Nitrogen geochemistry of a Cretaceous-Tertiary boundary site in New Zealand

Nitrogen in the basal layer of the K-T boundary clay at Woodside Creek, New Zealand, has an abundance of 1100 ppm, a 20-fold enrichment over Cretaceous and Tertiary values. The enrichment parallels that for Ir and elemental carbon (soot); all decrease over the next 6 mm of the boundary clay. The C/N ratio, assuming the nitrogen to be associated with organic rather than elemental carbon, is approximately 5 for the basal layer compared to 20 to 30 for the remainder of the boundary clay. The correlation between N and Ir abundances appears to persist above the boundary, implying that the N is intimately associated with the primary fallout and remained with it during the secondary redeposition processes that kept the Ir abundance relatively high into the lowermost Tertiary. Apparently the basal layer of the boundary clay represents the accumulation of a substantial quantity of N with an isotopic composition approximately 10 percent heavier than background delta value of N-15 values. If the boundary clay represents an altered impact glass from a meteorite impact than it probably denotes a time period of less than 1 year. Therefore, the changes in nitrogen geochemistry apparently occurred over a very short period of time. The high abundance of N and the correspondingly low C/N ratio may reflect enhanced preservation of organic material as a result of the rapid sweepout and burial of plankton by impact ejecta, with little or no bacterial degradation. It is conceivable that the shift in delta value of N-15 may represent an influx of nitrogen from a different source deposited contemporaneously with the impact ejecta. An interesting possibility is that it may be derived from nitrate, produced from the combustion of atmospheric nitrogen

日本におけるHIVの予想に関する研究

学位の種別: 論文博士審査委員会委員 : (主査)東京大学教授 神馬 征峰, 東京大学教授 橋本 英樹, 東京大学准教授 梅崎 昌裕, 東京大学准教授 近藤 尚己, 東京大学講師 グリーン ジョセフUniversity of Tokyo(東京大学

Explaining variation in referral from primary to secondary care: cohort study

Objectives To determine the extent to which referral for defined symptoms from primary care varies by age, sex, and social deprivation and whether any sociodemographic variations in referral differ according to the presence of national referral guidance and the potential of the symptoms to be life threatening

Vietnam’s healthcare system decentralization : how well does it respond to global health crises such as COVID-19 pandemic?

This article discussed Vietnam’s ongoing efforts to decentralize the health system and its fitness to respond to global health crises as presented through the Covid-19 pandemic. We used a general review and expert’s perspective to explore the topic. We found that the healthcare system in Vietnam continued to decentralize from a pyramid to a wheel model. This system shifts away from a stratified technical hierarchy of higher- and lower-level health units (pyramid model) to a system in which quality healthcare is equally expected among all health units (wheel model). This decentralization has delivered more quality healthcare facilities, greater freedom for patients to choose services at any level, a more competitive environment among hospitals to improve quality, and reductions in excess capacity burden at higher levels. It has also enabled the transformation from a patient-based traditional healthcare model into a patient-centered care system. However, this decentralization takes time and requires long-term political, financial commitment, and a working partnership among key stakeholders. This perspective provides Vietnam’s experience of the decentralization of the healthcare system that may be consider as a useful example for other countries to strategically think of and to shape their future system within their own socio-political context. Copyright © 2020 Via Medic

Factors associated with high-risk behaviors of people newly diagnosed with HIV/AIDS : results from a cross-sectional study in Vietnam

Towards the elimination of this global epidemic, understanding the high-risk behaviors of people newly diagnosed with HIV/AIDS (PNDWH) is essential. This study aimed to describe the general characteristics and high-risk behaviors of PNDWH and identify associated factors for adopting high-risk behaviors. A cross-sectional survey was conducted in Vietnam to explore the high-risk behaviors of 506 PNDWH. Associated factors were identified using multivariable logistic regressions. 83.2% of participants had sex without using a condom, and 27.9% had more than two sex partners. Among injected drug users, 44% had shared needles with an average number of 2.1 shared partners. Male, Kinh ethnicity (Vietnamese), high income, and high educational level were risk factors for high-risk behaviors. Our findings revealed the first time a comprehensive picture of PNDWH and emphasized the high prevalence of STIs, including untreated STIs and the long delay since the early HIV diagnosis. Also, our model found much higher risk behaviors among participants who were non-adherent to ART and those currently enrolled in ART. By better managing newly-diagnosed cases, better integrating STI management services and prevention consultants, as well as improving ART adherence programs, Vietnam can make better progress towards the complete control of HIV for its most vulnerable populations. © 2020 Informa UK Limited, trading as Taylor & Francis Group

Rapid impact assessments of COVID-19 control measures against the Delta variant and short-term projections of new confirmed cases in Vietnam

vital:17277As of 2020, the cumulative number of COVID-19 cases recorded in Vietnam was less than 1500, proving the success of COVID-19 control in Vietnam [1]. Vietnam has been recognized as one of the few countries that successfully controlled COVID-19 in 2020 [2]. Several recent articles have summarised a set of lessons learned, the so-called “Zero-new-case-approach”. These included (i) a rapid and coordinated public health response with a decentralized health care system [3]; (ii) massive quarantine and targeted lockdown; (iii) third-degree contact tracing; (iv) centralized patient management; (v) early school closures and robust border controls; (vi) mask policies and 5K message (5K refers to use face masks in public places, disinfect regularly, keep distance, stop gathering, and make health declaration); and (vii) innovative mass testing strategies in the resource-constraint system (sample pooling strategy of PCR test with 2-7 swaps) [4], These “Zero-newcase-approach” strategies all focused on the non-pharmaceutical aspect of disease control. They aimed to maintain zero community transmission by establishing a comprehensive public surveillance system and enacted drastic measures with the support of the police and military forces. © 2021 THE AUTHOR(S) JoGH 2021 ISoG

Translation, validation and psychometric properties of Effort-Reward Imbalance questionnaire among nurses in Vietnam

We translated the Effort-Reward imbalance questionnaire, an instrument for measuring work stress, into the Vietnamese language and investigated its psychometric properties among nurses in Vietnam. In a hospital-based cross-sectional study design, we sampled and interviewed 207 nurses working full-time (response rate 83%). We evaluated the internal consistency using standardized Cronbach's alpha coefficients and structural validity using confirmatory factor analysis. Discriminative validity was assessed by comparing the measured scores between age groups, gender, education levels, income groups, and job positions. In addition, we confirmed the criterion validity by investigating its association with self-reported health using simple and multiple logistic regression models. Most of the participants were female (73.3%), young (average 28.5 years old), and had education levels of college or higher (53.5%). We observed sufficient internal consistency in effort, reward, and over-commitment scales (Cronbach's alpha 0.80, 0.76, and 0.68, respectively). Confirmatory factor analysis of the three-factor hierarchical model showed an acceptable fit and fair construct validity with most moderate or stronger (>0.3) factor loading coefficients. Poor self-rated health was more likely in respondents in both Effort-Reward ratio's middle tertile (adjusted Odd-Ratio = 2.80, p-value = 0.031) and highest tertile (adjusted Odd-Ratio = 2.64, p-value = 0.05), adjusting for age, gender, and education levels. The Effort-reward imbalance scale has adequate reliability and validity for assessing work stress among nurses in Vietnam. Its significant association with poor self-rated health warrants further investigation. The validated instrument can help measure the effort-reward imbalance to manage better work-related emotional strains and mental health issues among nurses and ensure human resources' stability in healthcare in Vietnam. © 202

Trends in cause specific mortality across occupations in Japanese men of working age during period of economic stagnation, 1980-2005: retrospective cohort study

Objective To assess the temporal trends in occupation specific all causes and cause specific mortality in Japan between 1980 and 2005

COVID-19 and heat illness in Tokyo, Japan: implications for the summer Olympic and Paralympic Games in 2021

The 2020 summer Olympic and Paralympic Games in Tokyo were postponed to July– September 2021 due to the coronavirus disease 2019 (COVID-19) pandemic. While COVID-19 has emerged as a monumental health threat for mass gathering events, heat illness must be acknowl-edged as a potentially large health threat for maintaining health services. We examined the number of COVID-19 admissions and the Tokyo rule for emergency medical care, in Tokyo, from March to September 2020, and investigated the weekly number of emergency transportations due to heat illness and weekly averages of the daily maximum Wet Bulb Globe Temperature (WBGT) in Tokyo in the summer (2016–2020). The peak of emergency transportations due to heat illness overlapped the resurgence of COVID-19 in 2020, and an increase of heat illness patients and WBGT has been observed. Respect for robust science is critical for the decision-making process of mass gathering events during the pandemic, and science-based countermeasures and implementations for COVID-19 will be warranted. Without urgent reconsiderations and sufficient countermeasures, the double burden of COVID-19 and heat-related illnesses in Tokyo will overwhelm the healthcare provision system, and maintaining essential health services will be challenging during the 2021 summer Olympic and Paralympic Games

Trends in, projections of, and inequalities in non-communicable disease management indicators in Vietnam 2010–2030 and progress toward universal health coverage : a Bayesian analysis at national and sub-national levels

Background: Movement towards Universal Health Coverage (UHC) can improve health services, risk factor management, and inequality in non-communicable diseases (NCD); conversely, prioritizing and monitoring NCD management can support pathways to UHC in resource-limited settings. We aimed to estimate trends in NCD management indicators in Vietnam from 2010, and projections to 2030 at national and sub-national levels; compute the probability of reaching UHC targets; and measure inequalities in NCD management indicators at demographic, geographic, and socio-economic levels. Methods: We included data of 37,595 households from four nationally representative surveys from 2010. We selected and estimated the coverage of NCD health service and risk management indicators nationally and by six sub-national groups. Using Bayesian models, we provided trends and projections and calculated the probability of reaching UHC targets of 80% coverage by 2030. We estimated multiple inequality indices including the relative index of inequality, slope index of inequality, and concentration index of inequality, and provided an assessment of improvement in inequalities over the study period. Findings: Nationally, all indicators showed a low probability of achieving 2030 targets except sufficient use of fruit and vegetables (SUFV) and non-use of tobacco (NUT). We observed declining trends in national coverage of non-harmful use of alcohol (NHUA), sufficient physical activity (SPA), non-overweight (NOW), and treatment of diabetes (TOD). Except for SPA, no indicator showed the likelihood of achieving 2030 targets at any regional level. Our model suggested a non-achievement of 2030 targets for all indicators in any wealth quintile and educational level, except for SUFV and NUT. There were diversities in tendency and magnitude of inequalities with widening gaps between genders (SPA, TOD), ethnic groups (SUFV), urban-rural areas (TOH), wealth quintiles, and educational levels (TOD, NUT, NHUA). Interpretation: Our study suggested slow progress in NCD management at the national level and among key sub-populations in Vietnam, together with existing and increasing inequalities between genders, ethnicities, geographic areas, and socioeconomic groups. We emphasised the necessity of continuously improving the healthcare system and facilities, distributing resources between geographic areas, and simultaneously integrating economic, education, and gender intervention and programs. Funding: None. © 2022 The Author(s