| 1. |
- Stanaway, Jeffrey D., et al.
(författare)
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Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
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Tidskriftsartikel (refereegranskat)abstract
- Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
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| 2. |
- Lozano, Rafael, et al.
(författare)
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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Tidskriftsartikel (refereegranskat)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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| 3. |
- Nguyen, Hong Hanh, et al.
(författare)
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"I can make more from selling medicine when breaking the rules" : understanding the antibiotic supply network in a rural community in Viet Nam
- 2019
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: As in many other low and middle income countries (LIMCs), Vietnam has experienced a major growth in the pharmaceutical industry, with large numbers of pharmacies and drug stores, and increasing drug expenditure per capita over the past decade. Despite regulatory frameworks that have been introduced to control the dispensing and use of prescription-only drugs, including antibiotics, compliance has been reported to be strikingly low particularly in rural parts of Vietnam. This qualitative study aimed to understand antibiotic access and use practices in the community from both supplier and consumer perspectives in order to support the identification and development of future interventions.METHODS: This qualitative study was part of a project on community antibiotic access and use (ABACUS) in six LMICs. The focus was Ba Vi district of Hanoi capital city, where we conducted 16 indepth interviews (IDIs) with drug suppliers, and 16 IDIs and 6 focus group discussions (FGDs) with community members. Drug suppliers were sampled based on mapping of all informal and formal antibiotic purchase or dispensing points in the study area. Community members were identified through local networks and relationships with the field collaborators. All IDIs and FGDs were audio-taped, transcribed and analysed using content analysis.RESULTS: We identified a large number of antibiotic suppliers in the locality with widespread infringements of regulatory requirements. Established reciprocal relationships between suppliers and consumers in drug transactions were noted, as was the consumers' trust in the knowledge and services provided by the suppliers. In addition, antibiotic use has become a habitual choice in most illness conditions, driven by both suppliers and consumers.CONCLUSIONS: This study presents an analysis of the practices of antibiotic access and use in a rural Vietnamese setting. It highlights the interactions between antibiotic suppliers and consumers in the community and identifies possible targets for interventions.
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| 4. |
- Nguyen, Thanh N, et al.
(författare)
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Global Impact of the COVID-19 Pandemic on Stroke Volumes and Cerebrovascular Events: A 1-Year Follow-up.
- 2023
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Ingår i: Neurology. - 1526-632X. ; 100:4
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Tidskriftsartikel (refereegranskat)abstract
- Declines in stroke admission, IV thrombolysis (IVT), and mechanical thrombectomy volumes were reported during the first wave of the COVID-19 pandemic. There is a paucity of data on the longer-term effect of the pandemic on stroke volumes over the course of a year and through the second wave of the pandemic. We sought to measure the effect of the COVID-19 pandemic on the volumes of stroke admissions, intracranial hemorrhage (ICH), IVT, and mechanical thrombectomy over a 1-year period at the onset of the pandemic (March 1, 2020, to February 28, 2021) compared with the immediately preceding year (March 1, 2019, to February 29, 2020).We conducted a longitudinal retrospective study across 6 continents, 56 countries, and 275 stroke centers. We collected volume data for COVID-19 admissions and 4 stroke metrics: ischemic stroke admissions, ICH admissions, IVT treatments, and mechanical thrombectomy procedures. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases.There were 148,895 stroke admissions in the 1 year immediately before compared with 138,453 admissions during the 1-year pandemic, representing a 7% decline (95% CI [95% CI 7.1-6.9]; p < 0.0001). ICH volumes declined from 29,585 to 28,156 (4.8% [5.1-4.6]; p < 0.0001) and IVT volume from 24,584 to 23,077 (6.1% [6.4-5.8]; p < 0.0001). Larger declines were observed at high-volume compared with low-volume centers (all p < 0.0001). There was no significant change in mechanical thrombectomy volumes (0.7% [0.6-0.9]; p = 0.49). Stroke was diagnosed in 1.3% [1.31-1.38] of 406,792 COVID-19 hospitalizations. SARS-CoV-2 infection was present in 2.9% ([2.82-2.97], 5,656/195,539) of all stroke hospitalizations.There was a global decline and shift to lower-volume centers of stroke admission volumes, ICH volumes, and IVT volumes during the 1st year of the COVID-19 pandemic compared with the prior year. Mechanical thrombectomy volumes were preserved. These results suggest preservation in the stroke care of higher severity of disease through the first pandemic year.This study is registered under NCT04934020.
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| 5. |
- Son, Hoang Nghia, et al.
(författare)
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Effects of simulated microgravity on the morphology of mouse embryonic fibroblasts (MEFs)
- 2020
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Ingår i: Romanian Biotechnological Letters. - Bucharest : University of Bucharest. - 1224-5984 .- 2248-3942. ; 25:6, s. 2156-2160
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to assess the effects of simulated microgravity on mouse embryonic fibroblast (MEF) morphology. The results showed that the area of MEFs under simulated microgravity was 7843.39 +/- 551.31 mu m(2) which was lower than the control group (9832.72 +/- 453.86 mu m(2)) (p < 0.001). The nuclear area of MEFs under simulated microgravity (290.76 +/- 4.58 mu m(2)) and the control group (296.8 +/- 4.58 mu m(2)) did not statistically differ. In addition, the nuclear shape value of the MEFs under simulated microgravity and the control group did not statistically differ (0.86 +/- 0.006 vs. 0.87 +/- 0.003, respectively). The nuclear intensity of MEFs under simulated microgravity (19361 +/- 852) was higher than the control group (16997 +/- 285) (P <0.05). Moreover, the flow cytometry analysis indicated the reduced GO/G1 phase cell ratio and the increased S phase and G2/M phase cell ratio in MEFs under simulated microgravity. Simulated microgravity also induced a decrease in diameter of actin filament bundles of the MEFs under simulated microgravity (1.61 +/- 0.33 mu m) compared to the control group (1.79 +/- 0.32 mu m) (P <0.01). These results revealed that simulated microgravity is capable of inducing the morphological changes of mouse embryonic fibroblasts.
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| 6. |
- Jacobsson, Brittmarie, 1956-, et al.
(författare)
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Knowledge, attitudes and behaviour about dental diseases and dental care habits in adolescents in Jönköping, Sweden and in Da Nang, Vietnam
- 2008
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Ingår i: Knowledge, attitude and behaviour in oral health care among 10-15 year olds in Jönköping, Sweden and DaNang, Vietnam.
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Konferensbidrag (refereegranskat)abstract
- The aim of this article was to present data about oral hygiene and knowledge about dental diseases and dental care habits in 10-15 year olds in Jönköping, Sweden and 10-11 year-olds in Da Nang, Vietnam in 2003. Methods A random sample of 206 individuals 10 and 15 year olds, from the City of Jönköping and 369 individuals from the City of Da Nang, were asked about their attitudes towards and knowledge of teeth and dental care habits. Results In Jönköping 9% answered that gingivitis is the same as inflammation of the gum. In Da Nang study 40% knew about early sign of gingivitis (easily gum bleeding). 67% in Jönköping answered that bacteria and sugar cause the acid that gives caries. In Da Nang 47% could answer correctly the cause of dental caries. The percentage of children who brush their teeth twice a day was the same, around 80 %, in both studies. In Jönköping 100% of the children used fluoride toothpaste. In Da Nang 73 % always used Fluoride toothpaste and 14 % did not know if the toothpaste they used contained Fluoride or not.
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| 7. |
- Jacobsson, Brittmarie, et al.
(författare)
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Oral health of children and adolescents in Da Nang
- 2014
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Ingår i: Oral Hygiene & Health. - : OMICS Publishing Group. - 2332-0672. ; 2:4, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- This is a cross-sectional epidemiological study comprising 840 randomly selected children in the age groups of 3, 5, 10 and 15 year-olds. All children were clinically examined for number of teeth, dental caries, dental fillings, plaque, gingivitis and probing pocket depth. Dental care and dietary habits were collected using a self-reported questionnaire. Among 3 and 5 year olds, 98% suffered from dental caries, compared to 91% of 10 and 15 year olds. The mean (SD) of decayed (initial and manifest) and filled tooth surfaces (dfs/DFS) in the different age groups was: 18.2 (14.1), 23.0 (15.4), 5.1 (4.2) and 6.9 (6.0), respectively. There was an average of ~ 30% in all age groups with plaque and gingivitis. Consuming milk with sugar more than 2–3 times a week (3 and 5 year olds) and eating sweets between principal meals twice a day (in 10 and 15 year olds) were statistically significant with caries prevalence. It is concluded that dental caries and gingivitis are significant public health problems among children in Da Nang, Vietnam.
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| 8. |
- Jacobsson, Brittmarie, et al.
(författare)
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Sociodemographic conditions, knowledge of dental diseases, dental care, and dietary habits
- 2015
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Ingår i: Journal of Public Health Dentistry. - : Wiley. - 0022-4006 .- 1752-7325. ; 75:4, s. 308-316
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThis study's aim was to present data on the sociodemographic conditions, knowledge of dental diseases, dental care, and dietary habits among children aged 3, 5, 10, and 15 years in Da Nang, Vietnam.MethodsA cross-sectional epidemiological questionnaire study was conducted in a population of 840 children randomly selected by their year and month of birth (January to July), including 210 individuals in each age group. A self-reported questionnaire was completed by the parents of 3- and 5-year-olds, and a modified questionnaire was given to 10- and 15-year-olds to complete by themselves.ResultsMass media constituted the main source of oral healthcare information. Parents assisted with tooth brushing in 86 percent of 3-year-olds and 71 percent of 5-year-olds. Fluoride toothpaste was used by 44-78 percent of children, with no clear age-related trend. Within the past year, 60 percent of 3- and 5-year-olds, 20 percent of 10-year-olds, and 49 percent of 15-year-olds reported they had not visited a dental professional. Sweets were consumed between principal meals by 70-80 percent of children. Milk with sugar was regularly consumed by 71 percent of 3-year-olds and 91 percent of 5-year-olds.ConclusionsChildren showed frequent sugar consumption and insufficient frequency of brushing their teeth with fluoride toothpaste. Food-based dietary guidelines should play a significant role in nutrition and oral health. It is especially important that oral health prevention programs reach preschool children before they establish unhealthy dietary habits. Parental education about oral health and access to oral healthcare services are also needed to improve children's oral health.
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| 9. |
- Mvundura, Mercy, et al.
(författare)
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How much does it cost to get a dose of vaccine to the service delivery location? Empirical evidence from Vietnam's Expanded Program on Immunization.
- 2014
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Ingår i: Vaccine. - : Elsevier BV. - 0264-410X .- 1873-2518. ; 32:7, s. 834-8
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Tidskriftsartikel (refereegranskat)abstract
- Few studies document the costs of operating vaccine supply chains, but decision-makers need this information to inform cost projections for investments to accommodate new vaccine introduction. This paper presents empirical estimates of vaccine supply chain costs for Vietnam's Expanded Program on Immunization (EPI) for routine vaccines at each level of the supply chain, before and after the introduction of the pentavalent vaccine. We used micro-costing methods to collect resource-use data associated with storage and transportation of vaccines and immunization supplies at the national store, the four regional stores, and a sample of provinces, districts, and commune health centers. We collected stock ledger data on the total number of doses of vaccines handled by each facility during the assessment year. Total supply chain costs were estimated at approximately US$65,000 at the national store and an average of US$39,000 per region, US$5800 per province, US$2200 per district, and US$300 per commune health center. Across all levels, cold chain equipment capital costs and labor were the largest drivers of costs. The cost per dose delivered was estimated at US$0.19 before the introduction of pentavalent and US$0.24 cents after introduction. At commune health centers, supply chain costs were 104% of the value of vaccines before introduction of pentavalent vaccine and 24% after introduction, mainly due to the higher price per dose of the pentavalent vaccine. The aggregated costs at the last tier of the health system can be substantial because of the large number of facilities. Even in countries with high-functioning systems, empirical evidence on current costs from all levels of the system can help estimate resource requirements for expanding and strengthening resources to meet future immunization program needs. Other low- and middle-income countries can benefit from similar studies, in view of new vaccine introductions that will put strains on existing systems.
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| 10. |
- Thanh Hoan, Nguyen, et al.
(författare)
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Novel Time Series Bagging Based Hybrid Models for Predicting Historical Water Levels in the Mekong Delta Region, Vietnam
- 2022
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Ingår i: CMES - Computer Modeling in Engineering & Sciences. - : Tech Science Press. - 1526-1492 .- 1526-1506. ; 131:3, s. 1431-1449
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Tidskriftsartikel (refereegranskat)abstract
- Water level predictions in the river, lake and delta play an important role in flood management. Every year Mekong River delta of Vietnam is experiencing flood due to heavy monsoon rains and high tides. Land subsidence may also aggravate flooding problems in this area. Therefore, accurate predictions of water levels in this region are very important to forewarn the people and authorities for taking timely adequate remedial measures to prevent losses of life and property. There are so many methods available to predict the water levels based on historical data but nowadays Machine Learning (ML) methods are considered the best tool for accurate prediction. In this study, we have used surface water level data of 18 water level measurement stations of the Mekong River delta from 2000 to 2018 to build novel time-series Bagging based hybrid ML models namely: Bagging (RF), Bagging (SOM) and Bagging (M5P) to predict historical water levels in the study area. Performances of the Bagging-based hybrid models were compared with Reduced Error Pruning Trees (REPT), which is a benchmark ML model. The data of 19 years period was divided into 70:30 ratio for the modeling. The data of the period 1/2000 to 5/2013 (which is about 70% of total data) was used for the training and for the period 5/2013 to 12/2018 (which is about 30% of total data) was used for testing (validating) the models. Performance of the models was evaluated using standard statistical measures: Coefficient of Determination (R2), Root Mean Square Error (RMSE) and Mean Absolute Error (MAE). Results show that the performance of all the developed models is good (R2 > 0.9) for the prediction of water levels in the study area. However, the Bagging-based hybrid models are slightly better than another model such as REPT. Thus, these Bagging-based hybrid time series models can be used for predicting water levels at Mekong data.
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| 11. |
- Thanh, Nguyen Xuan, et al.
(författare)
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An assessment of the implementation of the Health Care Funds for the Poor policy in rural Vietnam.
- 2010
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Ingår i: Health Policy. - : Elsevier. - 0168-8510 .- 1872-6054. ; 98:1, s. 58-64
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Tidskriftsartikel (refereegranskat)abstract
- User fees at public health care facilities and out-of-pocket payments for health care services are major health financing problems in Vietnam. In 2002, the Government launched the Health Care Funds for the Poor (HCFP) policy which offered free public health care services to help the poor access public health services and reduce their health care expenditure (HCE). This paper is an assessment of the implementation of the HCFP in a rural district of Vietnam. The impacts of HCFP on household HCE as a percentage of total expenditure and health care utilization were assessed by a double-difference propensity score matching method using panel data of 10,711 households in 2001, 2003, 2005 and 2007. The results showed that the HCFP significantly reduced the HCE as a percentage of total expenditure and increased the use of the local public health care among the poor. However, the impacts of HCFP on the use of the higher levels of public health care and the use of go-to-pharmacies were not significant. In conclusion, this assessment indicates that the HCFP has met its objectives by reducing HCE for the poor and increasing their use of the local public health care services. However, further efforts are needed to help them access higher levels of public health care. Pharmacists should be better regulated and incorporated with primary health care to improve efficiency of the system.
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