AMR survivors? Chronic living with antimicrobial resistant infections.

Behind the statistics forecasting millions of deaths associated with antimicrobial resistance (AMR) is an even greater burden of morbidity leaving many people with long-term chronic illnesses and disability. Despite growing recognition of the importance of inter-sectoral and inter-disciplinary knowledge in forming responses to address this global health threat, there remains a paucity of social science research to understand the social burdens of AMR. In this qualitative study we explore the experiences of people living with chronic AMR infections, their interactions with health providers and therapeutic quests for care, and the effects upon their lives and that of their families and caregivers. Our analysis reveals that the resistant infections impacted not only the physical health but also the mental health of the sufferers and their caregivers, causing major disruptions to their social and work lives. Most undertook arduous treatment regimes - of powerful antibiotics with debilitating side effects, combined a range of other complementary and alternate therapies, including travel to seek treatment overseas. Further, we question the notion of 'AMR survivorship' currently being promoted as part of a public education campaign by the World Health Organisation and whether people with the diverse AMR experience really self-identify as 'survivors' of a biosocial group.

Reconfiguring Breast Reconstruction in the Post-Cancer Life in Vietnam.

In the context of breast cancer, women who refuse reconstruction are often portrayed as having limited agency or control over their bodies and treatment. Here we assess these assumptions by paying attention to how the local contexts and inter-relational dynamics influence women's decision-making about their mastectomized body in Central Vietnam. We situate the reconstructive decision within an under-funded public health system, but also show how the widespread perception of the surgery as merely an aesthetic practice dissuades women from seeking reconstruction. Women are shown both conform to existing gendered norms while simultaneously challenging and defying them.

Detection and assessment of risk factors associated with Newcastle disease virus infection in birds in backyard poultry in Laichau province of Vietnam.

Newcastle disease (ND) is a highly pathogenic and contagious viral infectious disease of poultry that causes a very serious problem for poultry production and economic loss worldwide. ND has been an epizootic disease in Vietnam. Information about the risk factors that are associated with virus transmission in backyard chickens in Vietnam is limited. To provide more epidemiological information about ND in Vietnam, this study was performed to estimate NDV prevalence and identify the risk factors for ND virus (NDV) infection in birds at the backyard flock level. Choanal swabs were taken from 400 randomly selected birds from 100 apparently healthy flocks from May to July 2020. Based on RT-PCR analysis, 43 of 400 swab samples (10.75%; 95% CI 8-14.17) and 21 of 100 flocks (21%; 95% CI 14.17-29.98) were positive for the fusion (F) gene of NDV. The management practice risks were: backyard flocks contacting wild birds (OR = 3.89; P = 0.030), mixed flocks with different types and species of birds (OR = 5.46; P = 0.004), and infrequency of cleaning and disinfecting poultry houses (OR (odds ratio) = 4.43; P = 0.034). The second and third risks (above) showed a positive interaction on the risk of NDV infection in birds (OR = 39.38; P = 0.001), and the first risk showed a negative interaction. Further studies on NDV surveillance in domestic waterfowl, longitudinal studies, a well-optimized RT-qPCR assay, and genetic characterization are needed. The development of handbooks, flyers, or lessons for educating poultry keepers are also needed.RESEARCH HIGHLIGHT RT-PCR was used to detect the F gene of NDV in choanal swabs.Risk factors associated with NDV-positive samples were determined.The evidence for NDV circulation in backyard healthy birds was observed.Contact with wild birds, mixed flocks, and poor hygiene were major risk factors.

Contamination, suffering and womanhood: Lay explanations of breast cancer in Central Vietnam.

Breast cancer has become the most frequent cancer among women in Vietnam, claiming over 6000 lives a year. In this article we investigate how laypeople explain the causes of this pressing health issue based on an ethnographic study conducted in the Central region of Vietnam in 2019, including hospital observation, interviews with 33 breast cancer patients and focus groups with 21 laypeople. Our findings show that their knowledge of causation is mediated through historical social contexts of warfare, a rapacious market economy, poverty, and cultural configurations of gender roles. Contamination of the environment and food, use of chemicals, failure to follow postpartum practices, breast ailments, and worry are understood to be immediate determinants of breast cancer. These popular accounts are unlikely to recognize biomedical narratives of breast cancer risk that focus upon individual responsibility and lifestyle factors because they may not reflect the lived realities of women. We emphasise the implications for public awareness campaigns to meaningfully engage with the situated social and cultural specificities of breast cancer.

'They know better than we doctors do': providers' preparedness for transgender healthcare in Vietnam.

While recognition of transgender people has increased in Vietnam, this population continues to face significant stigma and discrimination within their families and in public, including in medical settings. Understanding of transgender health is limited, especially regarding the provision of care to transgender people. This paper explores providers' preparedness for delivering transgender care using data from qualitative interviews with twelve healthcare professionals in Hanoi and Ho Chi Minh City. Drawing on the socio-ecological model, we illustrated multi-level factors that influenced the provision of medical services to transgender people, including restrictive legislation (policy level); shortage of transgender-specific services, and lack of training and guidelines (organisational level); and ambiguous perceptions, inappropriate provider-patient communication, and medical knowledge gaps (individual level). Overall, our study has identified a healthcare environment that is under-prepared to meet the complex health needs of transgender individuals. With this study, we call for intervention strategies beyond individual-level support and emphasise the urgency of allowing medical institutions to provide transgender-specific health services including gender-affirming surgery and hormonal treatments.