Workplace wellbeing in community pharmacy practice: A cross-sectional study in Can Tho, Vietnam.

Background: Among pharmacy workers, low workplace wellbeing can lead to reduced effectiveness. However, to date, studies on this issue are limited within the community pharmacy setting in Vietnam. Objectives: This study was conducted to identify the component aspects of workplace wellbeing and their associations with demographic characteristics. Methods: The cross-sectional descriptive study was conducted in Can Tho, Vietnam. Self-administered questionnaires were hand-delivered to all pharmacy workers working at selected community pharmacies. The workplace wellbeing scale comprised 18 items. Results: In total, 382 pharmacy workers participated in this study. Factor analysis revealed three fundamental aspects to workplace wellbeing: Factor 1 - perceived self-worth and job satisfaction, Factor 2 - positive emotions with work, and Factor 3 - negative emotions with work. Factor 1 showed a positive correlation with Factor 2, with a correlation coefficient (ρ) of 0.509, while both Factor 1 (ρ = -0.399) and Factor 2 (ρ = -0.416) demonstrated negative correlations with Factor 3. Higher income was associated with higher positive emotions with work (P = 0.008), higher perceived self-worth and job satisfaction (P = 0.013), and lower negative emotions with work (P < 0.001). Conclusion: Workplace wellbeing of pharmacy workers in their professional environments was associated with financial aspects. These findings suggest that policies aimed at improving income for pharmacy workers could bring benefits to enhancing job satisfaction and workplace wellbeing.

Psychological Distress and its Association With Job Satisfaction Among Hospital Pharmacists in Vietnam.

Background: No previous studies have examined the relationship between stress, anxiety, and depression among pharmacists in Vietnam. Objectives: This study aims to investigate the correlation between stress, anxiety, depression, and job satisfaction among hospital pharmacists in Vietnam. Methods: The study comprised a 12-month cross-sectional survey in Can Tho City, Vietnam, with 11 conveniently selected hospitals. Out of 305 the distributed questionnaires, 303 were completed (99.3% response rate). The 21-item depression, anxiety, and stress scale (DASS-21) assessed stress, anxiety, and depression (21 items), while job satisfaction was measured using a 44-item questionnaire. Results: The study revealed a prevalence of 15.5% for stress, 27.1% for anxiety, and 20.5% for depression among hospital staff. Additionally, the majority of hospital staff (72.9%) reported being satisfied with their job. Those with more than 2 children (95% CI = 1.183-14.519) were nearly 4 times as likely to experience higher stress. Female respondents (95% CI = 1.34-5.92) and those who rented (95% CI = 1.05-3.55) were more likely to encounter anxiety. Those living outside Can Tho City (95% CI = 1.32-9.88) were at a 3.61 times higher risk of depression, while individuals who had been working at the hospital for 5 to 10 years (95% CI = 0.17-0.82) had a lower risk of depression. Increased depression (aOR = 0.441; 95% CI = 0.21-0.94) was linked to job dissatisfaction. Conclusion: Depression was significantly associated with job dissatisfaction. The study findings suggest that management agencies should implement prevention and intervention strategies to reduce mental health issues among hospital pharmacists.

Correction: Job Satisfaction of Hospital Pharmacists in a representative province in Mekong Delta, Vietnam.

[This corrects the article DOI: 10.1371/journal.pone.0291201.].

Intimate partner violence during pregnancy and risks of low birth weight and preterm birth in hospitals of Tigray, Northern Ethiopia.

Intimate partner Violence (IPV) can affect any woman, irrespective of their economic status, religion, or culture. This is a human-rights issue and due to its prevalence and adverse effects on pregnancy and birth, it must be given greater attention. Further, there is a lack of data in the Tigray region about adverse birth outcomes due to intimate partner violence during pregnancy. The aim of this study was to assess intimate partner violence during pregnancy and its association with low birth weight and preterm birth in Tigray region. Across-sectional study design was used. 647 women were involved in the study. Simple random sampling techniques were employed to select health facilities and systematic sampling was used to select study participants. Data were entered using Epi info version 3.5.1 and was analyzed using SPSSversion 20. Logistic regression analysis was conducted to assess the association between exposure to intimate partner violence during pregnancy and preterm birth and low birth weight while adjusting for possible confounders. The prevalence of intimate partner violence during pregnancy was 7.3% and the prevalence of low birth weight and preterm birth were 18.5% and 10.8% respectively. There was a statistically significant association between exposure to intimate partner violence during pregnancy and low birth weight. After adjustment for socioeconomic status, women's habits and obstetric factors, the pregnant women who were exposed to intimate partner violence during pregnancy were two times more likely to have a child with a low birth weight (2.39 (95% CI: 1.26-4.55)). The prevalence of intimate partner violence during pregnancy, low birth weight, and preterm birth in this study was high. Women who experienced intimate partner violence during pregnancy had an increased risk of low birth weight. These findings justify a call to the federal minster of health to take measures aimed at avoiding intimate partner violence during pregnancy to reduce adverse birth outcomes.

A Survey of Pharmacists and Other Healthcare Professionals in Vietnam: Factors Influencing Knowledge and Attitudes Toward Reporting Adverse Drug Reactions.

Background: Knowledge and attitudes of healthcare professionals are significant factors that affect the reporting of adverse drug reactions (ADRs). No previous research has examined the predictors of knowledge and attitudes toward ADR reporting in Vietnam. Objectives: The aim of this study was to examine the factors (ie, demographic and job-related characteristics) associated with inadequate knowledge and negative attitudes toward ADR reporting in a Vietnamese public hospital. Methods: A survey recruited a cross-sectional sample of 511 healthcare professionals (with a response rate of 92.9%) at a public hospital in Vinh Long province, Vietnam, from December 2022 to February 2023, using a self-administered questionnaire. Factors related to knowledge and attitudes toward ADR reporting were identified using univariate and multivariate logistic regression. Results: Pharmacists had significantly lower knowledge scores (mean = 5.86) than medical practitioners (7.24) and nurses (6.72). Additionally, pharmacists' attitudes scored significantly lower (34.61) than those of medical practitioners (37.21) and nurses (36.86). Multivariate logistic regression showed that educational level, healthcare profession, monthly on-call shifts, and number of direct patient interactions were factors associated with a lower level of knowledge regarding ADR reporting. Additionally, age group and healthcare profession were identified as factors associated with negative attitudes toward ADR reporting among healthcare workers. Conclusions: Our study identified several factors associated with lower levels of knowledge and negative attitudes toward ADR reporting among healthcare workers in Vietnam. These findings highlight the need for targeted interventions and education programs to improve healthcare workers' knowledge and attitudes toward ADR reporting.

Job satisfaction of hospital pharmacists in a representative province in Mekong Delta, Vietnam.

BACKGROUND: Job satisfaction is an important factor affecting job performance and turnover of healthcare workers, especially hospital pharmacists. Nevertheless, limited studies have reported this issue in the context of Vietnam. OBJECTIVES: To help maintain the quality and size of the limited hospital pharmacy workforce in Vietnam, especially in the Mekong Delta area, this study investigated the job satisfaction of hospital pharmacists, and the associated factors, in Vinh Long province, a representative province in the central Mekong Delta. METHODS: A cross-sectional survey was conducted, recruiting hospital pharmacists working in all 17 province/district-affiliated healthcare facilities across Vinh Long province, Vietnam, between August and September 2022. RESULTS: Among the 235 survey participants (representing a response rate of 97.1%), 189 pharmacists (80.4%) reported that they were satisfied with their job. Working conditions, leadership styles, and benefits were factors found to significantly influence job satisfaction. Pharmacists who had worked in the field for 3-5 years (OR = 3.752, 95% CI = 1.036-13.595), more than 5 years (OR = 6.361, 95% CI = 2.264-17.875), did not have additional duties besides their primary responsibilities (OR = 2.046, 95% CI = 1.005-4.163), and worked in a private healthcare facility (OR = 12.021, 95% CI = 1.470-98.316), were significantly more likely to be satisfied with their job. CONCLUSIONS: Most hospital pharmacists were satisfied with their current job. To further improve job satisfaction in this population, further improvements to working conditions are necessary.

Ebola outbreak in DRC and Uganda; an East African public health concern.

On August 21, 2022, healthcare authorities in the Democratic Republic of the Congo (DRC) announced an outbreak of Ebola virus disease in North Kivu Province, bringing the total to 15 outbreaks nationwide. On September 20, 2022, Uganda's authorities declared an outbreak of the Sudan strain of the Ebola virus following a confirmed a case in Mubende district. As of October 6, 2022, the reported numbers of cases were 63, with 29 deaths in Uganda and 1 case with 1 death in DRC, respectively. Ebola virus causes an acute and severely fatal illness, resulting in death within a very short time if left untreated. In addition, these outbreaks in DRC and Uganda pose a major threat to the health and socioeconomic well-being of the people of East Africa due to multiple cross-border activities. Adequate preparations need to be made by the healthcare authorities of the nations concerned; the government, healthcare workers, and the East-African community as a whole have important roles to play in the effective prevention and control of the spread of Ebola virus within and across their borders.

Barriers to Community Pharmacists Referring Patients With Suspected COVID-19 Symptoms.

Background: With the necessary skills available to community pharmacists, they are well equipped to relieve pressure on hospitals and general practices by providing referral services for symptomatic patients for COVID-19 testing. Objective: The assessment of potential barriers that limit the successful implementation of a community pharmacy referral service for patients with suspected COVID-19 symptoms. Methods: A questionnaire comprising of 100 questions was administered to one pharmacist by interview in 1023 working community pharmacies in 4 regions of Egypt between May 17 and May 30th 2020. Results: Forty-five barriers were identified. Respondents (79%, n = 803) had difficulty obtaining an accurate patient history. Patient data confidentiality was a significant issue for pharmacists who had not received referral training, with these respondents being significantly (P = .010) less able to differentiate between COVID-19 and similar conditions. Respondents (68.8%, n = 698) were not confident in determining whether COVID-19 was the cause of the patient's presenting symptoms. A large majority (73.7%, n = 747) of respondents were worried about referring misdiagnosed patients and were concerned about the negative implications of proceeding with such a referral, including legal consequences. Of Respondents (71.7%, n = 727) reported that online referral was not easy, and 71.6% (n = 722) were unable to locate paper referral forms. Only a small number of pharmacists (11%, n = 112) preferred to report a referral in their own name. Conclusions: This study has demonstrated the potential of the community pharmacist's role as a point of referral for COVID-19 testing, and identified some major barriers to implementation of this. The lack of pharmacists' education, legal support, availability of referral forms, clarity of responsibility and unsupportive management teams are key obstacles that must be overcome for the successful implementation of a COVID-19 referral service.

Experience of tinnitus in adults who have severe-to-profound hearing loss: A scoping review.

Background: Tinnitus is defined as the subjective perception of sound in the absence of an external stimulus, and tinnitus disorder becomes relevant when it is associated with emotional distress, cognitive dysfunction, and/or autonomic arousal. Hearing loss is recognized as the main risk factor for the pathogenesis of tinnitus. However, clinical guidelines for tinnitus disorder provide little direction for those who have severe-to-profound hearing loss including those who are pre-lingually Deaf. The aim of this scoping review was to catalogue what is known from the existing literature regarding the experience and management of tinnitus in adults who have a severe-to-profound hearing loss. Summary: A scoping review was conducted following the Preferred Reporting Item for Systematic Reviews and Meta-analysis extension for Scoping Reviews. Records were included if they reported an evaluation of tinnitus in adults who had severe-to-profound hearing loss. The online databases Ovid (MEDLINE, EMBASE and PsycINFO), CINAHL, ProQuest, Scopus, and Google Scholar were searched using the search terms 'tinnitus' (as a MESH term) and 'deaf' OR 'profound hearing loss. Thirty-five records met the inclusion criteria for this review and were cataloged according to three major themes: Impact of tinnitus in deaf adults; Primary treatment of tinnitus in deaf adults; and Cochlear implant studies where tinnitus was a secondary outcome. Tinnitus symptom severity was assessed before and after intervention using tinnitus validated questionnaires in 29 records, with six further records using other assessment tools to measure tinnitus severity. Participants using cochlear implants were included in 30 studies. Medication, repetitive transcranial magnetic stimulation (rTMS), electrical promontory stimulation, and behavioral self-control therapy were each reported in single records. Key messages: This scoping review cataloged the experience, assessment, and treatment of tinnitus in adults who have severe-to-profound hearing loss. It is shown that there is very limited research reported in this field. Although this review included many records, most focused on the provision of cochlear implants for severe-to-profound hearing loss, with assessment and measurement of tinnitus as a baseline or secondary outcome. Largely missing in the literature are empirical studies that seek firstly to understand the nature of the experience of tinnitus by people with no or little residual access to external sound.

Designing a Surveillance System to Monitor the Adverse Health Effect of Environmental Disasters: A Case Study of Drying Lake Urmia-Iran.

Background: Through designing a surveillance system, steps to policy making and designing measures needed to reduce the potential risks of environmental disasters on human health could be taken. Therefore, this study aimed to develop a model for Environmental Disasters Diseases Surveillance System (EDDS) to monitor Adverse Health Effects (AHEs) of Environmental Disasters (AHEEDs). Methods: As the first step, the literature review was conducted to identify the AHEEDs. Then, using the results of the first step and analyzing the existing documents, the AHEEDs were identified, and, based on the experts' opinions, high-priority effects were included in the EDDS. Then, using semi-structured interviews, 20 experts' views on the appropriate model of EDDS were investigated. To design the initial model, a panel of experts was formed with six participants. Finally, the Delphi technique was used for expert opinion and model finalization. Results: As a result of the literature review and document analysis, 41 hazards/diseases were identified. Finally, ten diseases were suggested to enter the EDDS. In the experts' view, it is better that communicable diseases be reported actively and urgently and Non-Communicable Diseases (NCD) actively and non-urgently. From the participants' point of view, the most significant achievements of the EDDS can be organizational and managerial, health promotion, and economic achievements. Conclusion: Developing a dedicated EDDS for AHEEDs can be very helpful for better management of these effects. To this end, the model proposed in this study can serve as a guide for national and local policymakers to implement surveillance systems for AHEEDs.

A global survey of healthcare professionals undertaking MRI of patients with cochlear implants: a heterogeneity of practice and opinions.

OBJECTIVE: To capture practice and opinions around the current clinical use of MRI in patients with cochlear implants (CIs), and to characterise patient progression from referral to image reporting. METHODS: An online survey recruited 237 healthcare professionals between 9 December 2019 and 9 September 2020. Descriptive statistics and informal thematic analyses were conducted. RESULTS: Respondents estimated that approximately 75% of CI users referred for an MRI proceeded to image acquisition, of which ~70% of cases comprised image acquisition on the head and the remaining cases on another area. They estimated that the proportion of these images that were usable was 93 and 99%, respectively. Confidence in most processes was high, with at least two-thirds of respondents reporting to be very or somewhat confident in obtaining consent and acquiring images. Conversely, fewer than half the respondents had the same confidence when splinting and bandaging the implant and troubleshooting any issues arising. Patient safety was rated of paramount importance, with patient comfort a clear second and image quality third. CONCLUSION: These findings highlight the need for consistent publication of clear, succinct, and standardised operating procedures for scanning patients with CIs and the requirement for regular training of radiographic and radiological healthcare professionals to address the heterogeneity of devices available. ADVANCES IN KNOWLEDGE: There is a need to improve the communication to radiography and radiology personnel regarding the nature of CIs, the heterogeneity of devices in existence, and the key differences between them. CI users risk being underserved by diagnostic medical imaging.

Spontaneous adverse drug reaction reporting by community pharmacists: preparedness and barriers.

Background: Adverse drug reactions (ADRs) are undesired, unintended responses to drugs, and are significantly underreported. Pharmacists are drug experts recognized as custodians of drug safety, who are expected to be prepared for and knowledgeable about ADR reporting. Objectives: To identify Egyptian community pharmacists' preparedness for and perceived barriers to spontaneous ADR reporting. Methods: This cross-sectional study recruited a sample of community pharmacists across Egypt, who were invited to complete a self-administrated questionnaire during April 2020. Results: A total of 923 pharmacists across Egypt responded to the questionnaire. Most pharmacists were knowledgeable about the definition of ADRs (93.9 %) and indicated they felt reporting ADRs benefits the patients (82.2%). Despite recognizing their public health value, only a small percentage of participants conveyed familiarity with the reporting process for both paper (19.2%) and electronic (30.4%) forms, indeed 56.6% of participants did not remember what the ADR report form looked like. Moreover, 75.4% of respondents said they felt that community pharmacies are not the right place for reporting, with 49% suggesting that reporting was the responsibility of physicians. However, only 32.1% reported having insufficient time being a barrier to ADR reporting. Conclusions: Community pharmacists in Egypt are not well prepared for spontaneous ADR reporting due to a lack of knowledge about the formal process and not acknowledging their responsibility, although time was not a major barrier. Therefore, this highlights a clear opportunity for improvement likely involving targeted education.

Involvement of pharmacy students in scientific research activities in Vietnam.

INTRODUCTION: Scientific research is a crucial section of health-related student education to ensure the competence of graduates. This study is the first to explore attitudes on research, willingness and motivation to conduct research, and barriers preventing this amid pharmacy students in Can Tho, Vietnam. METHODS: A cross-sectional online survey was performed on undergraduate pharmacy students (years four and five) from three public and private universities in Can Tho, Vietnam between April and May 2021. RESULTS: Of the 576 respondents, the majority accredited the significance of conducting research to the field of pharmacy (85.9%) with the motivation of improving the profession (81.6%). Public university respondents were more than twice as likely to have a positive attitude toward research (odds ratio [OR] = 2.88, 95% CI = 1.32-6.27) and be willing to conduct research (OR = 5.73, 95%CI = 3.5-9.37) than their private university counterparts. Very good or excellent academic performance was associated with a positive attitude (OR = 3.09, 95% CI = 1.46-6.53), willingness (OR = 3.2, 95%CI = 1.7-6.03), and increased motivation (OR = 2.42, 95% CI = 1.26-4.64) toward conducting research compared to respondents with average or lower academic performance. A lack of experience (63.5%), knowledge and skills (46%), and research training (51.7%) were the most common personal and systemic barriers to conducting research. CONCLUSIONS: Most students reported having a positive attitude and strong motivation toward research. These findings revealed an opportunity for pharmacy policymakers and educators to utilize national strategy to improve pharmacy education and the profession.

Community pharmacy practice related to the COVID-19 pandemic: barriers and facilitators.

BACKGROUND: Community pharmacies provide an important healthcare service. Their significant value has been further highlighted during the COVID-19 pandemic crisis. OBJECTIVES: To identify and categorize potential barriers and facilitators to the role of community pharmacists during the pandemic and their association with demographic factors. METHODS: A cross-sectional survey of community pharmacists was conducted using a self-administered questionnaire during April 2020 across all regions of Egypt. KEY FINDINGS: Respondents (n = 1018; 98.4% response rate) revealed practical and psychological barriers, including inadequate levels of pandemic preparedness (mean 61.43%; ±SD 0.47), inadequate working environments (mean 56.23%; ±SD 0.49) and uncooperative behaviour from stakeholders (mean 65.3%; ±SD 0.47).The majority of respondents emphasized the universal, region-independent necessity for facilitators, including the availability of timely (94.9%) guidance (97.4%) published by the Egyptian healthcare authority (94.6%), in electronic format (82.1%), through smartphone application (80.0%) and the provision of a dedicated telephone hotline (89.5%). Furthermore, authorities must use the media to manage public perceptions (97.2%) and increase public trust (94.8%) towards the pharmacist. CONCLUSIONS: The barriers and facilitators identified herein could improve service provision in an integrated manner by overcoming the reported inadequate level of preparedness (barrier) through the provision of electronic guidance (facilitator), and the use of the media in managing public perceptions and trust (facilitators) to reduce the panic that negatively affects the working environment (barrier) for pharmacy staff. The varied level of healthcare authority cooperation reported in many regions requires further investigation.

Willingness of Healthcare Students in Vietnam to Volunteer During the COVID-19 Pandemic.

Healthcare students play an important role in volunteering activity, often addressing staff shortages. However, during the COVID-19 pandemic, the willingness of students to volunteer in contribution to the pandemic response, especially in Vietnam, has not been thoroughly investigated. This study aimed to determine the prevalence of and factors associated with the willingness of healthcare students to volunteer during the COVID-19 pandemic in Vietnam. For this, an online cross-sectional survey was conducted, between June 7th and July 6th, 2021, among healthcare students from 10 fields of study at the largest public university of medicine and pharmacy in the Mekong Delta, Vietnam. Of 2032 respondents, 1473 (72.5%) reported that they would be willing to volunteer during the COVID-19 pandemic. More than half of the students reported having a desire to volunteer in non-patient contact activities such as data entry (65.9%) and logistics (57.7%). Whereas less than 50% of the participants were willing to volunteer with activities involving patients. Year of education, study field, educational format, living arrangements, health status self-perception, chronic illness possession, COVID-19 fear level, past volunteering experience in non-healthcare sectors, and COVID-19 prevention and control training course attendance were all associated with a willingness to volunteer. The strongest barriers preventing volunteering included fear for the health of their family and lack of training/knowledge. Conclusively, healthcare students reported a high level of willingness, indicating a positive attitude toward responding to the COVID-19 pandemic. Adequate training should be employed to increase the willingness among healthcare students in Vietnam.

Neurological complications of SARS-CoV-2: A single-center case series authors.

The neurological manifestations of SARS-CoV-2 are wide-ranging from simple headache to severe demyelinating brain disease. This is a review of collected case reports of patients with SARS-CoV-2 with neurological manifestations presenting to the Pakistan Institute of Medical Sciences (PIMS). Neurological manifestations associated with SARS-CoV-2 such as encephalitis, acute cerebrovascular disease, encephalitis with chorea, post-COVID myositis and Guillain-Barré Syndrome (GBS) are of great concern but are often overlooked in the presence of life-threatening abnormal vital signs in severely ill SARS-CoV-2 patients. There is a need to diagnose these manifestations at the earliest opportunity to limit long-term consequences and complications. Much research is needed to explore the role of SARS-CoV-2 in causing these neurological manifestations by isolating it either from the cerebrospinal fluid (CSF) or the brain tissue of the deceased on autopsy. We also recommend exploring the risk factors that lead to the development of these neurological manifestations.

YouTube as a source of information during the Covid-19 pandemic: a content analysis of YouTube videos published during January to March 2020.

BACKGROUND: Institutions, government departments, and healthcare professionals engage in social media because it facilitates reaching a large number of people simultaneously. YouTube provides a platform whereby anyone can upload videos and gain feedback on their content from other users. Many YouTube videos are related to health and science, and many people search YouTube for health-related information. YouTube has been acknowledged as a key public information source in recent crises caused by Zika, H1N1, swine flu, and most recently, COVID-19. METHODS: YouTube videos were collected from the YouTube Application Programming Interface (API) using the search terms COVID-19, coronavirus, COVID19, and corona. The search was conducted on April 4 and 5, 2020. The initial investigation found a total of 1084 videos. The second step involved identifying and verifying the videos for their relationship to COVID-19 information and excluding videos that did not relate to COVID-19 or were in a language other than English and Hindi. RESULTS: An analysis of YouTube videos covering COVID-19, uploaded in early 2020, in English and Hindi. The sample comprised 349 videos (n = 334 English). Videos were characterized by contributor, duration, content, and reception (views/likes/dislikes/comments). The majority contained general information, with only 4.01% focusing on symptoms and 11.17% on treatment and outcomes. Further, the majority (n = 229) were short videos of under 10 min duration. Videos provided by government and health care professionals comprised 6.87% and 5.74% % of the sample, respectively. News channels uploaded 71.63% of videos. CONCLUSIONS: YouTube may provide a significant resource for disseminating of information on public health issues like outbreaks of viral infections and should be utilized by healthcare agencies for this purpose. However, there is currently no way to determine whether a video has been produced or verified by authorized healthcare professionals. This limitation needs to be addressed so that the vital distribution services offered by platforms like YouTube can be fully utilized for increasing public understanding of healthcare science, particularly during a crisis such as a pandemic.

Parametric Assessment of the Effect of Cochlear Implant Positioning on Brain MRI Artefacts at 3 T.

BACKGROUND: Brain magnetic resonance imaging in patients with cochlear implants (CIs) is impacted by image artefacts. HYPOTHESIS: The optimal positioning of the CI to minimize artefacts is unknown. This study aimed to characterize the dependence of the extent and distribution of the artefact on CI positioning. METHODS: Three normally hearing individuals underwent magnetic resonance imaging using a standard T1-weighted 3D sequence. Scans were acquired with a non-functioning CI placed underneath a swimming cap at four plausible scalp positions on each side, and without the CI in situ. The artefact in each image was assessed quantitatively using voxel-based techniques. Two radiologists also independently rated the likely impact of the artefact on the detection of pathology for 20 neuroradiological locations. RESULTS: The procedure was well tolerated. The most postero-inferior CI positions resulted in the smallest apparent artefacts. Radiological evaluations suggested that artefacts would likely limit pathology detection in the ipsilateral temporal, parietal, and occipital lobes, regardless of CI location. Pathology detection in contralateral structures and anterior corpus callosum was rarely affected. Certain CI locations appeared to selectively spare ipsilateral structures, for example, postero-inferior CI locations selectively spared ipsilateral midbrain, deep grey matter, and frontal lobes. CONCLUSION: A CI placed under a swimming cap is a feasible tool for observing the effect of CI location on image usability within a single subject and potentially informing surgical planning. Regardless of CI placement, artefacts involving ipsilateral parietal, temporal, and occipital lobes severely limited diagnostic image utility. Between 35% and 70% of neuroradiological features were deemed unaffected by the implant.

Evaluating the cost-effectiveness of universal hepatitis B virus vaccination in Iran: a Markov model analysis.

Vaccination is an essential way to prevent the transmission of hepatitis B virus (HBV). Various studies have been published on the cost-effectiveness of HBV vaccination, but since the results vary according to the target population and related health outcomes, this study examined the cost-effectiveness of the universal HBV vaccination in Iran. In this economic evaluation study, a decision tree with the Markov model was used to compare the universal HBV vaccination with a strategy of non-vaccination. Health states used in the model included healthy, chronic hepatitis B, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and death. Analyses were performed from a payer's perspective. Incremental cost-effectiveness ratio (ICER) per life-year gained, and quality-adjusted life-years (QALYs) gained were calculated at a 5% annual discount rate. The sensitivity analysis was conducted using Monte Carlo simulation. Analyses were performed using Microsoft Excel and TreeAge Pro 2011 software. In 2017, the estimated cost per dose for any HBV vaccine was $3.20 USD. The universal HBV vaccination was economically advantageous compared to non-vaccination, and the estimated cost of this program per life-year and QALY gained were $6,319 and negative (-) $1,183.85 USD, respectively. Given the uncertainty of all parameters, the model remained robust and reliable. In Iran, the universal HBV vaccination strategy for both health outcomes of QALY and life-years gained was cost-effective and advantageous. The vaccination strategy saved money, increased life years and improved quality of life. Therefore, it is recommended that this program continues to be provided.

Use of and attitudes towards herbal medicine during the COVID-19 pandemic: A cross-sectional study in Vietnam.

Introduction: Herbal medicine has a long and rich history of practice in Vietnam. The use and attitudes towards herbal medicine, during the COVID-19 pandemic was explored in this study. The aims were to examine (1) the prevalence and indications for herbal medicine use, (2) the factors associated with herbal medicine use, and (3) Vietnamese peoples' attitudes towards herbal medicine. Methods: A cross-sectional online survey was conducted in Vietnamese adults aged 18 years and older, distributed equally across the Northern, Central, and Southern regions of Vietnam, between September and October 2020. Descriptive statistics, chi-square tests, and univariate and multivariate logistic regression analyses were performed to achieve the study objectives. Results: Nearly half of the respondents reported using herbal medicine for common illnesses during the COVID-19 pandemic. The prevalence was strongly associated with marital status, urbanicity, monthly income, and health status perception. Ginger (Zingiber officinale Rosc.), honey (Mel), garlic (Allium sativum L.), and perilla (Perilla frutescens (L.) Britt.) were the most commonly used herbal medicines, mainly for the treatment of sore throat, cough, nasal congestion, and fever. Nearly 70% of the participants believed herbal medicines to be safe, to have less side effects than conventional medicines, and to be effective for minor health conditions. Conclusion: The use of herbal medicine during the COVID-19 pandemic was a common practice among Vietnamese people. These findings may have implications for future medical research in Vietnam, and for policy-makers and those in the pharmaceutical industry with regard to future regulations and product development.