A graphene oxide based composite granule for methylene blue separation from aqueous solution: Adsorption, kinetics and thermodynamic studies.

Graphene oxide and chitosan composite material using as a high-efficiency and low-cost granular adsorbent for methylene blue removal was fabricated via self-assembling method. The effects of pH value, contact time, initial concentration, adsorbent dose, temperature, and recyclic stability on the adsorption performance of methylene blue in aqueous solution were investigated in detail. Desorption process with the effects of solvents, contact time, and temperature were also conducted carefully in this study. The adsorption kinetics and adsorption isotherm of dye adsorption process showed that dye adsorption process was fitted to the pseudo-second-order kinetic model and the Freundlich adsorption isotherm, indicating a physical adsorption process with multilayer adsorption. The intra-particle diffusion model indicated that the dye adsorption by the granular adsorbent was strongly happened during the first 4 h. The thermodynamic study showed that the adsorption was a spontaneous and exothermic process and dye ions were condensed onto the surface of adsorbent. The maximum adsorption capacity of dye on the granular adsorbent was calculated as 951.35 mg/g and the adsorbent could maintain its adsorption performance after six cycles. In general, this study provided an efficient, cost-effective, and recyclable the granular adsorbent for dye separation from aqueous solution.

Large-scale real-world data on a multidisciplinary approach to spinal cord stimulation for persistent spinal pain syndromes: first evaluation of the Neuro-Pain® nationwide screening and follow-up interactive register.

Introduction: Spinal cord stimulation is a common treatment option for neuropathic pain conditions. Despite its extensive use and multiple technological evolutions, long term efficacy of spinal cord stimulation is debated. Most studies on spinal cord stimulation include a rather limited number of patients and/or follow-ups over a limited period. Therefore, there is an urgent need for real-world, long-term data. Methods: In 2018, the Belgian government initiated a nationwide secure platform for the follow-up of all new and existing spinal cord stimulation therapies. This is a unique approach used worldwide. Four years after the start of centralized recording, the first global extraction of data was performed. Results: Herein, we present the findings, detailing the different steps in the centralized procedure, as well as the observed patient and treatment characteristics. Furthermore, we identified dropouts during the screening process, the reasons behind discontinuation, and the evolution of key indicators during the trial period. In addition, we obtained the first insights into the evolution of the clinical impact of permanent implants on the overall functioning and quality of life of patients in the long-term. Discussion: Although these findings are the results of the first data extraction, some interesting conclusions can be drawn. The long-term outcomes of neuromodulation are complex and subject to many variables. Future data extraction will allow us to identify these confounding factors and the early predictors of success. In addition, we will propose further optimization of the current process.

Depression in Final-Year Medical Students in Ho Chi Minh City, Vietnam: The Role of Career-Choice Motivation.

OBJECTIVES: Depression in medical students is concerning, potentially fueled by many stressors including career choice-relating stress. Choosing Medicine is a life-long commitment, and low intrinsic motivation or excessive dependence on family can complicate this decision and adding stress throughout their training. This stress intensifies in the final year, as students lacking personal drive struggle to see themselves continuing the career. Given limited studies on this crucial topic in Asia and Vietnam, we explored direct linkage between career choice motivation and depression in final-year medical students. METHODS: A cross-sectional study was conducted with 569 final-year students between June and July 2020. The Vietnamese Patient Health Questionnaire 9 (PHQ-9) and 16-item CCM questionnaire were used as survey tools. Univariate analysis was used for descriptive statistics (absolute and relative frequency, mean (M), standard deviation (SD). Multinomial logistic regression models were used to explore the relationship between variables using STATA 5.1. RESULTS: The depression among participants was about 24.6% (PHQ-9 cut-off ≥ 12). No difference in gender was found regarding depression. The most acknowledged motivator is securing employment (M = 4.14, SD = 1.02) and the least is parental wishes (M = 3.17, SD = 1.32). Familial influence on career choice significantly increased odds of having "moderately-severe depression" (OR = 1.17, 95% CI 1.04-1.32) and "severe depression" (OR = 1.36, 95% CI 1.10-1.68), whereas, career-choice motivators including satisfaction (OR = .76, 95% CI .60-.97), self-competence (OR = .80, 95% CI .66-.97) and career success (OR = .84, 95% CI .71-.99) were found to be protective factors for depression. CONCLUSIONS: Roughly a quarter of final-year medical students encountered depression. Occupational security ranked as the primary motivator, with parental wish being the least. Familial influence heightened depression risk, while career prospects, satisfaction and self-efficacy acted as protective factors. Medical career paths should align with intrinsic motivations and personal interests for better mental health outcomes.

Brain mediators of negative affect-induced physical symptom reporting in patients with functional somatic syndromes.

Functional somatic syndromes (FSS) include fibromyalgia, irritable bowel syndrome (IBS), and others. In FSS patients, merely viewing negative affective pictures can elicit increased physical symptoms. Our aim was to investigate the neural mechanisms underlying such negative affect-induced physical symptoms in FSS patients. Thirty patients with fibromyalgia and/or IBS and 30 healthy controls (all women) watched neutral, positive and negative affective picture blocks during functional MRI scanning and rated negative affect and physical symptoms after every block. We compared brain-wide activation during negative versus neutral picture viewing in FSS patients versus controls using robust general linear model analysis. Further, we compared neurologic pain signature (NPS), stimulus intensity-independent pain signature (SIIPS) and picture-induced negative emotion signature (PINES) responses to the negative versus neutral affect contrast and investigated whether they mediated between-group differences in affective picture-induced physical symptom reporting. More physical symptoms were reported after viewing negative compared to neutral pictures, and this effect was larger in patients than controls (p = 0.025). Accordingly, patients showed stronger activation in somatosensory regions during negative versus neutral picture viewing. NPS, but not SIIPS nor PINES, responses were higher in patients than controls during negative versus neutral pictures (p = 0.026). These differential NPS responses partially mediated between-group differences in physical symptoms. In conclusion, picture-induced negative affect elicits physical symptoms in FSS patients as a result of activation of somatosensory and nociceptive brain patterns, supporting the idea that affect-driven alterations in processing of somatic signals is a critical mechanism underlying FSS.

Health-Related Quality of Life Among Patients Recovered From COVID-19.

The Coronavirus disease 2019 (COVID-19) has impacted the lives and well-being of individuals worldwide, affecting both short-term and long-term quality of life. This study aimed to assess health-related quality of life (HRQoL) and associated factors among patients who have recovered from COVID-19. A cross-sectional survey was conducted at 2 hospitals in Ho Chi Minh City, Vietnam between January and March 2022. Data were obtained from patients who recovered from COVID-19 using a structured questionnaire which included the EuroQoL-5 Dimension-5 Level (EQ-5D-5L) scale to quantify problems in 5 health dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and the EuroQoL-Visual Analog Scale (EQ-VAS) to determine self-rated health status. Factors associated with HRQoL were determined using a generalized linear model (GLM). A total of 325 participants were included in the analysis. The overall mean score from the EQ-5D-5L and EQ-VAS was 0.86 (SD 0.21) and 78.6 (SD 19.9), respectively. Anxiety/Depression and Pain/Discomfort were the major problems experienced by the participants. Lower HRQoL scores were reported among those who were 60 years and older, female, had comorbidities, persistent symptoms, living alone and experiencing stress (all P < .05). This study showed that there was a significant reduction in HRQoL among individuals who recovered from COVID-19, compared with the general population. The findings suggest that more interventions need to be implemented to increase such individuals' quality of life, particularly for those who exhibit high-risk factors such as females, those with comorbidities, persistent symptoms, living alone and experiencing from stress.

Assessment of Insomnia and Associated Factors Among Patients Who Have Recovered from COVID-19 in Vietnam.

Introduction: The COVID-19 pandemic has been affecting the lives of millions of people globally. Patients recovering from COVID-19 are facing, not only the symptom of long COVID, but also psychological problems, such as sleep disturbance. This study aims to assess the proportion of COVID-19 recovered adult patients that suffer from insomnia and associated factors in Vietnam. Methods: A cross-sectional study was performed between January and March 2022 among patients who have recovered from a COVID-19 infection. Data were collected based on a self-administered questionnaire that included sociodemographic and standardized questionnaires from the Hospital Anxiety and Depression Scale (HADS), the Perceived stress scale (PSS) and the dependent variable using Insomnia Severity Index (ISI). Multivariable logistic regression was conducted to explore factors associated with the patients' insomnia disorder. Results: A total of 325 participants were included in this analysis, 34.5% of participants had insomnia. According to multivariable logistic regression, participants who were equal to and over 50 years of age, feeling alienated from others, and were not supported by families or relatives, reported significantly higher levels of insomnia disorders over those aged under 50 years, having closer ties with family and had received support from family or relatives. Besides, respondents who recorded mental health problems that included anxiety, depression and stress were more likely to get insomnia disorders than those without mental health symptoms (OR 2.7, 95% CI 1.1-6.6) (OR 4.5, 95% CI 2.3-8.9) (OR 2.3, 95% CI 1.1-5.3), respectively, all p < 0.05. Conclusion: There was a remarkable rate of COVID-19 recovered patients experiencing insomnia disorders. Older age, alienated relationships and not being supported by families or relatives, as well as had mental health problems, are factors that affected the patients' insomnia, which showed that these sleep issues need to be screened and managed among adults who have recovered from COVID-19.

Determinants of COVID-19 vaccine hesitancy among parents in Ho Chi Minh City, Vietnam.

BACKGROUND: COVID-19 vaccines are critical tools to manage the current pandemic. The objective of this study is to assess determinants of COVID-19 vaccine hesitancy among parents in Ho Chi Minh City, Vietnam. METHODS: A cross-sectional study of parents were performed, who had at least one child aged 5-17 years. The data were collected by a self-report questionnaire, which was based, predominately, on the Health Belief Model (HBM), between January 21 and 20 April 2021. The main outcome of this study aims to investigate the self-reported parental COVID-19 vaccine hesitancy for their children that has been approved by health authorities in Vietnam. RESULTS: A total of 1,015 parents completed the survey. Parental COVID-19 Vaccine Hesitancy for their children (26.2%) was decreased with blue-collar workers, intended to get vaccinated themselves, indicated sufficient knowledge toward COVID-19, and their older children reported having comorbidities. In the HBM structure, the barriers were positively related to parents' hesitancy to vaccinate their children, whilst perceived susceptibility and severity to illness, benefits of vaccination, and cues to action were less likely to cause a refusal of a vaccination for their children (all p < 0.05). The reasons for vaccine hesitancy included, predominately, concerns about side effects (81.6%), and vaccine safety (76.3%). CONCLUSION: The findings show that almost a quarter of the study population are hesitant to vaccinate their children. Factors were associated with parental vaccination hesitancy for their children include sufficient knowledge of the COVID-19, older children and those with chronic conditions, and domains of HBM like the perception of susceptibility and severity to illness, benefit and barriers of vaccination, and cues to action. These will contribute to make planning in health communication strategies for the upcoming vaccination campaigns, as well as managing the pandemic.

Assessment of COVID-19 Preventive Practice and Associated Factors Among Educators in Vietnam.

BACKGROUND: Educators play a critical role in offering knowledge that is vital to preventing the spread of the COVID-19 in educational settings. This study aims to assess the proportion of preventive practices towards COVID-19 and associated factors among educators in Vietnam. METHODS: A cross-sectional study was conducted on educators at the University of Medicine and Pharmacy at Ho Chi Minh City (UMP) using a self-administered questionnaire between June and August 2020. Online surveys and a multivariable logistic regression analysis were used to determine factors associated with practices. Adjusted odds ratio (AOR) and 95% confidence interval (95% CI) were performed using Stata 14. RESULTS: A total of 779 eligible participants were approached, most of them under 50 years (84.1%), around three-fifth were female (61.0%) and lecturers (61.1%), with only 38.1% of them working at hospitals. Overall, the majority of participants had good preventive practices towards COVID-19 (88.6%). Factors identified as being associated with good practices included participants who are lecturers (AOR 1.8, 95% CI: 1.05-2.97), attending training courses related to COVID-19 (AOR 1.7, 95% CI: 1.05-2.87), working at hospitals (AOR 2.5, 95% CI: 1.28-4.76) and having a higher level of knowledge and attitude relating to COVID-19 (AOR 2.8, 95% CI: 1.52-5.17; AOR 2.8, 95% CI: 1.70-4.48, respectively) (all p < 0.05). CONCLUSION: These findings revealed that most educators reported a good level of preventive practices towards COVID-19. However, lower levels of practices still exist towards COVID-19 among participants who were administrative staff and have less access to training courses related to COVID-19, who reported that they did not work at the hospital and had a lower level of knowledge and attitude related to COVID-19. Because of the important role of educators in the education system, this study is expected to help education and health authorities implement suitable interventions to fill the gaps in practices between educators.

Integrating Health Behavior Theories to Predict Intention to Get a COVID-19 Vaccine.

COVID-19 vaccines are put forward as the most promising solution for combatting the COVID-19 pandemic. This study aims to assess the willingness to get vaccinated against COVID-19 by using the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) as a theoretical framework. A self-administered questionnaire was considered among Vietnamese adult patients between March and May 2021. The dependent variable was a COVID-19 vaccine acceptance, the hierarchical multivariable regression was done to assess the fit of the predictor model and the associations of variables. A total of 462 participants completed the questionnaire, with 80.5% vaccination intention. A model containing demographics, as well as HBM and TPB variables, demonstrated to be a predictor of intention to receive a COVID-19 vaccine, interpreting 39% of the variance (adjusted R 2 = 0.39). For HBM and TPB constructs, respondents were more likely to accept vaccination if they had higher level of cues to action, self-efficacy, and a lower level of the perceived barriers (all P < .001). The theoretical framework provided a predictor of intention to get a COVID-19 vaccine, which is important for elaborating intervention plans to ensure the success of conducting mass vaccination campaigns.

Predictors of Intention to Get a COVID-19 Vaccine of Health Science Students: A Cross-Sectional Study.

BACKGROUND: Vaccination is one of the interventions that can be employed to control coronavirus disease (COVID-19). The aim of this study is to identify factors that affect vaccination intention among health science students, by using the health belief model (HBM) as a theoretical framework. METHODS: This study was undertaken in April 2021 using a convenience sample strategy among health science students in Tra Vinh University, which is a university in South Vietnam. Participants were required to complete the self-report questionnaire. All data were calculated by using STATA 14 software, to determine the factors associated with COVID-19 vaccine acceptance, a multivariable logistic regression analysis was performed, along with odds ratio (OR) and 95% confidence interval (95% CI). RESULTS: A total of 412 eligible participants were taken part in the study, with a questionnaire response rate of 48.2%, reporting that 77.7% of participants intended to receive a COVID-19 vaccination when available. An overall score of knowledge was 7.8 ± 1.5 (range 0-10), a positive attitude toward vaccination including perceived susceptibility and severity (3.1 ± 0.7), perceived benefits (3.1 ± 0.7) and cues to action (4.0 ± 0.6). Determinants of willingness to get a COVID-19 vaccination included their field of education, knowledge and factors in HBM model including perceived susceptibility and severity, perceived benefits and cues to action (all p < 0.05). In contrast, perceived barriers had a negative association with the probability of vaccine acceptance (p < 0.05). The study did indicate a number of participants not willing to receive a vaccination due to, mainly, safety (67.4%), development issues (58.7%) and side effects (79.3%). CONCLUSION: The theoretical framework recognized factors that influence vaccine acceptance. These are considered evidence for the development of planning strategies to optimize the vaccination uptake and offer success in vaccination campaigns for both health science students and the general population.

The intention to get a COVID-19 vaccine among the students of health science in Vietnam.

This study determines factors related to the intention to vaccinate against COVID-19 for health science students in Ho Chi Minh City (HCMC), using both the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) model. A cross-sectional survey was considered in April 2021, using a self-administered questionnaire to all health sciences students of the University of Medicine and Pharmacy in Ho Chi Minh City (UMP), Vietnam. The multiple regression was performed to specify the predictable factors of willingness to get a future COVID-19 vaccination.A total of 854 students completed the survey, whose vaccination acceptance was 77.1%. Predictors of intention to receive a COVID-19 vaccination included year of education, knowledge, and the HBM and TPB variables including the perceived benefits, cues to action, perceived behavioral control, and positive attitudes toward the vaccine (all p < .05). The main reasons for hesitancy included being afraid of the side effects (73.0%), vaccine safety (65.3%), and the process of new vaccine development (53.6%). The study examined students' intention toward COVID-19 vaccine and related factors to notify university administrators and policymakers. The findings showed the acceptability of vaccines had differences within the education year of students, besides, knowledge, perception of benefits, cues to action, behavioral control, and attitudes toward the vaccine were positive predictive factors. These may be useful for developing health education messages to promoting vaccination acceptability for students who had hesitancy of a new vaccine and in broader groups.

Knowledge, Attitude, and Practice Towards COVID-19 Among Healthcare Students in Vietnam.

BACKGROUND: Healthcare students are a force that will aid healthcare workers in responding to the COVID-19 pandemic. This study aims to evaluate the knowledge, attitude, and preventive practices (KAP) towards COVID-19 for this population in Vietnam. METHODS: An online-based cross-sectional survey was considered with all students at the University of Medicine and Pharmacy in Ho Chi Minh City (UMP), Vietnam, between June and August 2020. A structured questionnaire was used to assess KAP towards COVID-19 with response having considerable data missing in the areas of KAP being excluded from the analysis. All data were analysed by using STATA 14 software, to determine the factors associated with preventive practices, and a multivariable regression analysis was performed, along with odds ratio (OR) and 95% confidence interval (95% CI). RESULTS: A total of 2351 eligible participants completed the survey, 65.6% of whom were female, and their mean age was 21.9 years old (SD = 2.7). Almost all had sufficient knowledge (86.6%) and good preventive practice (92.8%) towards COVID-19; however, there was also a rather low level of positive attitude recorded, at 68.8%. The multivariable logistic regression analysis showed that the female participants, and the receiving of information from the official websites, reported a significantly higher level of good practice. Besides, students who had a high level of sufficient knowledge and positive attitude towards COVID-19 were more likely to have good preventive practices (All p<0.001). CONCLUSION: The findings demonstrated good preventive practice towards COVID-19; however, sufficient knowledge and positive attitude were lower. Therefore, it is an identified requirement to continue with additional education and training strategies to offer a better understanding and positive viewpoint of the pandemic for all students, including healthcare students.

Health Science Students' Perspective on Quality-of-Care-Relating Medical Professionalism.

PURPOSE: Health science students need to be professional to improve quality of care (QOC) in the current Vietnamese healthcare system. Therefore, we aim to evaluate medicine and traditional medicine (TM) students' perception of the professional attributes relating to QOC for improving inter-disciplined professionalism training that promotes QOC in Vietnam. METHODS: The cross-sectional study was carried on 2039 students of 6 years at the University of Medicine and Pharmacy at Ho Chi Minh City (HUMP) from the medical and TM faculty in March, 2021. The Vietnamese American Board of Internal Medicine (ABIM) questionnaire (2011) was used as the survey instrument. The confirmatory factor analysis (CFA) was performed to confirm the validity of the scale in TM students. Mean, Min-Max, standard deviation and sample paired t-test were performed for Likert scale. The one-way ANOVA was used for inferential statistics. RESULTS: The CFA demonstrated the validity of the Vietnamese questionnaire in measuring 4 QOC-relating professional attributes, previously found in medical students for TM students. In both faculties and across academic years, students perceived self-awareness and ensuring QOC as the leading important attribute, while social duty and professional habit as the least important attribute. Contrasting with preclinical phase, students' perception did not differ significantly between the two faculties in their clinical years (p > 0.05). CONCLUSION: TM students share universal QOC-relating professional traits with medical students. Moreover, exposure to clinical environment might increase inter-disciplined agreement on importance of these attributes. However, health sciences students' underestimation of social duty and professional habit persists throughout 6 academic years. Hidden curriculum in clinical training such as specialist-centeredness might hinder the students' improvement in perception of these traits. Therefore, these traits should strongly be emphasized in professionalism training to decrease the effects of hidden curriculum on them.

Development and Psychometric Properties of the Health Belief Scales Toward COVID-19 Vaccine in Ho Chi Minh City, Vietnam.

BACKGROUND: Beliefs of an individual about health conditions can play an important role in contributing to their behavior concerning good and bad health practices. The aim of this study was to develop and assess a set of vaccination belief scales in relation to COVID-19 vaccines. METHODS: A cross-sectional study was conducted between July 2020 and January 2021 using a systematic random sampling of 425 adult outpatients at two hospitals in Ho Chi Minh City, Vietnam. An instrument was designed based on the dimensional structure and wording of the health belief model (HBM), which was followed by the assessment of the instrument's internal consistency and the construct validity. RESULTS: The 15-item instrument showed the content validity index (CVI) of scales reached a value of 1.0. Exploratory factor analysis was performed on the first sample (n = 170) and extracted 12 out of 15 draft items in a four-factor model (threat of disease, perceived benefits, perceived barriers, and cues to action) that accounted for 68.3% of the total variance. Cronbach's alpha coefficient of 0.765 showed as satisfactory. Following this, the confirmatory factor analysis in the remaining sample (n = 255) found a good fit between a four-factor model and a theoretical model of HBM with acceptable values of fit indices. CONCLUSION: Beliefs scales for COVID-19 vaccination have been determined to be valid and reliable. They can be a helpful instrument for health educators to use for assessing immunization beliefs of individuals and the public where there is the need to implement new vaccines, such as the COVID-19 vaccine, before they are used more widely across the community.

Knowledge About COVID-19, Beliefs and Vaccination Acceptance Against COVID-19 Among High-Risk People in Ho Chi Minh City, Vietnam.

BACKGROUND: Vaccination is one of the best ways to control a pandemic such as COVID-19. However, identifying community apprehensions towards vaccination needs to be understood in detail. This study aims to determine the factors that can predict the acceptance of the COVID-19 vaccine. METHODS: A cross-sectional study was considered by systematic random sampling of 425 adults with chronic illnesses in Ho Chi Minh City. Data were collected between December 2020 and January 2021 via a self-administered, structured questionnaire. The main outcome was the acceptance of future COVID-19 vaccinations. RESULTS: A total of 425 eligible adults responded to the survey, whose mean age was 52.9±15.6 years; 67.8% of them were women, more than a half of them had high school education level or higher (57.4%) and received COVID-19 information mainly via television and social media accounted for 82.4% and 58.1%, respectively. Overall, knowledge of COVID-19 was reported as relatively good, with a mean score of 7.11 ± 1.77 (0-9). Determinants of vaccination acceptance were knowledge and cues to action. Accordingly, there was a 1.2-fold increase in the odds of acceptance of COVID-19 vaccination for a 1-unit increase in "the total knowledge score" (AOR 1.2, 95% CI: 1.1-1.3, p<0.05), and there was a 3.2-fold increase in the odds of vaccination acceptance for a 1-unit increase in "cues to action" (AOR 3.2, 95% CI: 1.7-5.8, p<0.001). CONCLUSION: Determinants that influence the intention to have the COVID-19 vaccination are identified, which can be applied to future health education interventions that should focus on enhanced knowledge towards COVID-19 via mass media messages and cues to action from healthcare workers' recommendations to promote vaccine acceptance.

Diabetes-Related Distress Among People with Type 2 Diabetes in Ho Chi Minh City, Vietnam: Prevalence and Associated Factors.

BACKGROUND: Diabetes-related distress (DRD) refers to the condition of negative emotion as a result of living with diabetes and the burden of self-care. This study aims to evaluate the prevalence and associated factors of DRD among people with type 2 diabetes. METHODS: A cross-sectional study was carried out on people with Type 2 Diabetes at three hospitals in Ho Chi Minh City, between April and November 2020. The study used the Vietnamese version of the Diabetes Distress Scale (DDS) which includes 17 items. The mean total distress score was calculated on the average of the 17 items. A mean score of equal to 2.0 or higher was classified as moderate to severe distress. Descriptive statistics were performed by frequency and percentage, and the multivariate Logistic Regression Analysis was used to assess information where p-value <0.05 was considered statistically significant. RESULTS: A total of 517 participants, who were mainly over 60 years old (56.8%) with females being 65.0%, participated in the study. Results showed that 23.6% and 5.8% of them, respectively, were found as being moderately or highly distressed. Some factors that correlated with the total distress results included age, timescale of diabetes, and glycemic control level (HbA1c). The rate of total distress in those who were over 60 years old and had a HbA1c <7 were less prevalent than those who were under 60, and had a HbA1c ≥7 (OR 0.5 95% CI 0.3-0.7; OR 0.5 95% CI: 0.3-0.9, respectively, all p<0.05), whilst the timescale of diabetes between 5 and 10 years was significantly more prevalent than those who had a timescale less 5 years (OR 1.8 95% CI 1.1-2.9, p<0.05). CONCLUSION: A high rate of distress exists in people with diabetes. Therefore, combining the evaluation of distress as part of the regular diagnostic procedures of diabetes care, and recommending physicians apply a comprehensive approach to diabetes management, is necessary.

Common and distinct neural representations of aversive somatic and visceral stimulation in healthy individuals.

Different pain types may be encoded in different brain circuits. Here, we examine similarities and differences in brain processing of visceral and somatic pain. We analyze data from seven fMRI studies (N = 165) and five types of pain and discomfort (esophageal, gastric, and rectal distension, cutaneous thermal stimulation, and vulvar pressure) to establish and validate generalizable pain representations. We first evaluate an established multivariate brain measure, the Neurologic Pain Signature (NPS), as a common nociceptive pain system across pain types. Then, we develop a multivariate classifier to distinguish visceral from somatic pain. The NPS responds robustly in 98% of participants across pain types, correlates with perceived intensity of visceral pain and discomfort, and shows specificity to pain when compared with cognitive and affective conditions from twelve additional studies (N = 180). Pre-defined signatures for non-pain negative affect do not respond to visceral pain. The visceral versus the somatic classifier reliably distinguishes somatic (thermal) from visceral (rectal) stimulation in both cross-validation and independent cohorts. Other pain types reflect mixtures of somatic and visceral patterns. These results validate the NPS as measuring a common core nociceptive pain system across pain types, and provide a new classifier for visceral versus somatic pain.

Validity and Reliability Assessment of Attitude Scales for Hepatitis B Vaccination Among Parents in Ho Chi Minh City, Vietnam.

BACKGROUND: Attitudes and beliefs could be associated with the low number of vaccinations in low- to middle-income countries such as Vietnam. This study aims to describe ways to develop and assess the attitudes towards Hepatitis B vaccination. METHODS: A mixed-method study was carried out between April 2015 and July 2017. Qualitative data were gathered via semi-structured interviews and focus group discussions. The data were then analyzed thematically into four domains of the Health Belief Model (HBM) in order to design the structured questionnaire. The quantitative strand was followed by the evaluation of the reliability and the construct validity, for which data were obtained after interviewing 768 parents whose children aged from 12 to 24 months, who were receiving the vaccines as part of the Expanded Programme on Immunization (EPI) schedules at the Commune Health Centers. RESULTS: The findings showed the content validity index value of 13 items ranged from 0.86 to 1.00. The factor analyses showed that 11 items remained in the final questionnaire after deleting 2 problematic items due to no relation to the total scales and revealed four factors (perceived susceptibility, perceived severity, perceived benefits, perceived barriers) that jointly accounted for 62.1% of the observed variances. All four factors have good internal consistency with a total Cronbach's alpha of 0.735. A confirmatory factor analysis demonstrated the proposed factor model which fits well in four domains of HBM. CONCLUSION: Attitude scales for Hepatitis B vaccination based on HBM have been developed. This has confirmed to be a valid and reliable instrument that might be useful in assessing parents' attitudes regarding Hepatitis B vaccination and may be used to promote interventions within the increasing vaccination coverage for Vietnamese children.

Knowledge, Attitude, and Practices Regarding COVID-19 Among Chronic Illness Patients at Outpatient Departments in Ho Chi Minh City, Vietnam.

BACKGROUND: The novel coronavirus disease (COVID-19) has become a major threat to human life around the world. This study aims to assess the knowledge, attitude, and practices regarding COVID-19 among people with chronic diseases at the outpatient departments in Ho Chi Minh City. METHODS: A cross-sectional study was carried out between February and March 2020 using a convenience sampling strategy in three hospitals in Ho Chi Minh City (HCMC) via the use of a structured self-administered questionnaire. Factors relating to practices, prevalence ratio (PR), and 95% confidence interval were estimated by using the Poisson regression with robust options. P-value <0.05 was considered as statistically different. RESULTS: A total of 522 participants had a mean age of 51.5 ± 10.6 years. Most of them reported seeing information regarding the COVID-19 pandemic (93.7%) via television and social media (72.8% and 62.1%, respectively). Just over two-thirds of the participants (68.4%) answered with sufficient knowledge of COVID-19. Most respondents had a positive attitude toward COVID-19 (90.8%), although some misconceptions existed. Almost over three-fourths of them (77.2%) maintained good practices for prevention. The rate of good practices in those who had sufficient knowledge was 1.24 times greater than that among those who had insufficient knowledge (PR 1.24, 95% CI: 1.10-1.41, P<0.05). Also, the rate of good practices in males was lower than that of females (PR: 0.91, 95% CI: 0.83-0.99, P<0.05). CONCLUSION: There still exists an amount of insufficient knowledge and negative attitude regarding COVID-19, which may be barriers to good prevention practices among chronic illness patients. Education programs need to continue via television and social media and emphasize that people with chronic diseases are more likely to experience severe symptoms, including death from COVID-19. Additionally, management authorities should prolong specific policies to protect the more vulnerable in our community.