotic organisms. Moreover, m6A methylation is a dynamic and reversible process that requires the functioning of various proteins and their complexes that are evolutionarily conserved between species and include methylases, demethylases, and m6A-binding proteins. Over the past decade, the m6A methylation process in plants has been extensively studied and the understanding thereof has drastically increased, although the regulatory function of some components relies on information derived from animal systems. Notably, m6A has been found to be involved in a variety of factors in RNA processing, such as RNA stability, alternative polyadenylation, and miRNA regulation. The circadian clock in plants is a molecular timekeeping system that regulates the daily and rhythmic activity of many cellular and physiological processes in response to environmental changes such as the day-night cycle. The circadian clock regulates the rhythmic expression of genes through post-transcriptional regulation of mRNA. Recently, m6A methylation has emerged as an additional layer of post-transcriptional regulation that is necessary for the proper functioning of the plant circadian clock. In this review, we have compiled and summarized recent insights into the molecular mechanisms behind m6A modification and its various roles in the regulation of RNA. We discuss the potential role of m6A modification in regulating the plant circadian clock and outline potential future directions for the study of mRNA methylation in plants. A deeper understanding of the mechanism of m6A RNA regulation and its role in plant circadian clocks will contribute to a greater understanding of the plant circadian clock.

Average lifespan shortened due to cancer in selected countries of North America, Europe, Asia and Oceania, 2006 and 2016.

PURPOSE: We applied a novel measure of average lifespan shortened (ALSS) to examine changes in lifespan among patients who died of cancer over a 10-year period from 2006 to 2016 in 20 selected high-income countries from North America, Europe, Asia, and Oceania. METHODS: We retrieved cancer deaths in each country from the World Health Organization mortality database. We calculated ALSS as a ratio of years of life lost to the expected lifespan among patients who died from cancer. RESULTS: Between 2006 and 2016, we observed modest changes in ALSS for overall cancer deaths over the study in many countries. The changes in the ALSS over time due to any cancer ranged between -1.7 and +0.4 percentage points (pps) among men and between -1.9 and +0.6 pps among women. Across countries, overall cancer deaths led to an average loss between 16% and 22% of their lifespan in men, and between 18% and 24% in women. Across cancer sites, patients who died of central nervous system cancers, for instance, lost a large proportion of their lifespan. CONCLUSIONS: In this study, we demonstrated the use of ALSS across selected high-income countries, which enables population-level assessment of premature mortality among cancer patients over time.

Surgical treatment of tension pneumomediastinum in patients with covid-19 at the field hospital: a case series.

BACKGROUND: Tension pneumomediastinum is one of the most serious complications in COVID-19 patients with respiratory distress requiring invasive mechanical ventilation. This complication can lead to rapid hemodynamic instability and death if it is not recognized in a timely manner and intervenes promptly. CASE PRESENTATION: We reported 7 COVID-19 patients with tension pneumomediastinum at a field hospital. All patients were critically ill with ARDS. These 7 patients, including 3 females and 4 males in this series, were aged between 39 and 70 years. Tension pneumomediastinum occurred on the first day of mechanical ventilation in 3 patients and later in the course of hospital stay, even 10 days after being intubated and ventilated. The tension pneumomediastinum caused hemodynamic instability and worsened respiratory mechanics with imminent cardiopulmonary collapse. In this series, we used two surgical techniques: (i) mediastinal decompression by suprasternal drainage with or without simultaneous pleural drainage in the first two cases and (ii) mediastinal drainage via suprasternal and subxiphoid incisions in 5 patients. The surgical procedures were feasible and reversed the pending cardiopulmonary collapse. Four patients had a favorable postprocedural period and were discharged from the intensive care center. Both patients undergoing suprasternal drainage died of failed/recurrent tension pneumomediastinum and nosocomial infection. Only one in five patients who underwent mediastinal drainage via suprasternal and subxiphoid incisions died of septic shock secondary to ventilator-associated pneumonia. CONCLUSION: Tension pneumomediastinum was a life-threatening complication in critically ill COVID-19 patients requiring mechanical ventilation. Surgical mediastinal decompression was the salvage procedure. The surgical technique of mediastinal drainage via suprasternal and subxiphoid incisions proved an advantage in tension relief, hemodynamic improvement and mortality reduction.

Rapid Investigation of Functional Roles of Genes in Regulation of Leaf Senescence Using Arabidopsis Protoplasts.

Leaf senescence is the final stage of leaf development preceding death, which involves a significant cellular metabolic transition from anabolism to catabolism. Several processes during leaf senescence require coordinated regulation by senescence regulatory genes. In this study, we developed a rapid and systematic cellular approach to dissect the functional roles of genes in senescence regulation through their transient expression in Arabidopsis protoplasts. We established and validated this system by monitoring the differential expression of a luciferase-based reporter that was driven by promoters of SEN4 and SAG12, early and late senescence-responsive genes, depending on effectors of known positive and negative senescence regulators. Overexpression of positive senescence regulators, including ORE1, RPK1, and RAV1, increased the expression of both SEN4- and SAG12-LUC while ORE7, a negative senescence regulator decreased their expression. Consistently with overexpression, knockdown of target genes using amiRNAs resulted in opposite SAG12-LUC expression patterns. The timing and patterns of reporter responses induced by senescence regulators provided molecular evidence for their distinct kinetic involvement in leaf senescence regulation. Remarkably, ORE1 and RPK1 are involved in cell death responses, with more prominent and earlier involvement of ORE1 than RPK1. Consistent with the results in protoplasts, further time series of reactive oxygen species (ROS) and cell death assays using different tobacco transient systems reveal that ORE1 causes acute cell death and RPK1 mediates superoxide-dependent intermediate cell death signaling during leaf senescence. Overall, our results indicated that the luciferase-based reporter system in protoplasts is a reliable experimental system that can be effectively used to examine the regulatory roles of Arabidopsis senescence-associated genes.

Isolated Congenital Mitral Regurgitation Repair in Children: Long-term Outcomes of Artificial Rings.

BACKGROUND: Because isolated congenital mitral regurgitation (ICMR) is rare, the role of artificial rings in annuloplasty for ICMR is still debated. In this study we compared long-term results of annuloplasty with and without rings for ICMR. METHODS: We performed a retrospective review of all patients ≤ 18 years old undergoing repair for ICMR from 1993 to 2019 at our hospital. Techniques of annuloplasty depended on individual lesions of the mitral valve (MV). One hundred twelve cases were divided into 3 groups: group A (43 cases) with ≥26-mm ring, group B (35 cases) with <26-mm ring, and group C (34 cases) with a band. Study endpoints were overall survival and MV reoperation. RESULTS: Patients in group A were older than the others (median age 11 compared with 5 and 4 years, respectively). The MV lesions were complicated, but annular dilatation existed in 91% of cases. Three patients died, and there were 25 reoperations during a median follow-up period of 11 years. Groups B and C had higher rates of reoperation than group A (hazard ratios, 5.35 [95% confidence interval, 1.71-17.75] and 3.61 [95% confidence interval, 1.03-12.60], respectively). Most reoperations in group B (13/14 cases) were due to stenosis, whereas 6 of 7 reoperations in group C were due to recurrent regurgitation. CONCLUSION: MV reconstruction for ICMR in children had good long-term survival. Annuloplasty with ≥26-mm ring had the lowest risk of reoperation. In cases of young children bands are more favored than <26-mm rings, but they carry a risk of recurrent regurgitation.

Assessment of total concentrations of heavy metals in industrial sludges from the North of Vietnam and their potential impact on the ecosystem.

Industrial sludges from wastewater treatment plants of industrial parks and a drinking water treatment plant in northern Vietnam were investigated in this study. The total concentrations of heavy metals (As, Cd, Cu, Cr, Ni, Hg, Pb, Zn) and other elements (Mn, Pd, Sb, V) in the sludges were measured using the ICP-MS method. In addition, the surface characteristics of the samples were analyzed using SEM-EDS and FTIR techniques. According to Vietnam's current waste management regulation, the investigated industrial sludges belonged to the hazardous waste category (with Pb concentration > 300 µg/g). In contrast, the sludge from the drinking water treatment plant had a low content of heavy metals and toxic elements. The sequential extraction method revealed that the heavy metals in the industrial sludges exhibited higher mobilization forms (exchangeable and reduceable fractions) than those in the drinking water sludges. The mobilization ability of heavy metals is probably related to the surface function groups of the sludges, which were dominated by (-COOH) and (-OH) groups. The potential ecological risk assessment calculations indicated that the industrial sludges had high potential risk (with the RI values ranging from 229.7 to 605.4), mainly due to the content of Cd in the sludge samples. Further studies about the fate and transport of Cd and other toxic metals in the sludges are highly recommended to better understand their risk to the surrounding environment, such as groundwater and agricultural soil.

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.

mHealth Messaging to Motivate Quitline Use and Quitting: Protocol for a Community-Based Randomized Controlled Trial in Rural Vietnam.

BACKGROUND: Tobacco kills more than 8 million people each year, mostly in low- and middle-income countries. In Vietnam, 1 in every 2 male adults smokes tobacco. Vietnam has set up telephone Quitline counseling that is available to all smokers, but it is underused. We previously developed an automated and effective motivational text messaging system to support smoking cessation among US smokers. OBJECTIVE: The aim of this study is to adapt the aforementioned system for rural Vietnamese smokers to promote cessation of tobacco use, both directly and by increasing the use of telephone Quitline counseling services and nicotine replacement therapy. Moreover, we seek to enhance research and health service capacity in Vietnam. METHODS: We are testing the effectiveness of our culturally adapted motivational text messaging system by using a community-based randomized controlled trial design (N=600). Participants were randomly allocated to the intervention (regular motivational and assessment text messages) or control condition (assessment text messages only) for a period of 6 months. Trial recruitment took place in four communes in the Hung Yen province in the Red River Delta region of Vietnam. Recruitment events were advertised to the local community, facilitated by community health workers, and occurred in the commune health center. We are assessing the impact of the texting system on 6-month self-reported and biochemically verified smoking cessation, as well as smoking self-efficacy, uptake of the Quitline, and use of nicotine replacement therapy. In addition to conducting the trial, the research team also provided ongoing training and consultation with the Quitline during the study period. RESULTS: Site preparation, staff training, intervention adaptation, participant recruitment, and baseline data collection were completed. The study was funded in August 2017; it was reviewed and approved by the University of Massachusetts Medical School Institutional Review Board in 2017. Recruitment began in November 2018. A total of 750 participants were recruited from four communes, and 700 (93.3%) participants completed follow-up by March 2021. An analysis of the trial results is in progress; results are expected to be published in late 2022. CONCLUSIONS: This study examines the effectiveness of mobile health interventions for smoking in rural areas in low- and middle-income countries, which can be implemented nationwide if proven effective. In addition, it also facilitates significant collaboration and capacity building among a variety of international partners, including researchers, policy makers, Quitline counselors, and community health workers. TRIAL REGISTRATION: ClinicalTrials.gov NCT03567993; https://clinicaltrials.gov/ct2/show/NCT03567993. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/30947.

Autologous adipose-derived stem cells therapy in COPD treatment: a case report.

Here, we describe the clinical course of a patient with chronic obstructive pulmonary disease treated with autologous adipose-derived stem cell therapy. In September 2019, our patient was admitted to Bach Mai Hospital. His post-bronchodilator forced expiratory volume in 1 sec (FEV1) was 21% and FEV1/forced vital capacity (FVC) was 40%. He had suffered from two exacerbations of chronic obstructive pulmonary disease (COPD) in the previous year. He received treatment with autologous stem cells from adipose tissue. Follow-up indicated that autologous stem cells from adipose tissue was a safe treatment and improved the patient's dyspnoea and quality of life.

Benzodiazepine-induced photosensitivity reactions: A compilation of cases from literature review with Naranjo causality assessment.

OBJECTIVE: Benzodiazepines have been reported to cause photosensitivity reactions. We characterized the clinical presentation and diagnosis of benzodiazepine-associated photosensitivity and adjudicated these cases for a causal association with benzodiazepines. METHODS: A literature search on PubMed's "MeSH" search feature and CINAHL (1964 to 2019) was performed using search terms: benzodiazepine, photosensitivity, and photosensitivity disorders/chemically induced. We applied the Naranjo scale, a standardized causality assessment algorithm, to identified cases. RESULTS: We identified eight published cases, with 50% of patients being female with a mean age of 46.3 years. Alprazolam, tetrazepam, clobazam, and clorazepate induced phototoxic reactions. Chlordiazepoxide induced one photoallergic reaction. Photosensitivity occurred between 1-3 days (37.5%), 7-14 days (25%), and >14 days (25%). Photosensitivity resolved after drug discontinuation within 2 weeks (62.5%). Benzodiazepine rechallenge confirmed photosensitivity in 75% of cases. Photopatch testing was negative in two patients; however, these patients had positive oral provocation testing. However, an oral photoprovocation test, an ideal diagnostic test, was not administered to several patients. Despite these challenges, the Naranjo scale identified 5 cases as definite benzodiazepine-induced photosensitivity. CONCLUSION: Five benzodiazepines induced photosensitivity reactions. Five patients showed a definite association with the Naranjo scale. Reporting to pharmacovigilance databases may help identify other benzodiazepines causing photosensitivity reactions.

Respiratory microbes detected in hospitalized adults with acute respiratory infections: associations between influenza A(H1N1)pdm09 virus and intensive care unit admission or fatal outcome in Vietnam (2015-2017).

BACKGROUND: Acute respiratory tract infection (ARI) is a leading cause of hospitalization, morbidity, and mortality worldwide. Respiratory microbes that were simultaneously detected in the respiratory tracts of hospitalized adult ARI patients were investigated. Associations between influenza A(H1N1)pdm09 virus (H1N1pdm) detection and intensive care unit (ICU) admission or fatal outcome were determined. METHODS: This prospective observational study was conducted between September 2015 and June 2017 at Bach Mai Hospital, Hanoi, Vietnam. Inclusion criteria were hospitalized patients aged ≥15 years; one or more of symptoms including shortness of breath, sore throat, runny nose, headache, and muscle pain/arthralgia in addition to cough and fever > 37.5 °C; and ≤ 10 days from the onset of symptoms. Twenty-two viruses, 11 bacteria, and one fungus in airway specimens were examined using a commercial multiplex real-time PCR assay. Associations between H1N1pdm detection and ICU admission or fatal outcome were investigated by univariate and multivariate logistic regression analyses. RESULTS: The total of 269 patients (57.6% male; median age, 51 years) included 69 ICU patients. One or more microbes were detected in the airways of 214 patients (79.6%). Single and multiple microbes were detected in 41.3 and 38.3% of patients, respectively. Influenza A(H3N2) virus was the most frequently detected (35 cases; 13.0%), followed by H1N1pdm (29 cases; 10.8%). Hematological disease was associated with ICU admission (p < 0.001) and fatal outcomes (p < 0.001) using the corrected significance level (p = 0.0033). Sex, age, duration from onset to sampling, or number of detected microbes were not significantly associated with ICU admission or fatal outcomes. H1N1pdm detection was associated with ICU admission (odds ratio [OR] 3.911; 95% confidence interval [CI] 1.671-9.154) and fatal outcome (OR 5.496; 95% CI 1.814-16.653) after adjusting for the confounding factors of comorbidities, bacteria/Pneumocystis jirovecii co-detection, and age. CONCLUSIONS: H1N1pdm was associated with severe morbidity and death in adult patients hospitalized with respiratory symptoms. The diagnosis of subtype of influenza virus may be epidemiologically important.

Lumos: a statewide linkage programme in Australia integrating general practice data to guide system redesign.

Objective: With ageing of the Australian population, more people are living longer and experiencing chronic or complex health conditions. The challenge is to have information that supports the integration of services across the continuum of settings and providers, to deliver person-centred, seamless, efficient and effective healthcare. However, in Australia, data are typically siloed within health settings, precluding a comprehensive view of patient journeys. Here, we describe the establishment of the Lumos programme-the first statewide linked data asset across primary care and other settings in Australia and evaluate its representativeness to the census population. Methods and analysis: Records extracted from general practices throughout New South Wales (NSW), Australia's most populous state, were linked to patient records from acute and other settings. Innovative privacy and security technologies were employed to facilitate ongoing and regular updates. The marginal demographic distributions of the Lumos cohort were compared with the NSW census population by calculating multiple measures of representation to evaluate its generalisability. Results: The first Lumos programme data extraction linked 1.3 million patients' general practice records to other NSW health system data. This represented 16% of the NSW population. The demographic distribution of patients in Lumos was >95% aligned to that of the NSW population in the calculated measures of representativeness. Conclusion: The Lumos programme delivers an enduring, regularly updated data resource, providing unique insights about statewide, cross-setting healthcare utilisation. General practice patients represented in the Lumos data asset are representative of the NSW population overall. Lumos data can reliably be used to identify at-risk regions and groups, to guide the planning and design of health services and to monitor their impact throughout NSW.

Inadequate Knowledge, Attitude and Practices about Second-Hand Smoke among Non-Smoking Pregnant Women in Urban Vietnam: The Need for Health Literacy Reinforcement.

The rate of exposure to second-hand smoke (SHS) is relatively high in several countries, including Vietnam, and health issues related to SHS have worsened in recent years, especially for pregnant women and their infants. Enhancement of knowledge, attitude, and practice (KAP) scores of pregnant women in Vietnam could raise practical interventions to protect their health and reduce complications of SHS. A cross-sectional study of 432 pregnant women who came to the Obstetrics Department of Bach Mai Hospital, Hanoi, Vietnam for antenatal care was conducted in 2016 to collect information about their KAP related to SHS. Composite mean scores from survey questions assessing their KAP were calculated on a 10-point scale, finding mean scores of 4.19, 7.45, and 4.30, respectively. Higher scores indicated better knowledge, attitude, and practice. Generalized linear models identified that age, occupation, living place, and sources of information were associated with SHS-related KAP. Findings from this study indicate that suitable programs related to SHS should be implemented to improve and reinforce health literacy to both mothers and smokers to reduce the harmfulness of smoking on women and their infants' health.