| 1. |
- Chu, Dinh-Toi, et al.
(author)
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An update on obesity : Mental consequences and psychological interventions
- 2019
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In: Diabetes & Metabolic syndrome. - : Elsevier. - 1871-4021 .- 1878-0334. ; 13:1, s. 155-160
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Research review (peer-reviewed)abstract
- Besides physical consequences, obesity has negative psychological effects, thereby lowering human life quality. Major psychological consequences of this disorder includes depression, impaired body image, low self-esteem, eating disorders, stress and poor quality of life, which are correlated with age and gender. Physical interventions, mainly diet control and energy balance, have been widely applied to treat obesity; and some psychological interventions including behavioral therapy, cognitive behavioral therapy and hypnotherapy have showed some effects on obesity treatment. Other psychological therapies, such as relaxation and psychodynamic therapies, are paid less attention. This review aims to update scientific evidence regarding the mental consequences and psychological interventions for obesity. (c) 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.
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| 2. |
- Hoang-Minh, Thao, et al.
(author)
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Use of TEM-EDX for structural formula identification of clay minerals : a case study of Di Linh bentonite, Vietnam
- 2019
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In: Journal of applied crystallography. - : International Union of Crystallography (IUCr). - 0021-8898 .- 1600-5767. ; 52:1, s. 133-147
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Journal article (peer-reviewed)abstract
- Transmission electron microscopy linked with energy-dispersive X-ray spectroscopy (TEM-EDX) was applied to characterize mineralogical signals ofweathering processes in the Di Linh bentonite deposit (Vietnam) and to visualize the effects of Na activation on the smectitic phases. Modelling of X ray diffraction patterns (oriented mount) was applied in order to refine the computed structural formula. X-ray diffraction, X-ray fluorescence and Fouriertransform infrared spectroscopy (FT-IR) methods were also applied to verify the TEM-EDX results. An Excel-based routine has been developed in this research to allow fast computation of structural formulae and classification of the investigated clay particles. This routine supports the acquirement of 100 300 TEM-EDX analyses as a representative set of individual particles for each sample. The Excel-based routine involves end members of different clay mineral groups and interstratifications with two or three members (e.g. illite smectite interstratifications – IS-ml; dioctahedral vermiculite–smectite interstratifications – diVS-ml; and kaolinite–montmorillonite–dioctahedral vermiculite interstratifications – KSV-ml). The routine is now freely available. According to the identification procedure, the <2 mm fraction of the Di Linh bentonite (Vietnam) is composed mainly of K- and charge-deficient illite smectite interstratifications (or diVS-ml): montmorillonite-rich randomly ordered (R0) type and illite-rich regularly ordered (R1) type. Additionally, Fe-poor KSV-ml was identified.Industrial Na activation of the Di Linh bentonite resulted in an increase of theR1 diVS-ml portion and dissolution of a large part of the smectite-rich phases.The TEM-EDX approach also gave analytical proof of a sedimentary processfor Di Linh smectite. The parent muscovite was altered in two different environments: (i) K-leaching and layer-wise alteration into kaolinite (weathering), and (ii) further edge-controlled alteration of mica into lath-like montmorillonite particles associated with a dissolution of kaolinite layers from the former kaolinite–mica intergrowths by heat impact (basalt flow).
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| 3. |
- Lindblad-Toh, Kerstin, et al.
(author)
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Genome sequence, comparative analysis and haplotype structure of the domestic dog.
- 2005
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In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 438:7069, s. 803-19
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Journal article (peer-reviewed)abstract
- Here we report a high-quality draft genome sequence of the domestic dog (Canis familiaris), together with a dense map of single nucleotide polymorphisms (SNPs) across breeds. The dog is of particular interest because it provides important evolutionary information and because existing breeds show great phenotypic diversity for morphological, physiological and behavioural traits. We use sequence comparison with the primate and rodent lineages to shed light on the structure and evolution of genomes and genes. Notably, the majority of the most highly conserved non-coding sequences in mammalian genomes are clustered near a small subset of genes with important roles in development. Analysis of SNPs reveals long-range haplotypes across the entire dog genome, and defines the nature of genetic diversity within and across breeds. The current SNP map now makes it possible for genome-wide association studies to identify genes responsible for diseases and traits, with important consequences for human and companion animal health.
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| 4. |
- Clark, Andrew G., et al.
(author)
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Evolution of genes and genomes on the Drosophila phylogeny
- 2007
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In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 450:7167, s. 203-218
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Journal article (peer-reviewed)abstract
- Comparative analysis of multiple genomes in a phylogenetic framework dramatically improves the precision and sensitivity of evolutionary inference, producing more robust results than single-genome analyses can provide. The genomes of 12 Drosophila species, ten of which are presented here for the first time (sechellia, simulans, yakuba, erecta, ananassae, persimilis, willistoni, mojavensis, virilis and grimshawi), illustrate how rates and patterns of sequence divergence across taxa can illuminate evolutionary processes on a genomic scale. These genome sequences augment the formidable genetic tools that have made Drosophila melanogaster a pre-eminent model for animal genetics, and will further catalyse fundamental research on mechanisms of development, cell biology, genetics, disease, neurobiology, behaviour, physiology and evolution. Despite remarkable similarities among these Drosophila species, we identified many putatively non-neutral changes in protein-coding genes, non-coding RNA genes, and cis-regulatory regions. These may prove to underlie differences in the ecology and behaviour of these diverse species.
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| 5. |
- Do, Nga T. T., et al.
(author)
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Community-based antibiotic access and use in six low-income and middle-income countries: a mixed-method approach
- 2021
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In: The Lancet Global Health. - : Elsevier. - 2214-109X. ; 9:5, s. e610-e619
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Journal article (peer-reviewed)abstract
- Background: Antimicrobial misuse is common in low-income and middle-income countries (LMICs), and this practice is a driver of antibiotic resistance. We compared community-based antibiotic access and use practices across communities in LMICs to identify contextually specific targets for interventions to improve antibiotic use practices.Methods: We did quantitative and qualitative assessments of antibiotic access and use in six LMICs across Africa (Mozambique, Ghana, and South Africa) and Asia (Bangladesh, Vietnam, and Thailand) over a 2·5-year study period (July 1, 2016–Dec 31, 2018). We did quantitative assessments of community antibiotic access and use through supplier mapping, customer exit interviews, and household surveys. These quantitative assessments were triangulated with qualitative drug supplier and consumer interviews and discussions.Findings: Vietnam and Bangladesh had the largest proportions of non-licensed antibiotic dispensing points. For mild illness, drug stores were the most common point of contact when seeking antibiotics in most countries, except South Africa and Mozambique, where public facilities were most common. Self-medication with antibiotics was found to be widespread in Vietnam (55·2% of antibiotics dispensed without prescription), Bangladesh (45·7%), and Ghana (36·1%), but less so in Mozambique (8·0%), South Africa (1·2%), and Thailand (3·9%). Self-medication was considered to be less time consuming, cheaper, and overall, more convenient than accessing them through health-care facilities. Factors determining where treatment was sought often involved relevant policies, trust in the supplier and the drug, disease severity, and whether the antibiotic was intended for a child. Confusion regarding how to identify oral antibiotics was revealed in both Africa and Asia.Interpretation: Contextual complexities and differences between countries with different incomes, policy frameworks, and cultural norms were revealed. These contextual differences render a single strategy inadequate and instead necessitate context-tailored, integrated intervention packages to improve antibiotic use in LMICs as part of global efforts to combat antibiotic resistance.
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| 6. |
- Eriksson, Leif, 1971-, et al.
(author)
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Secular trend, seasonality and effects of a community-based intervention on neonatal mortality : follow-up of a cluster-randomised trial in Quang Ninh province, Vietnam
- 2018
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In: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 72:9, s. 776-782
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Journal article (peer-reviewed)abstract
- Background: Little is know about whether the effects of community engagement interventions for child survival in low-income and middle-income settings are sustained. Seasonal variation and secular trend may blur the data. Neonatal mortality was reduced in a cluster-randomised trial in Vietnam where laywomen facilitated groups composed of local stakeholders employing a problem-solving approach for 3 years. In this analysis, we aim at disentangling the secular trend, the seasonal variation and the effect of the intervention on neonatal mortality during and after the trial.Methods: In Quang Ninh province, 44 communes were allocated to intervention and 46 to control. Births and neonatal deaths were assessed in a baseline survey in 2005, monitored during the trial in 2008–2011 and followed up by a survey in 2014. Time series analyses were performed on monthly neonatal mortality data.Results: There were 30 187 live births and 480 neonatal deaths. The intervention reduced the neonatal mortality from 19.1 to 11.6 per 1000 live births. The reduction was sustained 3 years after the trial. The control areas reached a similar level at the time of follow-up. Time series decomposition analysis revealed a downward trend in the intervention areas during the trial that was not found in the control areas. Neonatal mortality peaked in the hot and wet summers.Conclusions: A community engagement intervention resulted in a lower neonatal mortality rate that was sustained but not further reduced after the end of the trial. When decomposing time series of neonatal mortality, a clear downward trend was demonstrated in intervention but not in control areas.Trial registration number: ISRCTN44599712, Post-results.
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| 7. |
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| 8. |
- Luu, Chinh, et al.
(author)
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Framework of Spatial Flood Risk Assessment for a Case Study in Quang Binh Province, Vietnam
- 2020
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In: Sustainability. - Switzerland : MDPI. - 2071-1050. ; 12:7, s. 1-17
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Journal article (peer-reviewed)abstract
- Vietnam has been extensively affected by floods, suffering heavy losses in human life andproperty. While the Vietnamese government has focused on structural measures of flood defence such as levees and early warning systems, the country still lacks flood risk assessment methodologies and frameworks at local and national levels. In response to this gap, this study developed a flood risk assessment framework that uses historical flood mark data and a high- resolution digital elevation model to create an inundation map, then combined this map with exposure and vulnerability data to develop a holistic flood risk assessment map. The case study is the October 2010 flood event in Quang Binh province, which caused 74 deaths, 210 injuries, 188,628 flooded properties, 9019 ha of submerged and damaged agricultural land, and widespread damages to canals, levees, and roads. The final flood risk map showed a total inundation area of 64348 ha, in which 8.3% area of low risk, 16.3% area of medium risk, 12.0% area of high risk, 37.1% area of very high risk, and 26.2% area of extremely high risk. The holistic flood risk assessment map of QuangBinh province is a valuable tool and source for flood preparedness activities at the local scale.
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| 9. |
- Mvundura, Mercy, et al.
(author)
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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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In: Vaccine. - : Elsevier BV. - 0264-410X .- 1873-2518. ; 32:7, s. 834-8
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Journal article (peer-reviewed)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. |
- Tien Viet Dung, Vu, et al.
(author)
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Antimicrobial susceptibility testing and antibiotic consumption results from 16 hospitals in Viet Nam: The VINARES project 2012-2013
- 2019
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In: Journal of Global Antimicrobial Resistance. - : ELSEVIER SCI LTD. - 2213-7165 .- 2213-7173. ; 18, s. 269-278
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Journal article (peer-reviewed)abstract
- Objective: To establish a hospital-based surveillance network with national coverage for antimicrobial resistance (AMR) and antibiotic consumption in Viet Nam. Methods: A 16-hospital network (Viet Nam Resistance: VINARES) was established and consisted of national and provincial-level hospitals across the country. Antimicrobial susceptibility testing results from routine clinical diagnostic specimens and antibiotic consumption data in Defined Daily Dose per 1000 bed days (DDD/1000 patient-days) were prospectively collected and analysed between October 2012 and September 2013. Results: Data from a total of 24 732 de-duplicated clinical isolates were reported. The most common bacteria were: Escherichia coli (4437 isolates, 18%), Klebsiella spp. (3290 isolates, 13%) and Acinetobacter spp. (2895 isolates, 12%). The hospital average antibiotic consumption was 918 DDD/1000 patient-days. Third-generation cephalosporins were the most frequently used antibiotic class (223 DDD/1000 patient-days, 24%), followed by fluoroquinolones (151 DDD/1000 patient-days, 16%) and second-generation cephalosporins (112 DDD/1000 patient-days, 12%). Proportions of antibiotic resistance were high: 1098/1580 (69%) Staphylococcus aureus isolates were methicillin-resistant (MRSA); 115/344 isolates (33%) and 90/358 (25%) Streptococcus pneumoniae had reduced susceptibility to penicillin and ceftriaxone, respectively. A total of 180/2977 (6%) E. coli and 242/1526 (16%) Klebsiella pneumoniae were resistant to imipenem, respectively; 602/1826 (33%) Pseudomonas aeruginosa were resistant to ceftazidime and 578/1765 (33%) to imipenem. Of Acinetobacter spp. 1495/2138 (70%) were resistant to carbapenems and 2/333 (1%) to colistin. Conclusions: These data are valuable in providing a baseline for AMR among common bacterial pathogens in Vietnamese hospitals and to assess the impact of interventions. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.
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| 11. |
- Bergström, Anna, 1983-, et al.
(author)
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A facilitated social innovation : stakeholder groups using Plan-Do-Study-Act cycles for perinatal health across levels of the health system in Cao Bang province, Vietnam
- 2023
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In: Implementation Science Communications. - : BioMed Central (BMC). - 2662-2211. ; 4:1
-
Journal article (peer-reviewed)abstract
- BackgroundUniversal coverage of evidence-based interventions for perinatal health, often part of evidence-based guidelines, could prevent most perinatal deaths, particularly if entire communities were engaged in the implementation. Social innovations may provide creative solutions to the implementation of evidence-based guidelines, but successful use of social innovations relies on the engagement of communities and health system actors. This proof-of-concept study aimed to assess whether an earlier successful social innovation for improved neonatal survival that employed regular facilitated Plan-Do-Study-Act meetings on the commune level was feasible and acceptable when implemented on multiple levels of the health system (52 health units) and resulted in actions with plausibly favourable effects on perinatal health and survival in Cao Bang province, northern Vietnam.MethodsThe Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework guided the implementation and evaluation of the Perinatal Knowledge-Into-Practice (PeriKIP) project. Data collection included facilitators’ diaries, health workers’ knowledge on perinatal care, structured observations of antenatal care, focus group discussions with facilitators, their mentors and representatives of different actors of the initiated stakeholder groups and an individual interview with the Reproductive Health Centre director. Clinical experts assessed the relevance of the identified problems and actions taken based on facilitators’ diaries. Descriptive statistics included proportions, means, and t-tests for the knowledge assessment and observations. Qualitative data were analysed by content analysis.ResultsThe social innovation resulted in the identification of about 500 relevant problems. Also, 75% of planned actions to overcome prioritised problems were undertaken, results presented and a plan for new actions to achieve the group’s goals to enhance perinatal health. The facilitators had significant roles, ensuring that the stakeholder groups were established based on principles of mutual respect. Overall, the knowledge of perinatal health and performance of antenatal care improved over the intervention period.ConclusionsThe establishment of facilitated local stakeholder groups can remedy the need for tailored interventions and grassroots involvement in perinatal health and provide a scalable structure for focused efforts to reduce preventable deaths and promote health and well-being.
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| 12. |
- Bergström, Anna, et al.
(author)
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Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings
- 2015
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In: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 10
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Journal article (peer-reviewed)abstract
- Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.
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| 13. |
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| 14. |
- Duc, Duong M., 1984-, et al.
(author)
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Measuring local healthcare context for knowledge translation in primary and secondary levels of care in northern Vietnam: A cross-sectional study
-
Other publication (other academic/artistic)abstract
- BackgroundThe influence of context in shaping the effectiveness of knowledge translation (KT) is widely recognized. The Context Assessment for Community Health (COACH) tool aims to assess contextual aspects that are of importance for KT in healthcare in low- and middle-income settings. This study used the COACH tool to describe healthcare context as perceived by health workers in primary and secondary levels of care in a northern province in Vietnam and to further evaluate the internal structure of the COACH tool.MethodsThis cross-sectional study administered the COACH tool to 677 eligible health workers in primary and secondary levels of care. The relationships between individual background variables and COACH dimensions were analysed using binary logistic regression. Further, internal construct validity was calculated by a first-order independent cluster model confirmatory factor analysis (CFA).ResultsOverall, the healthcare context was perceived as supportive for KT. Gender, age, and geographic location showed significant relationships to one of the COACH dimensions. Male health workers rated their Commitment to work as lower than female health workers (OR=0.39, 95% CI: 0.20–0.78). There were, however, only minor differences in scores for the dimensions of context, at each health facility as well as between health facilities. The CFA asserted an acceptable internal structure of the COACH tool.ConclusionsThe survey enhanced the understanding of how aspects of the healthcare context for KT are perceived by health workers at primary and secondary levels of care in a province in Vietnam. There was an overall positive perception of the work context with only minor variability, reflecting a ‘receptive to change’ context for KT. This should, however, be interpreted with caution due to the risk of social desirability response bias. The findings on the acceptable internal structure of the COACH tool supports its further use as a valid instrument.
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| 15. |
- Duy, Duong The, et al.
(author)
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Assessment of technical, economic, and allocative efficiencies of shrimp farming in the Mekong Delta, Vietnam
- 2023
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In: Journal of the World Aquaculture Society. - : Wiley. - 0893-8849 .- 1749-7345. ; 54:4, s. 915-930
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Journal article (peer-reviewed)abstract
- This study applied a stochastic frontier production model to analyze the technical (TE), allocative (AE), and economic (EE) efficiencies of intensive shrimp farming households, and to identify socioeconomic and shrimp farm-specific factors (farm size, labor, feed, seed, chemicals/medicine) that influence the TE, AE, and EE of shrimp production in the Ca Mau, Ben Tre, Bac Lieu, and Tra Vinh provinces of the Mekong Delta, Vietnam. The AE was calculated based on TE and EE. The stochastic frontier production and cost function model were used to evaluate the EE and TE at the shrimp farming household level. The results showed that the mean TE, AE, and EE of shrimp farming systems were 75%, 68.5%, and 61.4%, respectively. Age, gender, education, experience, cooperatives, and technical training significantly impacted the efficiency of shrimp production. The results suggest that shrimp farmers can improve shrimp productivity and EE by decreasing feed cost (FEE) and medicine/chemical cost (MED) of farm inputs. The study showed that shrimp farmers who participated in training activities, cooperatives, or management boards of aquaculture associations were more technically efficient than other farmers. The findings of this study provide essential information about the TE, AE, and EE of shrimp production, which can help local policy makers and shrimp farmers in the region to make better decisions on how to improve the EE and sustainability of shrimp production in the future. There is a need for recommendations on how to improve policies, technical guidance, and training courses on feed management and feeding practices, water quality, and disease management, to help shrimp farmers in the coastal provinces of the Mekong Delta to improve their shrimp production efficiencies in the future.
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| 16. |
- Eriksson, Leif, et al.
(author)
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Evidence-based practice in neonatal health : knowledge among primary health care staff in northern Viet Nam
- 2009
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In: Human Resources for Health. - : Springer Science and Business Media LLC. - 1478-4491. ; 7, s. 36-
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Journal article (peer-reviewed)abstract
- BACKGROUND: An estimated four million deaths occur each year among children in the neonatal period. Current evidence-based interventions could prevent a large proportion of these deaths. However, health care workers involved in neonatal care need to have knowledge regarding such practices before being able to put them into action.The aim of this survey was to assess the knowledge of primary health care practitioners regarding basic, evidence-based procedures in neonatal care in a Vietnamese province. A further aim was to investigate whether differences in level of knowledge were linked to certain characteristics of community health centres, such as access to national guidelines in reproductive health care, number of assisted deliveries and geographical location. METHODS: This cross-sectional survey was completed within a baseline study preparing for an intervention study on knowledge translation (Implementing knowledge into practice for improved neonatal survival: a community-based trial in Quang Ninh province, Viet Nam, the NeoKIP project, ISRCTN44599712). Sixteen multiple-choice questions from five basic areas of evidence-based practice in neonatal care were distributed to 155 community health centres in 12 districts in a Vietnamese province, reaching 412 primary health care workers. RESULTS: All health care workers approached for the survey responded. Overall, they achieved 60% of the maximum score of the questionnaire. Staff level of knowledge on evidence-based practice was linked to the geographical location of the CHC, but not to access to the national guidelines or the number of deliveries at the community level. Two separated geographical areas were identified with differences in staff level of knowledge and concurrent differences in neonatal survival, antenatal care and postnatal home visits. CONCLUSION: We have identified a complex pattern of associations between knowledge, geography, demographic factors and neonatal outcomes. Primary health care staff knowledge regarding neonatal health is scarce. This is a factor that is possible to influence and should be considered in future efforts for improving the neonatal health situation in Viet Nam.
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| 17. |
- Eriksson, Leif, et al.
(author)
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Newborn care and knowledge translation - perceptions among primary health care staff in northern Vietnam
- 2011
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In: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 6, s. 29-
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Journal article (peer-reviewed)abstract
- BACKGROUND: Nearly four million neonatal deaths occur annually in the world despite existing evidence-based knowledge with the potential to prevent many of these deaths. Effective knowledge translation (KT) could help to bridge this know-do gap in global health. The aim of this study was to explore aspects of KT at the primary healthcare level in a northern province in Vietnam. METHODS: Six focus-group discussions were conducted with primary healthcare staff members who provided neonatal care in districts that represented three types of geographical areas existing in the province (urban, rural, and mountainous). Recordings were transcribed verbatim, translated into English, and analyzed using content analysis. RESULTS: We identified three main categories of importance for KT. Healthcare staff used several channels for acquisition and management of knowledge (1), but none appeared to work well. Participants preferred formal training to reading guideline documents, and they expressed interest in interacting with colleagues at higher levels, which rarely happened. In some geographical areas, traditional medicine (2) seemed to compete with evidence-based practices, whereas in other areas it was a complement. Lack of resources, low frequency of deliveries and, poorly paid staff were observed barriers to keeping skills at an adequate level in the healthcare context (3). CONCLUSIONS: This study indicates that primary healthcare staff work in a context that to some extent enables them to translate knowledge into practice. However, the established and structured healthcare system in Vietnam does constitute a base where such processes could be expected to work more effectively. To accelerate the development, thorough considerations over the current situation and carefully targeted actions are required.
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| 18. |
- Eriksson, Leif, 1971-, et al.
(author)
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Process evaluation of a knowledge translation intervention using facilitation of local stakeholder groups to impove neonatal survival in Quang Ninh province, Vietnam
- 2016
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In: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 17:1
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Journal article (peer-reviewed)abstract
- BackgroundAnnually, 2.8 million neonatal deaths occur worldwide, despite the fact that three-quarters of them could be prevented if available evidence-based interventions were used. Facilitation of community groups has been recognized as a promising method to translate knowledge into practice. In northern Vietnam, the Neonatal Health – Knowledge Into Practice trial evaluated facilitation of community groups (2008–2011) and succeeded in reducing the neonatal mortality rate (adjusted odds ratio, 0.51; 95 % confidence interval 0.30–0.89). The aim of this paper is to report on the process (implementation and mechanism of impact) of this intervention.MethodsProcess data were excerpted from diary information from meetings with facilitators and intervention groups, and from supervisor records of monthly meetings with facilitators. Data were analyzed using descriptive statistics. An evaluation including attributes and skills of facilitators (e.g., group management, communication, and commitment) was performed at the end of the intervention using a six-item instrument. Odds ratios were analyzed, adjusted for cluster randomization using general linear mixed models.ResultsTo ensure eight active facilitators over 3 years, 11 Women’s Union representatives were recruited and trained. Of the 44 intervention groups, composed of health staff and commune stakeholders, 43 completed their activities until the end of the study. In total, 95 % (n = 1508) of the intended monthly meetings with an intervention group and a facilitator were conducted. The overall attendance of intervention group members was 86 %. The groups identified 32 unique problems and implemented 39 unique actions. The identified problems targeted health issues concerning both women and neonates. Actions implemented were mainly communication activities. Communes supported by a group with a facilitator who was rated high on attributes and skills (n = 27) had lower odds of neonatal mortality (odds ratio, 0.37; 95 % confidence interval, 0.19–0.73) than control communes (n = 46).ConclusionsThis evaluation identified several factors that might have influenced the outcomes of the trial: continuity of intervention groups’ work, adequate attributes and skills of facilitators, and targeting problems along a continuum of care. Such factors are important to consider in scaling-up efforts.
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| 19. |
- Eriksson, Leif, 1971-, et al.
(author)
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Sustainability of knowledge implementation in a low- and middle- income context : Experiences from a facilitation project in Vietnam targeting maternal and neonatal health
- 2017
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:8
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Journal article (peer-reviewed)abstract
- BACKGROUND: In a previous trial in Vietnam, a facilitation strategy to secure evidence-based practice in primary care resulted in reduced neonatal mortality over a period of three years. While little is known as to what ensures sustainability in the implementation of community-based strategies, the aim of this study was to investigate factors promoting or hindering implementation, and sustainability of knowledge implementation strategies, by means of the former Neonatal Knowledge Into Practice (NeoKIP) trial.METHODS: In 2014 we targeted all levels in the Vietnamese healthcare system: six individual interviews with representatives at national, provincial and district levels, and six focus group discussions with representatives at the commune level. The interviews were transcribed verbatim, translated to English, and analysed using inductive and deductive thematic analysis.RESULTS: To achieve successful implementation and sustained effect of community-based knowledge implementation strategies, engagement of leaders and key stakeholders at all levels of the healthcare system is vital-prior to, during and after a project. Implementation and sustainability require thorough needs assessment, tailoring of the intervention, and consideration of how to attain and manage funds. The NeoKIP trial was characterised by a high degree of engagement at the primary healthcare system level. Further, three years post trial, maternal and neonatal care was still high on the agenda for healthcare workers and leaders, even though primary aspects such as stakeholder engagement at all levels, and funding had been incomplete or lacking.CONCLUSIONS: The current study illustrates factors to support successful implementation and sustain effects of community-based strategies in projects in low- and middle-income settings; some but not all factors were represented during the post-NeoKIP era. Most importantly, trials in this and similar contexts require deliberate management throughout and beyond the project lifetime, and engagement of key stakeholders, in order to promote and sustain knowledge implementation.
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| 20. |
- Gil, Jeovanis, et al.
(author)
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An observational study on the molecular profiling of primary melanomas reveals a progression dependence on mitochondrial activation
- 2021
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In: Cancers. - : MDPI AG. - 2072-6694. ; 13:23
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Journal article (peer-reviewed)abstract
- Melanoma in advanced stages is one of the most aggressive tumors and the deadliest of skin cancers. To date, the histopathological staging focuses on tumor thickness, and clinical staging is a major estimate of the clinical behavior of primary melanoma. Here we report on an observational study with in‐depth molecular profiling at the protein level including post-translational modifications (PTMs) on eleven primary tumors from melanoma patients. Global proteomics, phosphoproteomics, and acetylomics were performed on each sample. We observed an up‐regulation of key mitochondrial functions, including the mitochondrial translation machinery and the down‐regulation of structural proteins involved in cell adhesion, the cytoskeleton organization, and epidermis development, which dictates the progression of the disease. Additionally, the PTM level pathways related to RNA processing and transport, as well as chromatin organization, were dysregulated in relation to the progression of melanoma. Most of the pathways dysregulated in this cohort were enriched in genes differentially expressed at the transcript level when similar groups are compared or metastasis to primary melanomas. At the genome level, we found significant differences in the mutation profiles between metastatic and primary melanomas. Our findings also highlighted sex‐related differences in the molecular profiles. Remarkably, primary melanomas in women showed higher levels of antigen processing and presentation, and activation of the immune system response. Our results provide novel insights, relevant for developing personalized precision treatments for melanoma patients.
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| 21. |
- Hoa, Dinh P, et al.
(author)
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Persistent neonatal mortality despite improved under-five survival : a retrospective cohort study in northern Vietnam
- 2008
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In: Acta Paediatrica. - 0803-5253 .- 1651-2227. ; 97:2, s. 166-170
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Journal article (peer-reviewed)abstract
- Aim: To examine trends in neonatal, infant and under-five mortality rates in a northern Vietnamese district during 1970-2000, and to analyze socioeconomic differences in child survival over time. Methods: Retrospective interviews with all women aged 15-54 years in Bavi district in Northern Vietnam (n = 14 329) were conducted. Of these women, 13 943 had been pregnant, giving birth to 26 796 children during 1970-2000. Results: There was a dramatic reduction in infant and under-five mortality rate (47%) over time. However, the neonatal mortality rate (NMR) showed a very small reduction, thus causing its proportion of the total child mortality to increase. Mortality trends followed the political and socioeconomic development of Vietnam over war, peace and periods of reforms. There were no differences in under-five and neonatal mortalities associated with family economy, while differentials related to mothers' education and ethnicity were increasing. Conclusion: Interventions to reduce child mortality should be focused on improving neonatal care. In settings with a rapid economic growth and consequent social change, like in Vietnam, it is important that such interventions are targeted at vulnerable groups, in this case, families with low level of education and belonging to ethnic minorities.
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| 22. |
- Hoa, Dinh Thi Phuong, et al.
(author)
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Sex of newborns associated with place and mode of delivery : a population-based study in northern Vietnam
- 2012
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In: Gender Medicine. - : Elsevier BV. - 1550-8579 .- 1878-7398. ; 9:6, s. 418-23
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Journal article (peer-reviewed)abstract
- BACKGROUND: There is increasing evidence of an elevated sex ratio at birth (SRB) in many Asian countries, including Vietnam, and that this prenatal gender inequity is related to sex-selective abortion. However, few studies have investigated the relation between the sex of offspring and delivery care utilization.OBJECTIVE: The aim of the present study was to relate sex of newborns to place and mode of delivery in a province in northern Vietnam.METHODS: A population-based surveillance system within the Neonatal Health-Knowledge Into Practice (NeoKIP) project (ISRCTN44599712) recorded all births within eight districts of Quang Ninh province in northern Vietnam from July 2008 to June 2011.RESULTS: In total, there were 22,377 live births within the study area. SRB was 108 boys per 100 girls. There was a large difference in SRB depending on place of delivery, with 94 boys per 100 girls being delivered at home, whereas 113 boys per 100 girls were delivered at a district-level hospital. Cesarean section (CS) rate was 17%, and within the CS group, the SRB was 135:100.CONCLUSIONS: We demonstrated an elevated SRB, especially at district hospital level, and that sex of offspring influenced place and mode of delivery. Although mothers to boys were more likely to receive more qualified delivery care, they were at the same time more likely to undergo unnecessary surgery. Correct information to women and family members about CS and stricter implementation of the medical indications for CS are urgently called for.
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| 23. |
- Klingberg-Allvin, Marie, et al.
(author)
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Ethics of justice and ethics of care. Values and attitudes among midwifery students on adolescent sexuality and abortion in Vietnam and their implications for midwifery education : a survey by questionnaire and interview
- 2007
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In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 44:1, s. 37-46
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Journal article (peer-reviewed)abstract
- Adolescent’s sexuality and related reproductive health and rights problems are sensitive issues in Vietnam. Globalisation has had an impact on the lifestyles of young people, and rising numbers of abortion and STI/HIV risks among youth are posing major health concerns in the country. These problems need to be addressed. Midwives belong to a key category of health personnel in Vietnam, whose task it is to promote adolescents’ sexual and reproductive health and prevent reproductive ill health. It is important to understand future midwives’ perceptions and attitudes in order to improve their education and training programmes. Aim: The aim of this study was to investigate Vietnamese midwifery students’ values and attitudes towards adolescent sexuality, abortion and contraception and their views on professional preparation. Methods: A quantitative survey including 235 midwifery students from four different secondary medical colleges in northern Vietnam was carried out in 2003. A qualitative study addressing similar questions was performed and 18 midwifery students were individually interviewed. Findings: Findings revealed a general disapproval of adolescent pre-marital sexual relations and abortion – ‘an ethics of justice’ - but also an empathic attitude and willingness to support young women, who bear the consequences of unwanted pregnancies and social condemnation – ‘an ethics of care’. Gender-based imbalance in sexual relationships, limited knowledge about reproductive health issues among youth, and negative societal attitudes were concerns expressed by the students. The students saw their future tasks mainly related to childbearing and less to other reproductive health issues, such as abortion and prevention of STI/HIV. Conclusion: Midwifery education in Vietnam should encourage value-reflective thinking around gender inequality and ethical dilemmas, in order to prepare midwives to address adolescents’ reproductive health needs.
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| 24. |
- Klingberg-Allvin, Marie, et al.
(author)
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Perspectives of midwives and doctors on adolescent sexuality and abortion care in Vietnam.
- 2006
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 34:4, s. 414-421
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Journal article (peer-reviewed)abstract
- Background: Vietnam has one of the highest abortion rates in the world and adolescent abortions are thought to constitute at least one third of all cases. Lack of balanced reproductive health information and services to adolescents and negative social attitudes towards adolescent sexuality are contributing factors to the high abortion rates. Health providers are important in guiding and counselling adolescents on how to protect their reproductive health. There is a lack of studies on health providers’ perspectives on their work in adolescent reproductive health care. Aim: To explore the perspectives of midwives and doctors on adolescent sexuality and abortion, and what they considered to be quality abortion care for adolescents and the barriers to it, as well as to their own training needs. Methods: Observations of care in abortion clinics and focus group discussions (FGD) were used to collect data. Doctors and midwives from three health care facilities in Quang Ninh province in Northern Vietnam participated in a total of eight FGDs. Data were analysed using latent content analysis.Findings: Major barriers identified for quality abortion care were of technical and managerial nature. Participants considered that counselling unmarried clients in connection with abortion should focus on warning against the risks and dangers of abortion and pre-marital sexual relations, which they strongly disapproved of. However, they also expressed a pragmatic and caring attitude towards the unmarried girls and couples coming for abortion. Adolescent sexuality and abortion are morally sensitive issues in the Vietnamese culture. The contradictions between cultural norms and the reality facing health providers while counselling the unmarried adolescents need to be addressed in education and training programmes.
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| 25. |
- Li, Zhongtian
(author)
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Dynamic Thermal Rating for Improved Utilization of Wind Farm Export Systems : A Methodology for Improving Load Profile Estimation of Wind Farm Export Transformers
- 2023
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Licentiate thesis (other academic/artistic)abstract
- The power system components connected to renewable energy sources, such as transformers, are often oversized and conservatively loaded. The design of transformers normally ignores the intermittent nature of the connected renewable energy sources (e.g. solar, wind). Due to the variations in weather conditions and operation states, the transformer load oscillates and the actual hot spot temperature is significantly lower than the designed thermal rating.For wind farms, the oversized transformer causes extra resourcematerial waste and a higher wind power price. Dynamic thermal rating can be applied to determine the rating of the transformers based on real-time environmental conditions (e.g. ambient temperature, wind speed). However, in order to optimize the operation of the transformers with dynamic thermal rating, the prediction of the load profile of transformers is an obstacle.The load of wind farm export transformers oscillates due to thechange of load conditions (e.g. turbine availability, power curtailment) and environmental conditions (e.g. wind speed, wind direction and ambient temperature). This thesis proposes a new methodology to improve the utilization of wind farm export transformers by estimating their load profile more accurately and assessing their aging rate. The estimation of the load profile takes the wake effect and turbine availability into account. Specifically, the variation in the wind turbine failure and repair rates, which is influenced by the wind, is considered in the evaluation of turbine availability. Additionally, a correction method is proposed to improve the accuracy of the wake loss computation.The results demonstrate that the estimation accuracy of the transformer load profile is improved after considering the influence of the wake effect and turbine availability. The wake effect and the turbine availability reduce the generated wind power and to some extent, reduce the load and the aging rate of transformers. However, the wake effect has limited influence when the wind farm reaches peak power production while turbine availability influences the load profile of transformers especially when the load is close to the installed capacity of the wind farm. After considering these two factors, the prediction accuracy of the hot spot temperature in the transformers can be enhanced and dynamic thermal rating can be applied to transformers with improved reliability.
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