Maternal healthcare for women with physical disabilities in Northern Vietnam: perspectives of healthcare providers.

BACKGROUND: Pregnancy among women with physical disabilities is common around the world; however, there are limited qualitative studies that explore the perspectives of healthcare providers toward pregnant women with disabilities outside of the Global North. OBJECTIVE: This article explores perspectives and experiences of maternal healthcare providers in the delivery of services to women with physical disabilities in Northern Vietnam. METHODS: Semi-structured interviews were conducted with 14 healthcare providers who worked in public and/or private healthcare North Vietnamese facilities where maternal services were provided. Data were thematically analyzed. RESULTS: The participants included six males and eight females. Ten were obstetricians/gynecologists, one was a doctor specializing in obstetric imaging diagnosis, three were midwives, and one was a midwife/assistant doctor. Four themes were identified. In the first theme, providers attached provisos to the right to motherhood including the view that the women were limited to one child and should undergo prenatal screenings for fetal abnormalities. In the second theme, the providers reported that disability was not incorporated into their education; this led to half of them lacking confidence in providing appropriate maternal healthcare services for women with physical disabilities. The third theme found that although women with physical disabilities were considered as a priority group, decisions around who was seen before others or provided with fee discount/exemption were left in the hands of staff. The fourth theme identified that some providers overlooked their needs for physical accessibility and independence. CONCLUSION: This study shows that maternal healthcare providers in Vietnam discounted the needs of women with physical disabilities. The needs of women with disabilities should be included in the training of maternal healthcare providers in Vietnam.

Welfare impact of climate change on capture fisheries in Vietnam.

Fisheries are forecasted to shrink in the tropics due to climate change. In Vietnam, fisheries are a pro-poor economic sector and essential nutrition source; however, welfares of producers and consumers in the climate change context are not well understood. While most studies focus on the gains or losses of total products and revenues, this paper pays additional attention to the changes in surpluses of market players in the long run. A combination of the production function, demand and supply functions, and partial equilibrium analysis is employed to measure the production and welfare impacts based on time series data from 1976 to 2018 and a Vietnam household living standards survey in 2018. The results show that relative to the present, catch yield is likely to reduce 35%-45% by mid-century and 45%-80% by the end of the century. Consumers may lose their surplus of 7-9 billion USD (PPP, 2018) by 2035 and 10-18 billion USD by 2065 due to supply reduction, while producers may gain additional profit of 3.5-4.5 billion USD by 2035 and 5-9 billion USD by 2065 owing to a price increase. The research findings suggest that Vietnam could impose measures to limit capture effort, as set out in the Law of Fisheries 2017, without harming fisher welfare. The expansion of aquaculture could reduce the gap between supply and demand of wild fish to mitigate consumer welfare loss; however, this impact is still ambiguous.

"Nothing suitable for us": experiences of women with physical disabilities in accessing maternal healthcare services in Northern Vietnam.

PURPOSE: This article explores how maternal healthcare access was experienced by women with physical disabilities in Northern Vietnam. METHODS: A qualitative methodology with an interpretive phenomenological design was used. In-depth interviews were conducted with women with physical disabilities who had given birth in the previous three years. Twenty-nine women participated in a first in-depth interview, and 27 women completed follow-up interviews. Physical access audits were also conducted at 14 facilities providing maternal healthcare services. Data were thematically analyzed. RESULTS: The women said they highly valued antenatal care but rarely attended postnatal check-ups. Their decisions around service uptake were influenced by attitudinal barriers from staff, particularly failure to recognize that women with physical disabilities had a right to motherhood and quality maternal healthcare. Specialized information on pregnancy and childbirth for women with physical disabilities was limited. Long waiting times, confusing referral systems, and financial hardship were also significant problems in accessing maternal healthcare. Many healthcare facilities were not disability friendly. CONCLUSIONS: Women with physical disabilities in Northern Vietnam encountered multiple challenges when accessing maternal healthcare services. Many Vietnamese healthcare services are ill-equipped to provide disability-inclusive and responsive maternal healthcare because of inadequate structural design, attitudinal barriers, limited appropriate information, and financial burden. There should be increased attention paid to mainstreaming the needs of women with physical disabilities into maternal healthcare services in Vietnam.Implications for rehabilitationThere is a need for strong and sustained advocacy from all related staff, including rehabilitation workers, to improve the quality of healthcare for pregnant women with physical disabilities in Vietnam.Disability training should be integrated into mainstream in-service courses for maternal healthcare providers and curricula for medical, midwifery and nursing students.A resource package that provides women with physical disabilities with reliable and comprehensive information on disability and pregnancy, childbirth and maternal healthcare should be developed and disseminated.Professional protocols and infrastructure for maternal healthcare for women with physical disabilities should be more sensitive and responsive to their needs and rights.

Whose decision? Caesarean section and women with physical disabilities in Northern Vietnam: A qualitative study.

BACKGROUND: Pregnant women with physical disabilities are more likely to have caesarean sections than are women without disabilities. For some women with disabilities, caesarean birth may not be clinically necessary, as they may lack autonomy in decision-making to a greater extent than is the case for other pregnant women. OBJECTIVE: To explore the relative influence of health staff, family, friends, and the women themselves on key decisions about childbirth of women with physical disabilities in northern Vietnam. RESEARCH DESIGN/SETTING: A qualitative approach using a phenomenological design was employed. Fifty-six in-depth interviews were conducted with women with physical disabilities who had given birth in the previous three years in two northern provinces in Vietnam (Hanoi and Thaibinh). Twenty-nine women participated in a first interview and 27 completed follow-up interviews several months later. Additionally, semi-structured interviews were conducted with 12 maternal healthcare providers. Interviews were transcribed and thematically analysed. RESULTS: Twenty-eight of the 29 participants underwent caesarean sections. Two themes were identified: (1) The women reported that caesarean section was mandated by attending doctors "because of their disability". Consistently, the healthcare providers said caesarean section is essential for women with physical disabilities; and (2) The women said that their parents and peers supported caesarean birth. Very few women indicated that they could influence this decision, even though one-third said their personal preference was for vaginal birth. CONCLUSIONS: Many women with physical disabilities are not given the opportunity to exercise informed choices around childbirth options. Women in Vietnam who live with physical disabilities should be empowered to make informed decisions about childbirth. It is recommended that professional guidelines and training are revised to properly engage women with physical disabilities in joint decision-making for the birth of their children.

"Under great anxiety": Pregnancy experiences of Vietnamese women with physical disabilities seen through an intersectional lens.

BACKGROUND: There is scant research on pregnancy experiences of women with physical disabilities in low and middle-income countries. This qualitative study used an intersectional lens to explore pregnancy experiences of women with physical disabilities in northern Vietnam. Specifically, socio-cultural, economic, and environmental influences were analysed, drawing upon their lived experiences. METHODS: Two in-depth interviews were conducted at different time-points in 2018 with women with physical disabilities who had given birth in the previous three years. Twenty-nine women participated in the first interview and 27 in the follow-up interview. The interviews were thematically analysed. RESULTS: The women were happy and excited when discovering their pregnancy but they also experienced anxiety, fear, and distress. Their ambivalence related to concerns around having a child with disabilities, their capability to carry a pregnancy, and their mothering abilities. Negative community views of disability were internalised by the women. These socio-culturally constructed beliefs led to lack of confidence in their pregnancy journey. This was exacerbated by inaccessible environments that contributed to increased risk of falls, and women who used wheelchairs experienced particular difficulties. Other powerful influences included poverty, lost income, and costs associated with pregnancy. Single mothers with disabilities experienced additional stigma and discrimination as Vietnamese society judged their pregnancies as socially unacceptable. CONCLUSION: This study contributes to knowledge and understanding about women with physical disabilities, specifically how the intersection of gender, disability, socio-economic, and marital status shaped their pregnancy experiences in Vietnam. Multiple challenges were encountered by the women in their pregnancy journey, including negative community views, inaccessible environments, and poverty. The findings highlight the necessity for Vietnamese women with physical disabilities to be actively engaged in talking about their experiences to ensure maternal and child health providers become more sensitive to their pregnancy and motherhood needs.

Traphanoside GO1, a new triterpenoid saponin from the aerial parts of Glinus oppositifolius with the inhibitory effect on PGE2 production in LPS-induced HepG2 cells.

A new saponin, 3-O-[α-ʟ-rhamnosyl-(1→3)-ß-D-glucopyranosyl]-28-O-ß-D-glucopyranosyl serjanic acid (Traphanoside GO1, 11) along with eleven compounds (1-10 and 12) were isolated from the aerial parts of Glinus oppositifolius. The structures of all isolates were elucidated by analyzing extensive 1 D- and 2 D-NMR and HR-ESI-MS, comparing with reported literature data. Compounds 7-8, 10-11, and 90% ethanol extract (GOE90) were evaluated for the inhibitory effect on PGE2 production from activated HepG2 cells. Among these, new compound 11 showed the most potent inhibitory activity by suppressing LPS-induced PGE2 production on the HepG2 cells.

The effectiveness of workplace health promotion in low- and middle-income countries.

Although many literature reviews synthesize literature regarding workplace health promotion (WHP) interventions, systematic reviews on the effectiveness of and factors influencing the operation of WHP activities in low- and middle-income countries (LMIC) are scarce. Therefore, we systematically reviewed evaluation studies to examine the effectiveness and factors related to the implementation of WHP programmes in LMIC. Twenty-six peer-reviewed and grey evaluation studies, published before November 2017, were included from electronic databases (PubMed, The Cochrane Library, PsycINFO, EMBASE and Web of Science) and manual searching. The results revealed that WHP intervention in LMIC was effective in reducing health risks in a wide range of industries and settings, including in resource-poor contexts such as small enterprises and the manufacturing industry. The main factors positively influencing the effectiveness of the intervention are long intervention time period, and needs-based and active intervention strategies. In addition, commitment from workplace leaders, the involvement of workers and support from authorities and professionals are factors contributing to a successful WHP programme. However, the evidence regarding the effectiveness of WHP in LMIC regarding the health outcomes and business productivity is inconclusive due to the several remaining methodological limitations. Future developments of more rigorous methods of evaluating the effectiveness of WHP activities should be addressed to produce higher-quality evidence that would inform future practice.

Strategies for developing gender-specific HIV prevention for adolescents in Vietnam.

In Vietnam, between 2000 and 2006, HIV rates among 15- to 49-year-olds in the general population have increased from 27% to 53%. The HIV epidemic is occuring in a context of rapid socioeconomic changes, which have brought about conflicting ideals and norms between "traditional" and "modern" gender roles. We discuss the processes for developing the Exploring the World of Adolescents gender-specific HIV prevention curricula for 15- to 21-year-old adolescents living in both rural and urban Vietnam. The curricula are modeled after an existing HIV prevention program previously adapted and evaluated in Vietnam (Vietnamese Focus on Kids) and based in social learning theory (prevention motivation theory) contextualized within socioeconomic changes. The overall capacity building and participatory strategies for program development included (a) review of the HIV/AIDS and socioeconomic conditions in Vietnam, (b) review of the Vietnamese Focus on Kids curriculum themes and the theoretical constructs from the protection motivation theory, () analysis of qualitative and quantitative needs assessment data to incorporate culturally significant issues of gender and sexuality, and (d) a review of themes and activities from existing evidence-based adolescent reproductive health curricula.

Studying the changes of leukocyte, erythrocyte and bone-marrow of mice treated by gamma irradiation

Studying the effectiveness of irradiation on bone-marrow, the numbers of leukocyte, erythrocyte, hemoglobin of mice (25 normal mice and 35 mice treated by gamma irradiation with the dose of 600 rad/(100rad/day) (60 Co) showed that: Gamma irradiation reduced total of leucocytes, the number of different leucocytic (lymphocyte, granulocyte, mono and natural killer cells), the ratio of reticulocyte, number of mature erythrocyte and hemoglobin: Total of leucocytes (3,14 ± 1,58 in comparison with 13,45 ± 4,6); monocytes (0,05 ± 0,03 in comparison with 0,26 ± 0,13), lymphocytes (1,66 ± 0,36 in comparison with 6,34 ± 2,84). After gamma irradiation, the number of reticulocyte was 55%, mature erythrocyte was 73% and hemoglobin was 82%

Endemic, epidemic clone of Salmonella enterica serovar typhi harboring a single multidrug-resistant plasmid in Vietnam between 1995 and 2002.

Salmonella enterica serovar Typhi strains resistant to ampicillin, chloramphenicol, tetracyclines, streptomycin, and cotrimoxazole, isolated from sporadic cases and minor outbreaks in Vietnam between 1995 and 2002, were typed and compared. Plasmid fingerprinting, Vi bacteriophage typing, XbaI pulsed-field gel electrophoresis, and PstI ribotyping showed that endemic, epidemic multidrug-resistant typhoid fever was due, for at least 74.1% of the isolates, to one or two clones of serovar Typhi harboring a single resistance plasmid. PstI ribotyping was used as a basic technique to ensure that a serovar Typhi expansion was clonal.

Ratio of B virus infection in Muong minority pupils

115/400 Muong minority pupils of boarding school in Hoa Binh province, all studied subjects have 3 genarations of Muong minority (grandparents, parents and themshelves being Muong minority), from 15 to 19 years old. Using Sero check product of USA to examine the ratio of HBsAg. Results: 19.05% of the boys having HBsAg(+), 13.38% of the girls having HBsAg(+). So the ratio of HBsAg(+) in girls are lower than in boys but it is not significant. The ratio of HBsAg(+) at the age of 15 is 19.61%, the age of 16-17 is 14.74% and the age of 18-19 is 16.67%, there is not significant between groups

Circulating immune-complexes in acute leprosy, chronic hepatitis, pharynx cancer and acute myelogenous leukemia

20 patients with acute leprosy, 12 patients with chronic hepatitis, 34 patients with acute myelogenous leukemia, 48 patients with pharynx cancer. 31 normal healthy persons in the control group. Immune-complexes were fixed quantity by 2 methods: precipitating the immune-complexes with PEG having molecular weight 6.10¬3 and better method. Immune-complexes (+) were identified on acute leprosy, chronic hepatitis and acute diseases with the ratio of positive differences depending on disease, stage and the character of applying technique

Contribute to understand the effect of chemicals on immunological responding capacity of people having frequent and long contact

Study on 48 people, of whom 16 are male and 32 are female, from 23 to 44 years old. They were long exposed with poly-chemicals, such as organic and iso-organic acids: benzene, toluene and their coequals. The parameters have been used: phagocyte capablity and phagocyte index of neutrophils; E, rossett formed T cells. The results showed that: Phagocyte capability and phagocyte index of neutrophils decreased significantly comparing with control group (p<0.001)

Changes in erythrocyte, leucocyte and platelet in people having frequent contact with chemicals

In this study, 48 long-term exposed people with polychemicals (the male/female ratio is 1/3, the age from 23 to 44): such as organic and iso-organic acids: benzene, toluene and their coequals were investigated. 17 normal people not exposed with polychemicals as the control group. Results were shown following: quantity of erythrocyte was lower than control group but not significantly. Leucocytes especially neutrophils reduced significantly (p<0.001). 15/48 cases (30%) appereared lymphoblast. There is no difference in platelet between studied group and control group

To finish the technique of identificating HLA in nasopharyngeal carcinoma patients

By the technique of indirect immunofluoresceine using 18 diverse markers, in the hospital K- Ha Noi, study was performed to determine the capacity of foreign antigene expression of tumor cells in the cell surface making them identified by immunology system through HLA system on NPC < 75 years old age patients. This system played an essential role in the regulation and realization of immune response.

The effects of "DYI" on experimental Heterogenous skin graft and mixed lymphocytic culture of human

Heterogenous transplantation of skin was studied on two strains of mice BALB/C and Swiss.The subjects were divided into various groups :normal group, cyclophosphamid (CP) inhibited group, cyclosporin A (CPA) inhibited group, and the group processed with DY1. The onset of reject phenomenon of the graft and the completed reject of the graft in the groups of mice using CP, CPA and DY1 were more delayed in comparing with the controlled subjects. The cell numbers decreased and the percentage of transformed cells also decreased in all groups using CP, CPA and DY1

Immunosuppressed model for experimental mice by cyclophosphamid

Study on white mices with age of 6-8 weeks, 18-20g body weight. They were divided into 3 groups: group 1 (control group): 30 mices; group 2: mices were immunesuppressed by 200mg cyclophosphamid per one kilogram of body weight, being checked after 5 days of injection; and 300mg cyclophosphamid per one kilogram (200mg on the first day and 100mg on the fifth day) and it was checked after 10 days of injection (group 3). The results: immunesuppressed model implemented by intraperitonial injection of 200mg per one kilogram of body weight checked after 5 days of injeciton. These parameters were used to assign the immune function