Methadone Maintenance Treatment Decentralization in Vietnam

BackgroundTo respond to the dual HIV and injecting drug use epidemic, Vietnam has implemented methadone maintenance treatment (MMT) nationwide since 2010 and decentralized it to primary care (i.e. commune health centers) since 2015. The study aims to explore the challenges that Vietnamese community health workers (CHW) at commune health centers encounter in providing MMT and the factors associated to these challenges.MethodsThis study had a mixed method design. We used two types of data in this study. For the sub-study 1, we used the secondary data from a quantitative survey conducted in Vinh Phuc and Phu Tho provinces among 300 CHWs who did not provide MMT at the time of the study. For the sub-studies 2 and 3, we collected quantitative and qualitative primary data from Dien Bien province. We conducted a quantitative survey among 276 CHWs including both MMT providers and non-MMT providers. From this sample, we selected 26 MMT providers with various characteristics for in-depth interviews.ResultsIn the sub-study 1, the mean score of CHWs’ interaction with PWUD 36.4 (SD 8.8) on a scale of 60. The interaction between CHW not providing MMT and people who use drugs (PWUD) was negatively associated with their stigmatizing attitude towards PWUD (β = -0.84, 95% CL: -1.05; -0.63) after adjusting for their background (gender, education level, job position and years of working experience) and job-related characteristics (perceived risk and challenges when working with PWUD, job satisfaction and empathy towards PWUD). In the sub-study 2, 114 (41.3%) CHW had ever provided MMT services. Better MMT knowledge was associated with higher levels of confidence in providing MMT services among CHW who had no experience with MMT program (β=0.90, 95%CL: 0.29; 1.51), not among those who had experiences. On the other hand, technical support in working with PWUD was associated with a higher level of confidence in providing MMT services for both groups (β=0.71, 95%CL: 0.35; 1.08 and β=0.58, 95%CL: 0.19; 0.96 among CHWs who had ever and who had never worked in MMT, respectively). In sub-study 3, the perceived challenges for MMT provision included lack of confidence and motivation to provide MMT, inadequate human resource, lack of institutional support, insufficient technical support, lack of referral resources and additional support for patients, lack of policies to support the MMT program at CHCs and to protect service providers.ConclusionCHWs in Vietnam faced several challenges in working with PWUD and providing MMT services at primary care settings. Supportive policies and tailored interventions should be developed at different levels to ensure the quality and effectiveness of the MMT decentralization program

The Potential Of Wollastonite As A New Filler For Natural Rubber Compounds

Wollastonite or calcium silicate, (CaSiO3) has potential as a new type of filler in natural rubber (NR) compounds. The curing characteristics, mechanical properties, swelling behavior, thermal stability and morphology of wollastonite filled NR compounds were investigated. Four series of experiments were performed. All NR compounds were prepared using a two roll mill with different filler loading from 0 to 40 phr. In the first series, the effects of different wollastonite loading on the properties of NR compounds were studied. Results indicated that the cure time (t90), scorch time (ts2), tensile strength and elongation at break (Eb) decreased, whereas, maximum torque (MH), tensile modulus, hardness, thermal stability and swelling behavior increased with wollastonite loading. The second series, the effect of physical ball mill treated wollastonite on the properties of NR compounds was investigated. Treated wollastonite improved the properties of NR compounds as compared to untreated wollastonite. The third series, the effect of 1 phr of 3- aminopropyltriethoxysilane (APTES) as silane coupling agent was studied. The presence of APTES showed an improvement in the properties of NR compounds. This was due to the presence of APTES, which enhanced the rubber-filler interaction of NR compounds. In the last series, the influence of partial replacement of wollastonite by carbon black or calcium carbonate was investigated. The substitution of wollastonite by commercial fillers have improved the properties of NR compounds

Youth Decision Making Autonomy and Test Performance

This paper investigates the relationship between youth participation in household decision making and test performance in three countries India, Peru, and Vietnam. Using Young Lives Surveys data, the study constructs autonomy indices using factor analysis and regresses test performance on each of these indices. Contrary to the hypothesis that autonomy may be less beneficial in collectivistic cultures, this study does not find a negative relationship between autonomy and test performance among 19-year-olds in all three countries. Youth unilateral decision making in Peru and joint decision making in Vietnam are associated with higher test performance. Parental unilateral decision making is associated with lower performance in both countries. Autonomy is not significantly related to performance in India. Robustness check suggests that participation in household decisions (buying household utilities, buying livestock, land and house) may be less important for the youths than participation in decisions directly relevant to them

Spectral properties of the surface reflectance of the northern polar region of Mercury

We analyse MESSENGER reflectance measurements covering the northern polar region of Mercury, the least studied region of the northern mercurian hemisphere. We use observations from the Mercury Dual Imaging System Wide-Angle Camera (MDIS/WAC) and the Mercury Atmospheric and Surface Composition Spectrometer (MASCS/VIRS) to study the spectral dependence of the surface reflectance. The results obtained from the observations made by both instruments are remarkably consistent. We find that a second degree polynomial description of the measured reflectance spectra gives very good fits to the data and that the information that they carry can best be characterized by two parameters, the mean reflectance and the mean relative spectral slope, averaged over the explored range of wavelengths. The properties of the four main types of terrains known to form Mercury's regolith in the northern region, smooth plains (SP), heavily cratered terrain (HCT), fresh ejecta/materials and red pitted ground (RPG) are examined in terms of these two parameters. The results are compared, and found consistent with those obtained by earlier studies in spite of difficulties met in obtaining accurate reflectance measurements under the large incidence angle condition characteristic of polar regions. These results will help with the preparation of the BepiColombo mission and with supporting its observational strategy.Comment: 21 pages, 15 figures, accepted for publication in Research in Astronomy and Astrophysic

Indochinese bamboos: biodiversity informatics to assist the identification of “vernacular taxa”

Bamboo (Bambusoides – Gramineae) is one of the most important natural resource in Southeast Asia. However, bamboo identification has many difficulties. In the area of SEP programme «Indochina Bamboos» (2008-2010), the final objective is to update the bamboo flora of Indochine (Vietnam, Laos, Cambodege) and to publish an e-flora including free access keys, digital images and information about the traditional and economic use of bamboos. During field trips in Vietnam, Laos and Cambodgia, samples, pictures and morphological description sheets were collected in various locations and previously assigned to the local vernacular names. We use an informatic program, Xper2, to assist the comparison and identification of “vernacular bamboo taxa” based on morphological characteristics

Numerical modeling of thermal dust polarization from aligned grains in the envelope of evolved stars with updated POLARIS

Magnetic fields are thought to influence the formation and evolution of evolved star envelopes. Thermal dust polarization from magnetically aligned grains is potentially a powerful tool for probing magnetic fields and dust properties in these circumstellar environments. In this paper, we present numerical modeling of thermal dust polarization from the envelope of IK Tau using the magnetically enhanced radiative torque (MRAT) alignment theory implemented in our updated POLARIS code. Due to the strong stellar radiation field, the minimum size required for RAT alignment of silicate grains is $\sim 0.005 - 0.05\,\rm\mu m$. Additionally, ordinary paramagnetic grains can achieve perfect alignment by MRAT in the inner regions of $r < 500\,\rm au$ due to stronger magnetic fields of $B\sim 10$ mG - 1G, producing thermal dust polarization degree of $\sim 10\,\%$. The polarization degree can be enhanced to $\sim 20-40\%$ for grains with embedded iron inclusions. We also find that the magnetic field geometry affects the alignment size and the resulting polarization degree due to the projection effect in the plane-of-sky. We also study the spectrum of polarized thermal dust emission and find the increased polarization degree toward $\lambda > 50\,\rm\mu m$ due to the alignment of small grains by MRAT. Furthermore, we investigate the impact of rotational disruption by RATs (RAT-D) and find the RAT-D effect cause a decrease in the dust polarization fraction. Finally, we compare our numerical results with available polarization data observed by SOFIA/HAWC+ for constraining dust properties, suggesting grains are unlikely to have embedded iron clusters and might have slightly elongated shapes. Our modeling results suggest further observational studies at far-infrared/sub-millimeter wavelengths to understand the properties of magnetic fields and dust in AGB envelopes.Comment: 27 pages, 23 figures, 1 table, to be submitte

Disclosure of HIV Status in Healthcare Settings: Practices and Considerations among Women Living with HIV/AIDS in Vietnam.

ObjectiveThis study investigated women living with HIV/AIDS (WLHA)'s practices and decision-making regarding disclosure of HIV status in healthcare settings in Vietnam. Introduction: Disclosure of HIV status in healthcare settings is under-studied.MethodsWe conducted in-depth interviews with 30 WLHA in Hanoi, Vietnam. Thematic analysis was conducted to investigate the patterns, considerations, and consequences of HIV disclosure. Results: Most participants chose a selective disclosure strategy based on the type of procedure and healthcare setting. They considered several factors: concerns about stigma/discrimination, risks of confidentiality breach, relevance to healthcare provision, and altruism towards protecting providers and other patients. Selective disclosure or non-disclosure often prevented participants from accessing comprehensive care. Conclusion: The study underscores the need to prepare WLHA to make informed decisions regarding disclosure and provide them with service navigations and support. It also highlights the necessity of reducing stigma and enhancing confidentiality protection to ensure safe disclosure in healthcare settings

Environmental Pollution of Heavy Metals in a Vietnamese Informal E-waste Processing Village

Inappropriate handlings of informal e-waste processing have increasingly become a global environmental and public health issue of concern. This study was conducted to quantify the concentrations of five heavy metals found in the environmental media at an exposed village and a reference village in Northern Vietnam. The correlations between a pair of the heavy metals found in a medium, and between a pair of the environmental media was found. The results showed that drinking water was safe for heavy metal exposure in both studied villages. However, at the exposed village, the levels of the heavy metals found in indoor soil were, in descending order, Pb (678.42 ± 846.11 mg kg-1) > Ni (148.77± 163.80 mg kg-1) > Cr (61.99 ± 42.50 mg kg-1) > As (7.62 ± 3.33 mg kg-1) > Cd (6.34 ± 12.39 mg kg-1). The levels of Pb, Cd, Cr, and Ni in indoor soil and surface dust in the exposed village were significantly higher than those in the reference village at p<0.001. The average concentrations of Pb, Cd, Cr, Ni and As in indoor soil were 3.57, 8.78, 1.90, 4.41, and 1.08 times, respectively, higher than those in outdoor soil at p<0.001. The levels of Pb and Cd found in indoor soil at the exposed village were 9.69 and 3.17 time, respectively, higher than the maximum allowable limits in Vietnam. Significant correlations between the pairs of the heavy metals in a medium and between the pair of the environmental media was found at the exposed village. This finding suggested that inappropriate activities conducted at an informal e-waste processing facility could be a major contributor to the heavy metal contaminations. This study highlighted the importance of release mitigation of a hazardous heavy metal from an informal e-waste processing facility to prevent its potential effects on human health