ความสัมพันธ์ระหว่างคุณภาพชีวิตครอบครัวและภาระของผู้ดูแลเด็กที่มีภาวะออทิซึมในครอบครัวในประเทศเวียดนาม Relationships between Family Quality of Life and Burden among Family Caregivers of Children with Autism in Vietnam

บทคัดย่อ วัตถุประสงค์: เพื่อศึกษาคุณภาพชีวิตครอบครัวและภาระของผู้ดูแลเด็กที่มีภาวะออทิซึมในครอบครัว และศึกษาความสัมพันธ์ระหว่างคุณภาพชีวิตครอบครัวและภาระ วิธีการศึกษา: การศึกษาเชิงพรรณนาและหาความสัมพันธ์ ดำเนินการที่แผนกผู้ป่วยนอก (OPD) ของโรงพยาบาลกุมารเวชศาสตร์แห่งชาติ ซึ่งตั้งอยู่ในกรุงฮานอยประเทศเวียดนาม สุ่มตัวอย่างแบบสะดวกในการคัดเลือกครอบครัวผู้ดูแลเด็กออทิสติกจำนวน 50 คน เครื่องมือที่ใช้ในการวิจัย ได้แก่ แบบสอบถามข้อมูลประชากร แบบวัดคุณภาพชีวิตครอบครัวของ Beach Center และดัชนีความเครียดผู้ดูแล วิเคราะห์ข้อมูลด้วยสถิติเชิงพรรณนาและค่าสัมประสิทธิ์สหสัมพันธ์ของเพียร์สัน ผลการศึกษา: ผู้ดูแลในครอบครัวรับรู้คุณภาพชีวิตครอบครัวโดยรวมในระดับต่ำ (M = 1.52, S.D. = 0.22) และภาระในระดับสูง (M = 3.81, S.D. = 0.32) พบมีความสัมพันธ์เชิงลบอย่างมีนัยสำคัญระหว่างคะแนนรวมคุณภาพชีวิตครอบครัวและภาระผู้ดูแล ดังนั้นยิ่งคุณภาพชีวิตครอบครัวต่ำลงภาระผู้ดูแลก็ยิ่งสูงขึ้น นอกจากนี้ พบความสัมพันธ์เชิงลบระหว่างการมีปฏิสัมพันธ์ในครอบครัว การเลี้ยงดู ความเป็นอยู่ที่ดีทางอารมณ์ กับภาระของผู้ดูแล สรุป: การค้นพบนี้ชี้ให้เห็นว่าพยาบาลและผู้ให้บริการด้านสุขภาพที่ดูแลครอบครัวและเด็กที่มีภาวะออทิซึม ควรให้ความสำคัญกับการจัดตั้งทีมดูแลสหสาขาวิชา รวมทั้งให้การสนับสนุนครอบครัวมากขึ้นเพื่อเพิ่มคุณภาพชีวิตครอบครัวและจะช่วยลดภาระผู้ดูแลครอบครัว ซึ่งส่งผลลัพธ์ทางบวกสำหรับเด็กที่มีภาวะออทิซึม คำสำคัญ: ภาวะออทิซึม, คุณภาพชีวิตครอบครัว, ภาระ, ความสัมพันธ์ ประเทศเวียดนาม Abstract Objective: To examine family quality of life and burden of family caregivers of children with autism, and determine relationships between the family quality of life and burden. Methods: A descriptive correlational study was conducted at the Outpatient Department (OPD) of the National Hospital of Pediatrics located in Hanoi, Vietnam. A convenience sampling method was used to recruit 50 family caregivers of children with autism. Research instruments included a demographic questionnaire, the Beach Center Family Quality of Life Scale and the Modified Caregiver Strain Index. Descriptive statistics and Pearson correlation coefficients were used for data analysis. Results: The family caregivers perceived a low level of the overall family quality of life (M = 1.52, S.D. = 0.22), and a high burden level (M = 3.81, S.D. = 0.32). There is a significant negative correlation between the total score of family quality of life and caregiver burden, therefore, the lower the family quality of life, the higher caregiver burden. Furthermore, there were negative relationships between their subscales of family interaction, parenting, emotional wellbeing and caregiver burden. Conclusion: Nurses and health care providers responsible for family and children with autism should pay more attention to establish a multi-disciplinary care team and provide more family support to increase family quality of life and thereby reduce family caregiver burden. Consequently, positive outcomes for children with autism would also be achieved. Keywords: autism, family quality of life, burden, relationship, Vietna

Challenges and Solutions for Ride-Hailing Motorbike Drivers in Vietnam: An Analysis of Working Conditions and Health

In the digital age, ride-hailing motorbike services have become an indispensable part of the urban transportation system in Vietnam, attracting thousands of workers with their flexibility and income potential. However, occupation also poses numerous health and safety challenges. The job requires long working hours, exposure to harsh weather conditions, and highly competitive pressure, leading to physical and mental health issues such as muscle pain, fatigue, and stress. This research article employs a survey method to collect data from ride-hailing motorbike drivers to analyze the labor burdens they endure. Based on the findings, the study suggests solutions such as improving working conditions, developing health support programs, and implementing more flexible policies to enhance the quality of life and job satisfaction among workers, thereby contributing to the sustainable development of the industry in Vietnam

Study on synthesis of carboxymethyl cellulose from pineapple leaf waste and its potential applications as a thickener

In this study, cellulose and hemicellulose were successfully extracted from pineapple leaf waste at yields of 58.8 and 16.1% by dried weight, respectively. Carboxymethyl cellulose (CMC) was synthesised from pineapple leaf cellulose by an esterification process using sodium hydroxide (NaOH) and monochloroacetic acid (MCA) with isopropanol as the supporting medium. Preparation of CMC was investigated by varying three free factors, namely, NaOH concentration, MCA dose, and cellulose size. The carboxymethylation process was optimised to produce CMC with differing degrees of substitution (DS). The highest DS of CMC (0.86) was obtained with 15% (w/v) NaOH solution, 0.6 g of MCA/g cellulose, and 50 μm cellulose. The obtained CMC were characterised by FTIR spectroscopy, SEM images and XRD diffractions. Moreover, the thickening performance of obtained CMC was also determined. The influence of the CMC’s molecular weight and degree of substitution on the viscosity of 1% (w/v) aqueous solution was tested. The experimental results suggest that the viscosity of the solution increases with increasing molecular weight and degree of substitution of CMC

Autologous bone marrow mononuclear cell infusion for liver cirrhosis after the Kasai operation in children with biliary atresia

Aim: To evaluate the safety and early outcomes of autologous bone marrow mononuclear cell (BMMNC) infusion for liver cirrhosis due to biliary atresia (BA) after Kasai operation. Methods: An open-label clinical trial was performed from January 2017 to December 2019. Nineteen children with liver cirrhosis due to BA after Kasai operation were included. Bone marrow was harvested through anterior iliac crest puncture under general anesthesia. Mononuclear cells (MNCs) were isolated by Ficoll gradient centrifugation and then infused into the hepatic artery. The same procedure was repeated 6 months later. Serum bilirubin, albumin, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, and prothrombin time were monitored at baseline, 3 months, 6 months, and 12 months after the first transplantation. Esophagoscopies and liver biopsies were performed in patients whose parents provided consent. Mixed-effect analysis was used to evaluate the changes in Pediatric End-Stage Liver Disease (PELD) scores. Results: The average MNC and CD34+ cell counts per kg body weight were 50.1 ± 58.5 × 106/kg and 3.5 ± 2.8 × 106 for the first transplantation and 57.1 ± 42.0 × 106/kg and 3.7 ± 2.7 × 106 for the second transplantation. No severe adverse events associated with the cell therapy were observed in the patients. One patient died 5 months after the first infusion at a provincial hospital due to the rupture of esophageal varices, while 18 patients survived. Liver function was maintained or improved after infusion, as assessed by biochemical tests. The severity of the disease reduced markedly, with a significant reduction in PELD scores. Conclusion: Autologous BMMNC administration for liver cirrhosis due to BA is safe and may maintain or improve liver function. Trial registration: ClinicalTrials.gov identifier: NCT03468699. Name of the registry: Vinmec Research Institute of Stem Cell and Gene Technology. https://clinicaltrials.gov/ct2/show/NCT03468699?cond=biliary+atresia&cntry=VN&draw=2&rank=2. Registered on March 16, 2018. The trial results will also be published according to the CONSORT statement at conferences and reported in peer-reviewed journals

Clinical Outcomes of Patients With Drug-Resistant Tuberculous Meningitis Treated With an Intensified Antituberculosis Regimen.

Drug-resistant tuberculous meningitis (TBM) is difficult to diagnose and treat. Mortality is high and optimal treatment is unknown. We compared clinical outcomes of drug-resistant and -susceptible TBM treated with either standard or intensified antituberculosis treatment. We analyzed the influence of Mycobacterium tuberculosis drug resistance on the outcomes of patients with TBM enrolled into a randomized controlled trial comparing a standard, 9-month antituberculosis regimen (containing rifampicin 10 mg/kg/day) with an intensified regimen with higher-dose rifampicin (15 mg/kg/day) and levofloxacin (20 mg/kg/day) for the first 8 weeks. The primary endpoint of the trial was 9-month survival. In this subgroup analysis, resistance categories were predefined as multidrug resistant (MDR), isoniazid resistant, rifampicin susceptible (INH-R), and susceptible to rifampicin and isoniazid (INH-S + RIF-S). Outcome by resistance categories and response to intensified treatment were compared and estimated by Cox regression. Of 817 randomized patients, 322 had a known drug resistance profile. INH-R was found in 86 (26.7%) patients, MDR in 15 (4.7%) patients, rifampicin monoresistance in 1 patient (0.3%), and INH-S + RIF-S in 220 (68.3%) patients. Multivariable regression showed that MDR (hazard ratio [HR], 5.91 [95% confidence interval {CI}, 3.00-11.6]), P < .001), was an independent predictor of death. INH-R had a significant association with the combined outcome of new neurological events or death (HR, 1.58 [95% CI, 1.11-2.23]). Adjusted Cox regression, corrected for treatment adjustments, showed that intensified treatment was significantly associated with improved survival (HR, 0.34 [95% CI, .15-.76], P = .01) in INH-R TBM. Early intensified treatment improved survival in patients with INH-R TBM. Targeted regimens for drug-resistant TBM should be further explored

Experiências do estudante de enfermagem na aprendizagem da prevenção e controlo de IACS em países asiáticos através do uso de simulação baseada em cenários: um estudo qualitativo exploratório

Background: Healthcare-associated infections (HAIs) have posed a major threat to both patients and to the safety healthcare personnel worldwide. According to the World Health Organization, 10% of hospitalized patients are affected by HAIs worldwide. Objective: The objective of this study was to explore the experiences of nursing students in learning HAIs prevention and control by the application of the scenario-based simulation pedagogy now in use in two Vietnamese and two Cambodian universities. Methods: A qualitative study was conducted among 160 nursing students from 2 Cambodian universities and 2 Vietnamese universities, and by using the purposive-sampling method. The data were collected through a focus group discussion and analyzed by the Graneheim and Lundman method (Graneheim &amp; Lundman, 2004). Results: Two themes and six categories were generated. 1) First theme: factors for enhancing student learning on the prevention and control of HAIs by use of scenario-based simulation; and 2) Second theme: factors hindering students learning on HAI prevention and control by use of scenario-based simulation. Conclusion: The findings showed that SBS is an effective learning method for nursing students that can be applied to enhance the quality of nursing education in the Asian countries as SBS not only improves the clinical skills, but also the soft skills of nursing students. However, the effective outcomes and impacts can only be achieved in the context with the appropriate learning materials and equipment, simulation facilities and the instructors with pedagogical skills.Enquadramento: As infeções associadas a cuidados de saúde (IACS) têm representado uma grande ameaça tanto para os pacientes quanto para a segurança dos profissionais de saúde em todo o mundo. De acordo com a Organização Mundial da Saúde, 10% dos pacientes hospitalizados são afetados por IACS em todo o mundo. Objetivo: O objetivo deste estudo foi explorar as experiências dos estudantes de enfermagem na aprendizagem da prevenção e controlo de IACS através da aplicação da pedagogia de simulação baseada em cenários, atualmente em uso em duas universidades vietnamitas e duas universidades cambojanas. Métodos: Um estudo qualitativo foi conduzido entre 160 estudantes de enfermagem de duas universidades cambojanas e duas universidades vietnamitas, utilizando o método de amostragem propositada. Os dados foram recolhidos através de uma discussão em grupo focal e analisados pelo método de Graneheim e Lundman (Graneheim &amp; Lundman, 2004). Resultados: Dois temas e seis categorias foram gerados. 1) Primeiro tema: fatores que contribuem para a aprendizagem dos estudantes na prevenção e controlo de IACS pelo uso de simulação baseada em cenários; e 2) Segundo tema: fatores que impedem a aprendizagem dos estudantes na prevenção e controlo de IACS pelo uso de simulação baseada em cenários (SBC). Conclusão: Os resultados demonstraram que a SBC é um método de aprendizagem eficaz para estudantes de enfermagem que pode ser aplicado para melhorar a qualidade da educação em enfermagem nos países asiáticos, uma vez que a SBC não só melhora as habilidades clínicas, mas também as habilidades interpessoais dos estudantes de enfermagem. No entanto, os resultados e impactos efetivos só podem ser alcançados no contexto com os materiais e equipamentos de aprendizagem apropriados, instalações de simulação e instrutores com habilidades pedagógicas

Experiência de aprendizagem de estudantes de enfermagem na prevenção e controlo de infeções associadas aos cuidados de saúde (PC-IACS) em países asiáticos: um estudo qualitativo exploratório

Background: Healthcare-associated infection prevention and control (HAI-PC) education programs in Asian countries seem limited and require improvement and support. Objective: This study explored students’ learning experiences with HAI-PC education programs in Asian countries (two Vietnamese and two Cambodian universities) to support a pedagogical model in HAI-PC. Method: A qualitative exploratory study design was employed, and inductive content analysis was conducted. Students were selected to participate in the focus group to investigate their experiences with HAI-PC using five structured questions. There were 48 nursing students in total from four universities, 28 from 2 universities in Cambodia, and 20 from two universities in Vietnam. Results: The summary results gained from the four universities were synthesized by grouping them into sub-categories and four primary categories, which were students’ HAI-PC competence, students’ current learning methods in HAI-PC Education, the HAI-PC teaching and learning environment, students’ capacity, and entrepreneurial skills in HAI-PC development. Conclusion: This study revealed evidence to improve nursing education in HAI-PC in Asian countries. The new learning method of the simulation scenario and the model fascinated the students; they were happy and more confident about their future careers in practicing HAI-PC skills in their clinical practicum and hospital practice. The current HAI-PC education faces issues related to education and healthcare systems in Asian countries, highlighting the need for improvement.Enquadramento: Os programas de educação em prevenção e controlo de infeções associadas aos cuidados de saúde (PC-IAS) em países asiáticos parecem ser limitados e necessitam de melhorias e apoio. Objetivo: Este estudo explorou as experiências de aprendizagem dos estudantes com programas de educação em PC-IAS em países asiáticos (duas universidades vietnamitas e duas universidades cambojanas) para apoiar um modelo pedagógico em PC-IAS. Método: Foi utilizado um desenho de estudo exploratório qualitativo, e foi realizada uma análise de conteúdo indutiva. Os estudantes foram selecionados para participar no grupo focal para investigar as suas experiências com PC-IAS usando cinco perguntas estruturadas. No total, participaram 48 estudantes de enfermagem de quatro universidades, sendo 28 de duas universidades no Camboja e 20 de duas universidades no Vietname. Resultados: Os resultados resumidos das quatro universidades foram sintetizados agrupando-os em subcategorias e quatro categorias principais, que eram competência dos estudantes em PC-IAS, métodos de aprendizagem atuais dos estudantes em Educação em PC-IAS, ambiente de ensino e aprendizagem em PC-IAS, capacidade dos estudantes e habilidades empreendedoras no desenvolvimento de PC-IAS. Conclusão: Este estudo revelou evidências para melhorar a educação em enfermagem em PC-IAS em países asiáticos. O novo método de aprendizagem do cenário de simulação e o modelo cativaram os estudantes; eles ficaram felizes e mais confiantes em relação às suas futuras carreiras na prática de habilidades em PC-IAS no estágio clínico e na prática hospitalar. A educação atual em PC-IAS enfrenta questões relacionadas aos sistemas de educação e saúde em países asiáticos, destacando a necessidade de melhorias

Simulação como método de ensino na formação em enfermagem na prevenção e controlo de infeções associadas aos cuidados de saúde em países asiáticos: um estudo qualitativo

Background: Applying simulation for nursing education, especially in healthcare-associated infection prevention and control (HAI-PC) in developing countries has limited evidence. The study was conducted to explore educators’ perceptions of simulation as a teaching method for nursing education in HAI-PC in two Vietnamese and two Cambodian universities. Methods: An exploratory qualitative design was applied. A focus group of 37 educators from four universities was conducted for data collection. Inductive and deductive qualitative content analysis was applied in analysing the data. Results: The core category was constructed to reflect educators’ perception of scenario-based simulation (SBS) as a teaching method for nursing education in HAI prevention and control. This main category included three subcategories: (i) enhancing nursing competence; (ii) preparing students for simulation; and [1] promoting simulation pedagogy competence. Conclusions: The findings identified the importance and benefits of applying simulation as a teaching method in nursing education. Additionally, it emphasized the necessity of enhancing knowledge associated with HAIs and providing additional training on simulation for educators to improve the quality of conducting simulations.Enquadramento: A aplicação da simulação no ensino de enfermagem, especialmente na prevenção e controlo de infeções associadas aos cuidados de saúde (IACS), em países em desenvolvimento, tem evidências limitadas. O estudo foi conduzido para explorar as perceções dos educadores sobre a simulação como método de ensino para a formação em enfermagem na prevenção e controlo de IACS em duas universidades vietnamitas e duas universidades cambojanas. Métodos: Foi aplicado um desenho qualitativo exploratório. Um grupo de discussão com 37 educadores de quatro universidades foi conduzido para a recolha de dados. A análise qualitativa de conteúdo indutiva e dedutiva foi aplicada na análise dos dados. Resultados: A categoria central foi construída para refletir a perceção dos educadores sobre a simulação baseada em cenários (SBC) como método de ensino para a formação em enfermagem na prevenção e controlo de IACS. Esta categoria principal incluiu três subcategorias: (i) aprimoramento da competência em enfermagem; (ii) preparação dos estudantes para a simulação; e [1] promoção da competência em pedagogia de simulação. Conclusões: Os resultados identificaram a importância e benefícios da aplicação da simulação como método de ensino na formação em enfermagem. Além disso, enfatizou a necessidade de aprimorar o conhecimento associado às ICACS e fornecer treinamento adicional sobre simulação para educadores, visando melhorar a qualidade da condução das simulações

Health services for reproductive tract infections among female migrant workers in industrial zones in Ha Noi, Viet Nam: an in-depth assessment

BACKGROUND: Rural-to-urban migration involves a high proportion of females because job opportunities for female migrants have increased in urban industrial areas. Those who migrate may be healthier than those staying in the village and they may benefit from better health care services at destination, but the 'healthy' effect can be reversed at destination due to migration-related health risk factors. The study aimed to explore the need for health care services for reproductive tract infections (RTIs) among female migrants working in the Sai Dong industrial zone as well as their services utilization. METHODS: The cross sectional study employed a mixed method approach. A cohort of 300 female migrants was interviewed to collect quantitative data. Two focus groups and 20 in-depth interviews were conducted to collect qualitative data. We have used frequency and cross-tabulation techniques to analyze the quantitative data and the qualitative data was used to triangulate and to provide more in-depth information. RESULTS: The needs for health care services for RTI were high as 25% of participants had RTI syndromes. Only 21.6% of female migrants having RTI syndromes ever seek helps for health care services. Barriers preventing migrants to access services were traditional values, long working hours, lack of information, and high cost of services. Employers had limited interests in reproductive health of female migrants, and there was ineffective collaboration between the local health system and enterprises. These barriers were partly caused by lack of health promotion programs suitable for migrants. Most respondents needed more information on RTIs and preferred to receive these from their employers since they commonly work shifts--and spend most of their day time at work. CONCLUSION: While RTIs are a common health problem among female migrant workers in industrial zones, female migrants had many obstacles in accessing RTI care services. The findings from this study will help to design intervention models for RTI among this vulnerable group such as communication for behavioural impact of RTI health care, fostered collaboration between local health care services and employer enterprises, and on-site service (e.g. local or enterprise health clinics) strengthenin