Severe mental illness and mortality in sepsis and septic shock: a systematic review and meta-analysis.

BACKGROUND: There have been conflicting reports regarding the case-fatality outcomes associated with sepsis and septic shock in patients with severe mental illness (SMI). METHODS: We searched Medline®, Web of Science® and the Cochrane Library® databases (from inception to 4-July-2023) for papers reporting outcomes associated with sepsis and septic shock in adult with (cases) vs. without SMI (controls). The main study outcome was the unadjusted case-fatality rate at hospital discharge, or 30 days if unavailable. Secondary outcomes included the rates of adjusted case-fatality at hospital discharge. RESULTS: A total of six studies were included in the systematic review, of which four provided data for meta-analysis involving 2,124,072 patients. Compared to controls, patients with SMI were younger and more frequently women. Unadjusted analyses showed that SMI patients had a lower case-fatality rate associated with sepsis and septic shock than their non-SMI counterparts (OR 0.61, 95% CI [0.58-0.65], PI 95% CI [0.49-0.77], I2 = 91%). Meta-regression and subgroup analyses showed that the denominator of the study population (i.e. septic shock or sepsis) was associated with the outcome with an R2 of 59.7%. CONCLUSION: In conclusion, our study reveals a survival advantage of SMI patients over their non-SMI counterparts. Further research is needed to fully elucidate the mechanisms involved and to develop targeted interventions that can improve the prognosis of both SMI and non-SMI patients facing sepsis.

Association between hospital procedure volume, socioeconomic status, comorbidities, and adverse events related to surgical abortion: A nationwide population-based cohort study.

BACKGROUND: Limited evidence exists on the influence of hospital procedure volume, socioeconomic status, and comorbidities on surgical abortion outcomes. OBJECTIVE: Our study aimed to assess the association between hospital procedure volume, individual and neighborhood deprivation, comorbidities, and abortion-related adverse events. STUDY DESIGN: A nationwide population-based cohort study of all women hospitalized for surgical abortion was conducted from January 1, 2018, to December 31, 2019 in France. Annual hospital procedure volume was categorized into four levels based on spline function visualization: very low (<80), low ([80-300[), high ([300-650[), and very high-volume (≥650) centers. The primary outcome was the occurrence of at least one surgical-related adverse event, including hemorrhage, retained products of conception, genital tract and pelvic infection, transfusion, fistulas and neighboring lesions, local hematoma, failure of abortion, admission to an intensive care unit or death. These events were monitored during the index stay and during a subsequent hospitalization up to 90 days. The secondary outcome encompassed general adverse events not directly linked to surgery. RESULTS: Of the 112,842 hospital stays, 4,951 (4.39%) had surgical-related adverse events and 256 (0.23%) had general adverse events. The multivariate analysis showed a volume-outcome relationship, with lower rates of surgical-related adverse events in very high-volume (2.25%, aOR=0.34, 95%CI [0.29-0.39], p<0.001), high-volume (4.24%, aOR=0.61, 95%CI [0.55-0.69], p<0.001), and low-volume (4.69%, aOR=0.81, 95%CI [0.75-0.88], p<0.001) when compared to very low-volume centers (6.65%). Individual socioeconomic status (aOR=1.69, 95%CI [1.47-1.94], p<0.001), neighborhood deprivation (aOR=1.31, 95% CI [1.22-1.39], p<0.001), and comorbidities (aOR=1.79, 95%CI [1.35-2.38], p<0.001) were associated with surgical-related adverse events. Conversely, the multivariate analysis of general adverse events did not reveal any volume-outcome relationship. CONCLUSION: The presence of a volume-outcome relationship underscores the need for enhanced safety standards in low-volume centers to ensure equity in women's safety during surgical abortions. However, our findings also highlight the complexity of this safety concern which involves multiple other factors including socioeconomic status and comorbidities that policymakers must consider.

The impact of hospital saturation on non-COVID-19 hospital mortality during the pandemic in France: a national population-based cohort study.

BACKGROUND: A previous study reported significant excess mortality among non-COVID-19 patients due to disrupted surgical care caused by resource prioritization for COVID-19 cases in France. The primary objective was to investigate if a similar impact occurred for medical conditions and determine the effect of hospital saturation on non-COVID-19 hospital mortality during the first year of the pandemic in France. METHODS: We conducted a nationwide population-based cohort study including all adult patients hospitalized for non-COVID-19 acute medical conditions in France between March 1, 2020 and 31 May, 2020 (1st wave) and September 1, 2020 and December 31, 2020 (2nd wave). Hospital saturation was categorized into four levels based on weekly bed occupancy for COVID-19: no saturation (< 5%), low saturation (> 5% and ≤ 15%), moderate saturation (> 15% and ≤ 30%), and high saturation (> 30%). Multivariate generalized linear model analyzed the association between hospital saturation and mortality with adjustment for age, sex, COVID-19 wave, Charlson Comorbidity Index, case-mix, source of hospital admission, ICU admission, category of hospital and region of residence. RESULTS: A total of 2,264,871 adult patients were hospitalized for acute medical conditions. In the multivariate analysis, the hospital mortality was significantly higher in low saturated hospitals (adjusted Odds Ratio/aOR = 1.05, 95% CI [1.34-1.07], P < .001), moderate saturated hospitals (aOR = 1.12, 95% CI [1.09-1.14], P < .001), and highly saturated hospitals (aOR = 1.25, 95% CI [1.21-1.30], P < .001) compared to non-saturated hospitals. The proportion of deaths outside ICU was higher in highly saturated hospitals (87%) compared to non-, low- or moderate saturated hospitals (81-84%). The negative impact of hospital saturation on mortality was more pronounced in patients older than 65 years, those with fewer comorbidities (Charlson 1-2 and 3 vs. 0), patients with cancer, nervous and mental diseases, those admitted from home or through the emergency room (compared to transfers from other hospital wards), and those not admitted to the intensive care unit. CONCLUSIONS: Our study reveals a noteworthy "dose-effect" relationship: as hospital saturation intensifies, the non-COVID-19 hospital mortality risk also increases. These results raise concerns regarding hospitals' resilience and patient safety, underscoring the importance of identifying targeted strategies to enhance resilience for the future, particularly for high-risk patients.

Changes in Quality of life Outcomes of Patients with HIV/AIDS Under a Theory-based Mobile Health Intervention.

This study examined the effectiveness of a theory-based mHealth intervention on the quality of life (QOL) of people living with HIV. A randomized controlled trial was performed at two outpatient clinics in Hanoi, Vietnam. There were 428 patients with HIV/AIDs in selected clinics and were divided into the intervention arm (receiving HIV-assisted smartphone application and usual care) and the control arm (receiving only usual care). The WHOQOLHIV-BREF instrument was utilized to measure QOL. An intention-to-treat approach using Generalized Linear Mixed Model analysis was performed. The trial showed significant improvements in Physical health, Psychological health, and Level of Dependence among patients in the intervention arm compared to the control arm. However, the Environment and Spirituality/Personal beliefs improvements would require additional interventions, both individual, organizational, or governmental. This study explored the utility of a smartphone mobile application for individuals with HIV, and how the resultant application could improve the overall QOL.

Predicting the long-term effects of electronic cigarette use on population health: a systematic review of modelling studies.

OBJECTIVE: To systematically review and synthesise the findings of modelling studies on the population impacts of e-cigarette use and to identify potential gaps requiring future investigation. DATA SOURCE AND STUDY SELECTION: Four databases were searched for modelling studies of e-cigarette use on population health published between 2010 and 2023. A total of 32 studies were included. DATA EXTRACTION: Data on study characteristics, model attributes and estimates of population impacts including health outcomes and smoking prevalence were extracted from each article. The findings were synthesised narratively. DATA SYNTHESIS: The introduction of e-cigarettes was predicted to lead to decreased smoking-related mortality, increased quality-adjusted life-years and reduced health system costs in 29 studies. Seventeen studies predicted a lower prevalence of cigarette smoking. Models that predicted negative population impacts assumed very high e-cigarette initiation rates among non-smokers and that e-cigarette use would discourage smoking cessation by a large margin. The majority of the studies were based on US population data and few studies included factors other than smoking status, such as jurisdictional tobacco control policies or social influence. CONCLUSIONS: A population increase in e-cigarette use may result in lower smoking prevalence and reduced burden of disease in the long run, especially if their use can be restricted to assisting smoking cessation. Given the assumption-dependent nature of modelling outcomes, future modelling studies should consider incorporating different policy options in their projection exercises, using shorter time horizons and expanding their modelling to low-income and middle-income countries where smoking rates remain relatively high.

Toward sustainable development goals in gender inequality: an analysis of gender preferences among urban pregnant women in a Southeast Asian country.

BACKGROUND: Gender-biased discrimination and preferences are global phenomena, particularly son preferences. However, updated evidence about this issue in Vietnam has not yet been provided. Therefore, this study aimed to examine the gender preferences among pregnant women and identify associated factors of such preferences. METHODS: A cross-sectional survey was conducted in two hospitals in Vietnam with 732 pregnant women. Gender preferences for their child were asked, along with socio-demographic (e.g., education, occupation) and pregnancy characteristics (e.g., pressure to have a son, gender of first child, the importance to have a son of family members, and information sources on pregnancy care) by using face-to-face interviews and a structured questionnaire. Multinomial logistic regression was performed to determine factors associated with gender preferences. RESULTS: About 51.9% of the participants had no gender preference, while, among those who had a gender preference, 26.5% preferred sons, and 21.6% preferred daughters. Only 6.2% had pressure to have a son. Having the first child who was female (OR = 4.16, 95%CI = 1.54-11.25), having the pressure to have a son (OR = 6.77, 95%CI = 2.06-22.26), and higher self-perceived importance to have a son (OR = 3.05, 95%CI = 1.85-5.02) were positively associated with son preference. Otherwise, women having partners with high school education or above (OR = 2.04, 95%CI = 1.06-3.91), living with parents-in-law (OR = 2.33; 95%CI = 1.25-4.34), the higher number of pregnancies, and a higher degree of importance in having a son regarding parents-in-law (OR = 2.15, 95%CI = 1.38-3.35) associated with higher odds of preferring daughter. CONCLUSION: This study showed that gender preference was common among pregnant women, but the pressure to have a son was low. Further education programs and legal institutions should be implemented to improve gender inequality and gender preference in society.

Efficacy of a Mobile Phone-Based Intervention on Health Behaviors and HIV/AIDS Treatment Management: Randomized Controlled Trial.

BACKGROUND: Antiretroviral therapy (ART) is considered the most important intervention for HIV-positive patients; thus, encouraging the use of and adherence to ART are vital to HIV treatment outcomes. Advances in web and mobile technologies hold potential in supporting HIV treatment management. OBJECTIVE: The aim of this study was to evaluate the feasibility and efficacy of a theory-based mobile health (mHealth) intervention on health behaviors and HIV treatment adherence among patients with HIV/AIDS in Vietnam. METHODS: We performed a randomized controlled trial on 425 HIV patients in two of the largest HIV clinics in Hanoi, Vietnam. Both the intervention group (238 patients) and the control group (187 patients) received regular consultations with doctors and then participated in 1-month and 3-month follow-up visits. Patients in the intervention group received a theory-driven smartphone app to facilitate medication adherence and self-efficacy in HIV patients. Measurements were developed based on the Health Belief Model, which included the visual analog scale of ART Adherence, HIV Treatment Adherence Self-Efficacy Scale, and HIV Symptom Management Self-Efficacy Scale. We also included the 9-item Patient Health Questionnaire (PHQ-9) to assess patients' mental health throughout treatment. RESULTS: In the intervention group, the adherence score increased significantly (ß=1.07, 95% CI .24-1.90) after 1 month, whereas the HIV adherence self-efficacy was significantly higher after 3 months (ß=2.17, 95% CI 2.07-2.27) compared to the control group. There was a positive but low level of change in risk behaviors such as drinking, smoking, and drug use. Factors related to positive change in adherence were being employed and having stable mental well-being (lower PHQ-9 scores). Factors associated with self-efficacy in treatment adherence and symptom management were gender, occupation, younger age, and having no other underlying conditions. A longer duration of ART increased treatment adherence but decreased self-efficacy in symptom management. CONCLUSIONS: Our study demonstrated that the mHealth app could improve the overall ART adherence self-efficacy of patients. Further studies with larger sample sizes and longer follow-up periods are needed to support our findings. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20220928003; https://www.thaiclinicaltrials.org/show/TCTR20220928003.

Impacts of COVID-19 on career choices in health professionals and medical students.

BACKGROUNDS: The COVID-19 pandemic has resulted in not only significant mortalities in Vietnam but has had an impact on its economy. Previous studies have highlighted how the pandemic has had a marginal impact on Vietnamese healthcare workers working at the frontlines. To date, there have been several other studies examining the impact of COVID-19 on intentions to transition between jobs among healthcare professionals, but this has yet to be explored amongst Vietnamese healthcare workers. METHODS: To achieve the study's objectives an online cross-sectional study was conducted between September to November 2021. Snowball sampling methodology was adopted for the recruitment of participants. The questionnaire that was used for this study comprised of the following sections: (a) socio-demographic information; (b) impact of COVID-19 on work; (c) risk of exposure to COVID-19; (d) career choices/intentions to change job, and (e) motivation at work. RESULTS: There were 5727 completed the entire survey. 17.2% of the respondents have had increased job satisfaction, 26.4% reported increased motivation to work, and 40.9% reported decreased motivation to work. Whilst there were changes in the daily work intensity and the level of work-related stress, more than 60% of respondents we sampled did not intend to switch careers. Demographic variables like gender, whether one was a student or an existing healthcare worker, and income related to work motivation. The community's stigma was a negative factor that declined intrinsic motivation as well as decreased work retention. CONCLUSIONS: Our study is instrumental in identifying the impact of COVID-19 on career choices amongst Vietnamese healthcare workers. The factors identified have clear implications for policymaking.

Depressive symptoms are associated with immunological failure among HIV-positive patients in Vietnam.

As the lives of people living with HIV (PLWH) become increasingly normalized, more focus is being given to the associated comorbidities of HIV, including those related to mental health such as depression. This study aims to evaluate the correlation between depressive symptoms and HIV outcomes in Vietnam through the measurement of CD4 cell count. A mixed design was utilized, in which both a longitudinal assessment of CD4 cell counts and a cross-sectional survey of depressive symptoms were conducted on 481 patients in the Bach Mai and Ha Dong HIV clinics (Hanoi, Vietnam). CD4 cell count data was extracted from the medical records of participants, and depressive symptoms were screened using the Patient Health Questionnaire (PHQ-9). The results illustrate that the presence of moderately severe to severe depressive symptoms is associated with lower CD4 cell counts, indicating poorer HIV outcomes resulting from comorbid depression. This correlation was especially noticeable in the PHQ-9 items for psychomotor agitation/retardation (p < 0.05) and suicidal ideation (p < 0.05). Future policy and treatment options for HIV in Vietnam should consider the presence of comorbid mental health conditions in order to provide more suitable and effective treatment in the goal of providing a higher quality of life for PLWH.

Association between physical activity and health in healthcare professionals : Results from the nationwide AMADEUS survey.

OBJECTIVE: The objective of this study was to assess the prevalence of healthcare professionals engaging in insufficient levels of physical activity (PA) and to identify sociodemographic, professional and health characteristics associated with insufficient PA levels. METHODS: We conducted a nationwide online cross-sectional study targeting healthcare professionals in France from May 2021 to June 2021. Participant recruitment involved outreach through social networks, professional networks, and email invitations. PA levels were assessed using the International Physical Activity Questionnaire (IPAQ), with insufficient PA defined as weekly PA totaling less than 600 mets/week. RESULTS: The study included a total of 10,325 participants, of whom 3939 (38.1%, 95% confidence interval 37.1-39.0%) exhibited insufficient levels of PA. In the multivariable analysis, we identified factors associated with insufficient PA: ages between 35-44 (aOR=1.58, 95%CI [1.21-2.06], p=.001) and 45-54 years (aOR=1.40, 95%CI [1.07-1.83], p =.015), gender (female aOR=1.47, 95%CI [1.12-1.44], p<.001), and professions including health executive (aOR=1.27, 95%CI [1.32-1.64], p<.001), nurse assistant (aOR=1.25, 95%CI [1.07-1.47], p=.006), and physician (aOR=1.18, 95%CI [1.03-1.34], p=.015). Additionally, burnout (aOR=1.32, 95%CI [1.21-1.44], p<.001), tobacco use (aOR=1.33, 95%CI [1.20-1.58], p<.001), being overweight (aOR=1.39, 95%CI [1.28-1.52], p<.001), major depression (aOR=1.44, 95%CI [1.20-1.47], p<.001), and sleep disorders (aOR=1.14, 95%CI [1.05-1.25], p=.002) were associated with insufficient PA. Work night shifts was associated with sufficient PA. CONCLUSION: Our study has revealed a substantial prevalence of healthcare professionals with insufficient PA levels. This prevalence, coupled with various associated health-damaging behaviors and mental health issues, underscores the importance of acknowledging the barriers they encounter in adopting a physically active lifestyle.

Repetitive Transcranial Magnetic Stimulation for Fibromyalgia: An Updated Systematic Review and Meta-Analysis.

OBJECTIVE: Meta-analysis was performed to evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in fibromyalgia on the domains of pain, depression, anxiety and quality of life. METHOD: Publications were searched with the keywords "repetitive transcranial magnetic stimulation" and "fibromyalgia" for randomized controlled trials that compare rTMS with sham stimulation for treating pain, depression, anxiety, and quality of life. Trials available until April 2021 were searched through PubMed, Scopus, Web of Science, and Cochrane Controlled Trials Register. The postintervention scores after 4 weeks for pain, depression, anxiety, and quality of life were extracted to compare the effects of rTMS and sham. Subgroup analysis was conducted based on the stimulation site. RESULTS: From 265 screened articles, 11 eligible randomized controlled trials involving 303 patients were included. The results show that rTMS is more effective than sham stimulation in improving pain (standardized mean difference [SMD] = -0.35; 95% confidence interval [CI] = -0.62 to -0.08; p = .01) and quality of life (SMD = -0.51; 95% CI = -0.78 to -0.23; p = .0003). It is not more effective than sham stimulation for depression, and anxiety. After sensitivity analysis, subgroup analysis revealed that primary motor cortex stimulation was more effective than sham for improving pain (SMD = -0.57; 95% CI = -0.91 to -0.23; p = <0.01). Neither dorsolateral prefrontal cortex nor primary motor cortex stimulation was more effective than sham in improving depression and anxiety. CONCLUSIONS: rTMS is more effective than sham in improving pain and quality of life, but it does not demonstrate reduction in depression or anxiety.

Influence of Structural Disorders on the Tribological Behavior of Phosphate-Intercalated Layered Double Hydroxide Additives in Polyalphaolefin.

In this work, several phosphate-intercalated Mg-Al layered double hydroxides (LDHs) were synthesized and evaluated as solid lubricant additives in polyalphaolefin (PAO-4) by means of tribotesting on coupled GCr15/cast iron contacts. The effects of test parameters such as normal loads, additive concentrations, and substrate surface roughness were investigated, while the LDH crystal structure received considerable attention. Several types of structural disorder after anion exchange were identified based on X-ray diffraction (XRD) analysis. The unstable structures promote feasible shearing during sliding to improve friction and wear. In addition, antiwear properties correlate well with the anion charge number or the quantity of anion in the interlayer region. Overall, the tribological performance increased in the order HPO42--LDH < PO43--LDH < P2O74--LDH < (PO3)66--LDH. (PO3)66--LDH demonstrated the best antiwear performance with a reduction of 69% of the ball volume loss compared to PAO-4 oil due to the synergy of the disordered stacking LDH sheets and flexible ring structure of the (PO3)66- anion. Furthermore, on polished surfaces, the coefficient of friction (COF) of the (PO3)66--LDH sample dropped significantly by 26%, while the wear loss reduction of more than 80% was also substantial compared to the base oil sample. A performance comparison between the best-performing LDH additive was also conducted against popular nanomaterials, such as hexagonal boron nitride (BN), graphene nanoplatelets (GNPs), and titanium oxide (TiO2). The performance of (PO3)66--LDH was close to that of GNPs.

Gaps of Knowledge about HIV and Sexually Transmitted Infections Among Industrial Workers in Northern Vietnam.

Industrial workers are a vulnerable population for HIV and sexually transmitted infections (STIs). This cross-sectional study assessed the general knowledge about sexually transmitted infections (STIs) and HIV transmission risk among 289 industrial workers in Northern Vietnam. Results indicated that most workers could identify common routes of HIV transmissions and were aware of common STIs. However, insufficient knowledge about HIV transmission via anal sex practices, as well as common signs and symptoms of STIs were observed. Gender, marital status, education, locality status and health information sources were associated with the knowledge. This study reveals a gap of knowledge about HIV and other STIs, and suggested further tailored education interventions to improve the knowledge and promote sexual health-seeking behaviors in industrial workers.

A global analysis of literature on older adults and lifelong living with HIV.

With the growing number of older people living with HIV, "What is the most effective geriatric care and the research trend of existing literature?" is a compelling question after 30 years since the first paper related to aging and HIV/AIDS published. Our study aims to apply quantitative and qualitative analysis to explore the knowledge gaps and describes the research interest of gerontology research in the field of HIV. A bibliometric analysis was conducted based on the databased of the Web of Science from 1991 to 2019. The major domains of research areas were visualized by using VOSviewer software. Latent Dirichlet Allocation (LDA) was applied to classify the dataset into topics. There was a rising number of publications about this topic over time. Our findings indicated that antiretroviral treatment and evaluating quality of life and harm reduction were the major domains regarding care for OPLWH. In addition, the finding highlights the role of social competence in treatment outcomes. Further research needs to tailor multi-disciplinary programs and flexible interventions to reduce the burden and the mortality rate of HIV/AIDS.

Structural barriers for retention of HIV/AIDS patients after initiating antiretroviral therapy in outpatient clinics of Vietnam.

Little evidence is available about structural factors associated with the retention in care for people living with HIV/AIDS (PLWH) in Vietnam. This retrospective longitudinal study was conducted among PLWH initiating antiretroviral therapy (ART) in 62 ART clinics from 15 provinces, to estimate retention rates and identify specific related structural factors. Facility-related factors such as location, duration of HIV service implantation, level of healthcare facility, frequency of drugs dispensed, integration of HIV care were examined. Cox proportional hazard model was employed to estimate the retention rate and association between facility-level factors and loss-to-follow up (LTFU). Among 20,119 patients, the retention rates after 6, 12, 24, 36 and 48 months were 96.5% (95% CI = 96.2%-96.7%), 93.6% (95% CI = 93.2%-93.9%), 90.2% (95% CI = 89.8%-90.6%), 87.9% (95% CI = 87.4%-88.4%) and 86.0% (95% CI = 85.4%-86.5%), respectively. Facility-level factors associated with increased risk of LTFU included duration of HIV service implementation, frequency of drug dispensed per month, integration of HIV care and of treatment procedures into general care, clinics at central or provincial level and in the Middle region of Vietnam. Such association should be addressed in future care planning and HIV/AIDS management to ensure greater coverage of therapy in Vietnam.

Tribochemical synergy between phosphate-intercalated layered double hydroxide additives and super high oleic safflower oil on sliding contacts.

In this study, the tribological properties of a series of layered double hydroxides (LDHs) intercalated by various phosphate anions (hydrogen phosphate, orthophosphate, pyrophosphate, and hexametaphosphate) were investigated by ball-on-disc testing in safflower oil which has a super high content of oleic acid (OA). The Mg-Al-NO3- LDH precursor was first synthesized by a coprecipitation method, and then nitrate anions were substituted by different phosphate anions via anion exchange. The successful intercalations were confirmed by X-ray powder diffraction (XRD), Fourier-transform infrared (FTIR) spectroscopy, and scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS) analysis. The tribological results indicate that the antiwear properties increased linearly with the basic strength of the phosphate anions. Stronger bases, such as orthophosphate (PO43-) and pyrophosphate (P2O74-), encourage the dissociation of OA to form a protective oleate tribofilm on steel surfaces, leading to more than 40% wear reduction compared to the base oil. The tribological performance of the best antiwear candidate, PO43--LDH, was studied further under different loads and concentrations. A comparison between PO43--LDH and other nanomaterials was also carried out with PO43--LDH exhibiting a comparable performance against hexagonal boron nitride (BN).

Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities.

BACKGROUND: Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. METHODS: A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. FINDINGS: Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians' prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. CONCLUSION: This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.

Rural-urban differences in preferences for influenza vaccination among women of childbearing age: implications for local vaccination service implementation in Vietnam.

OBJECTIVES: Pregnant women and new mothers are among the most vulnerable to seasonal influenza; however, little is known about their preferences for flu vaccination. We examined the rural-urban differences in uptake, demand and willingness to pay (WTP) for influenza vaccination among women of childbearing age, to assess the feasibility of implementing locally produced vaccines in Vietnam. METHODS: A cross-sectional study was performed in both urban and rural areas of Hanoi in 2018. Socio-demographic characteristics, history of vaccination, demand and WTP for influenza vaccines were obtained. A multivariate logistic regression model was employed to identify the associated factors. RESULTS: Of 750 participants, 29.9% had had flu shots in the current or previous flu season and 64.3% indicated demand for this vaccine. The median of the maximum amount of WTP for influenza vaccination services was US$ 8.5 (IQR: 8.5-17.0). Women living in rural areas had a significantly lower uptake and higher demand, and were willing to pay less than women in urban locations (21.1% vs. 36.6%; 69% vs. 60.2%; and US $8.5 vs. US $11.7, respectively). For urban participants, factors associated with higher demand and WTP for flu shots included having ANC in health facilities and having been vaccinated against influenza in the past; for rural women, these factors were having suffered from influenza and hearing about it. CONCLUSIONS: This study informs the feasibility of implementing locally produced influenza vaccines in Vietnam. Educational programs, along with counselling services and government subsidies, should be implemented to improve the coverage, demand and WTP for the vaccine.

OBJECTIFS: Les femmes enceintes et les nouvelles mères sont parmi les plus vulnérables à la grippe saisonnière; cependant, on en sait peu sur leurs préférences pour la vaccination contre la grippe. Nous avons examiné les différences entre les zones rurales et urbaines dans l'adoption, la demande et la volonté de payer pour la vaccination antigrippale chez les femmes en âge de procréer, afin d'évaluer la faisabilité de la mise en œuvre de vaccins produits localement au Vietnam. MÉTHODES: Une étude transversale a été réalisée dans les zones urbaines et rurales de Hanoi en 2018. Les caractéristiques sociodémographiques, les antécédents de vaccination, la demande et la volonté de payer pour les vaccins antigrippaux ont été obtenus. Un modèle de régression logistique multivariée a été utilisé pour identifier les facteurs associés. RÉSULTATS: Sur 750 participantes, 29,9% s'étaient fait vacciner contre la grippe au cours de la saison grippale actuelle ou précédente, 64,3% ont indiqué une demande pour ce vaccin. La médiane du montant maximal de la volonté de payer pour les services de vaccination contre la grippe était de 8,5 USD (IQR: 8,5 à 17,0). Les femmes vivant dans les zones rurales avaient une adoption nettement plus faible, une demande plus élevée et étaient prêtes à payer moins que les femmes des zones urbaines (21,1% contre 36,6%; 69% contre 60,2%; et 8,5 USD contre 11,7 USD, respectivement). Pour les participantes urbaines, les facteurs associés à une demande plus élevée et à la volonté de payer pour les vaccins contre la grippe comprenaient le fait d'avoir des soins prénatals dans les établissements de santé et d'avoir été vaccinés contre la grippe dans le passé; pour les femmes rurales, ces facteurs comprenaient, avoir souffert de la grippe et en avoir entendu parler. CONCLUSIONS: Cette étude informe sur la faisabilité de la mise en œuvre de vaccins antigrippaux produits localement au Vietnam. Des programmes éducatifs, ainsi que des services de conseil et des subventions gouvernementales devraient être mis en œuvre pour améliorer la couverture, la demande et la volonté de payer pour le vaccin.

Acceptance and willingness to pay for COVID-19 vaccines among pregnant women in Vietnam.

OBJECTIVES: The aim of this study was to assess acceptance of COVID-19 vaccination and the willingness to pay (WTP) for it, and investigate associated factors among pregnant women in Vietnam. METHODS: Cross-sectional survey of pregnant women in two obstetric hospitals in Hanoi and Ca Mau provinces, Vietnam. Data on acceptance and WTP for COVID-19, demographic characteristics, maternal characteristics, and risk perceptions toward COVID-19 were collected. Multivariate logistic and linear regression models were performed to identify factors associated with the acceptance and WTP for the vaccine. RESULTS: Of 651 pregnant women, 60.4% accepted to receive the vaccine, and 82.6% of the total pregnant women were willing to pay for a COVID-19 vaccine with the mean amount of WTP of USD 15.2 (SD ± 27.4). The most common reason for refusing vaccination was "Worry about the safety of the vaccine" (66.9%) in Hanoi and "The preventive effect of COVID-19 is low" (45.2%) in Ca Mau. A higher income, having children, self-perceived risk of COVID-19 infection, and perceived risk to friends were associated with a higher likelihood of acceptance and WTP for the vaccine. CONCLUSIONS: Implementing COVID-19 vaccination and resource mobilisation among pregnant women in Vietnam is feasible, although communication programmes to improve risk perception and awareness about vaccine should be developed for facilitating acceptance of the vaccine.

Hydroxyl Influence on Adsorption and Lubrication of an Ultrathin Aqueous Triblock Copolymer Lubricant.

This research aims to provide insights into the adsorption behaviors of two monomers of triblock copolymers (1,2-dimethoxyethane (1,2-DME) and 1,2-dimethoxypropane (1,2-DMP)) on a TiO2 surface in aqueous solution. A multiscale theoretical framework by means of the density functional theory (DFT), ab initio molecular dynamics (AIMD), and classical molecular dynamics (MD) simulations is established. The DFT calculation confirms that these molecules adsorb more energetically on a hydroxylated surface than pure oxide. There is a difference in adsorption behaviors between 1,2-DMP and 1,2-DME molecules due to the covalent bonding between carbons and oxygen of the hydroxylated TiO2 surface. The AIMD simulation reveals that the adsorption of both copolymers to the TiO2 surface is hindered by the presence of water with 1,2-DME exhibiting a weaker adsorption than 1,2-DMP. The presence of 1,2-DME on the TiO2 surface with water produced a smaller number of hydroxyl groups on the surface than 1,2-DMP. Moreover, the dissociative adsorption of water onto the rutile surface is the main cause for a chemical formation of terminating hydroxyl groups. The number of associated bonds is insignificant compared to the dissociated one since the dissociative adsorption is more favored than the associative one. MD simulation indicates that triblock copolymers adsorb stronger on the hydroxylated surface with a thinner adsorbed film thickness than that on the pure rutile. The presence of terminal hydroxyl groups on the rutile surface helps reducing the friction for aqueous 17R2 triblock copolymers, while it results in an increase of friction for normal copolymer L62.