Acceptance patterns and decision-making for human papillomavirus vaccination among parents in Vietnam: an in-depth qualitative study post-vaccination

BACKGROUND: The GAVI Alliance’s decision in late 2011 to invite developing countries to apply for funding for human papillomavirus (HPV) vaccine introduction underscores the importance of understanding levels of HPV vaccine acceptance in developing country settings. In this paper, we present findings from qualitative research on parents’ rationales for vaccinating or not vaccinating their daughters (vaccine acceptance) and their decision-making process in the context of an HPV vaccination demonstration project in Vietnam (2008–2009). METHODS: We designed a descriptive qualitative study of HPV vaccine acceptability among parents of girls eligible for vaccination in four districts of two provinces in Vietnam(a). The study was implemented after each of two years of vaccinations was completed. In total, 133 parents participated in 16 focus group discussions and 27 semi-structured interviews. RESULTS: Focus group discussions and in-depth interviews with parents of girls vaccinated revealed that they were generally very supportive of immunization for disease prevention and of vaccinating girls against HPV. The involvement of the National Expanded Program of Immunization in the demonstration project lent credibility to the HPV vaccine, contributing to high levels of acceptance. For parents who declined participation, concerns about side effects, the possibility that the vaccine was experimental, and the possible impact of the vaccine on future fertility rose to the surface. In terms of the decision-making process, many parents exhibited ‘active decision-making,’ reaching out to friends, family, and opinion leaders for guidance prior to making their decision. CONCLUSION: Vietnam’s HPV vaccination experience speaks to the importance of close collaboration with the government to make the most of high levels of trust, and to reduce suspicions about new vaccines that may arise in the context of vaccine introduction in developing country settings

How Digital Natives Learn and Thrive in the Digital Age: Evidence from an Emerging Economy

As a generation of ‘digital natives,’ secondary students who were born from 2002 to 2010 have various approaches to acquiring digital knowledge. Digital literacy and resilience are crucial for them to navigate the digital world as much as the real world; however, these remain under-researched subjects, especially in developing countries. In Vietnam, the education system has put considerable effort into teaching students these skills to promote quality education as part of the United Nations-defined Sustainable Development Goal 4 (SDG4). This issue has proven especially salient amid the COVID−19 pandemic lockdowns, which had obliged most schools to switch to online forms of teaching. This study, which utilizes a dataset of 1061 Vietnamese students taken from the United Nations Educational, Scientific, and Cultural Organization (UNESCO)’s “Digital Kids Asia Pacific (DKAP)” project, employs Bayesian statistics to explore the relationship between the students’ background and their digital abilities. Results show that economic status and parents’ level of education are positively correlated with digital literacy. Students from urban schools have only a slightly higher level of digital literacy than their rural counterparts, suggesting that school location may not be a defining explanatory element in the variation of digital literacy and resilience among Vietnamese students. Students’ digital literacy and, especially resilience, also have associations with their gender. Moreover, as students are digitally literate, they are more likely to be digitally resilient. Following SDG4, i.e., Quality Education, it is advisable for schools, and especially parents, to seriously invest in creating a safe, educational environment to enhance digital literacy among students

Dexamethasone and long-term outcome of tuberculous meningitis in Vietnamese adults and adolescents.

BACKGROUND: Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long-term outcome of the disease is unknown. METHODS: Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability. RESULTS: 545 patients were randomised to receive either dexamethasone (274 patients) or placebo (271 patients). 50 patients (9.2%) were lost to follow-up at five years. In all patients two-year survival, probabilities tended to be higher in the dexamethasone arm (0.63 versus 0.55; p = 0.07) but five-year survival rates were similar (0.54 versus 0.51, p = 0.51) in both groups. In patients with grade 1 TBM, but not with grade 2 or grade 3 TBM, the benefit of dexamethasone treatment tended to persist over time (five-year survival probabilities 0.69 versus 0.55, p = 0.07) but there was no conclusive evidence of treatment effect heterogeneity by TBM grade (p = 0.36). The dexamethasone group had a similar proportion of severely disabled patients among survivors at five years as the placebo group (17/128, 13.2% vs. 17/116, 14.7%) and there was no significant association between dexamethasone treatment and disability status at five years (p = 0.32). CONCLUSIONS: Adjunctive dexamethasone appears to improve the probability of survival in patients with TBM, until at least two years of follow-up. We could not demonstrate a five-year survival benefit of dexamethasone treatment which may be confined to patients with grade 1 TBM. TRIAL REGISTRATION: ClinicalTrials.gov NCT01317654

Antioxidant and in vitro antidiabetic activities of Peperomia pellucida (L.) Kunth extract

Peperomia pellucida (L.) is commonly used as a herbal plant. Its effectiveness in treating inflammatory diseases, digestive disorders, and cancer in tropical and subtropical countries was introduced, especially in field of folk medicine. However, this plant species has not been studied widely in Vietnam, especially for its biological activities. This study was done to determine the antioxidant capacity of P. pellucida by using in vitro and in vivo methods, as well as its inhibitory ability to α-amylase enzyme activity. The total polyphenolic and flavonoid contents of P. pellucida extract were reported to be 359.91±0.77 mg GAE/g and 200.28±1.23 mg QE/g extract, respectively. The results showed the in vitro antioxidant activity of P. pellucida extract in four methods, including DPPH, and ABTS.+, RP and TAC, had EC50 values of 730.34 μg/mL, 84.33 μg/mL, 95.28 μg/mL, respectively, and Abs0.5 value of 114.73 μg/mL. Under H2O2-induced oxidative stress, fruit flies that were raised in the feed medium supplemented with a concentration of 1 mg/mL of P. pellucida extract showed their average survival time, 50% survival time, and 10% survival time at 1.6 times, 1.8 times, and 1.62 times, respectively, higher than those of the control treatment. The ability to inhibit the α-amylase activity in P. pellucida extract was determined with an EC50 value of 115.32±2.65 μg/mL compared with the commercial drug of 18.67±0, 01 μg/mL. The research results showed that P. pellucida is a potential species in the study of natural compounds with antioxidant and antidiabetic activities

Impact of Educational Intervention Concerning Awareness and Behaviors Relating to Avian Influenza (H5N1) in a High-Risk Population in Vietnam

BACKGROUND: Early initiation of treatment is essential for treatment of avian influenza A/H5N1 viral infection in humans, as the disease can lead to rapid development of severe pneumonia which can result in death. Contact with infected poultry is known to be a significant risk factor for contraction of H5N1 infection. However, handling and encountering poultry are a part of most peoples' daily lives, especially in rural communities in Vietnam where epidemic outbreaks among poultry have been continuously reported. Enhancing proper knowledge relating to H5N1 and to the importance of early initiation of treatment are crucial. The aim of this study was to develop an effective educational program to enhance awareness of H5N1 and motivate people to access to health care earlier when H5N1 infection is suspected or likely. METHODOLOGY AND PRINCIPAL FINDINGS: A study was conducted in two agricultural communities (intervention and control groups) in the Ninh Binh province in Vietnam, where epidemic outbreaks of avian influenza have recently occurred in birds. A unique educational intervention was developed and provided to the intervention group, and no intervention was provided to the control group. A knowledge, attitude and practice (KAP) survey was conducted in both groups with a face-to-face interview by trained local healthcare workers at time points before and after the educational intervention. KAP scores were compared between the different time points and between the groups. How educational intervention influenced awareness relating to H5N1 and accessibility of healthcare in the population was analyzed. The study indicated an increased awareness of H5N1 and increased reliance on local health care workers. CONCLUSIONS: The novel educational program which was developed for this study impacted awareness of H5N1, and resulted in more people seeking early access to healthcare, and also resulted in earlier medical intervention for patients with H5N1 avian influenza infection in Vietnam

UV Light Induced Thermoluminescence of Rare Earth doped Nanomaterials Y2_2O3_3:Eu3+^{3+}, Gd2_2O3_3:Eu3+^{3+} and Gd2_2O3_3:Er3+^{3+}

Thermoluminescence  properties of ultraviolet irradiated Y2O3:Eu3+, Gd2O3:Eu3+ and Gd2O3:Er3+ nanophosphors have been reported. The materials were synthesized by gel- combustion method with EDTA- Na2 as organic agent. This method allows production of very fine white powder at low temperature with very high efficiency. XRD has been studied to determine the structure of the prepared nano powders. The obtained materials exhibit sufficient sensibility to UV radiation and may be useful in UV light measurements

Dexamethasone and Long-Term Outcome of Tuberculous Meningitis in Vietnamese Adults and Adolescents

BACKGROUND: Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long-term outcome of the disease is unknown. METHODS: Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability. RESULTS: 545 patients were randomised to receive either dexamethasone (274 patients) or placebo (271 patients). 50 patients (9.2%) were lost to follow-up at five years. In all patients two-year survival, probabilities tended to be higher in the dexamethasone arm (0.63 versus 0.55; p = 0.07) but five-year survival rates were similar (0.54 versus 0.51, p = 0.51) in both groups. In patients with grade 1 TBM, but not with grade 2 or grade 3 TBM, the benefit of dexamethasone treatment tended to persist over time (five-year survival probabilities 0.69 versus 0.55, p = 0.07) but there was no conclusive evidence of treatment effect heterogeneity by TBM grade (p = 0.36). The dexamethasone group had a similar proportion of severely disabled patients among survivors at five years as the placebo group (17/128, 13.2% vs. 17/116, 14.7%) and there was no significant association between dexamethasone treatment and disability status at five years (p = 0.32). CONCLUSIONS: Adjunctive dexamethasone appears to improve the probability of survival in patients with TBM, until at least two years of follow-up. We could not demonstrate a five-year survival benefit of dexamethasone treatment which may be confined to patients with grade 1 TBM. TRIAL REGISTRATION: ClinicalTrials.gov NCT01317654

Analysis of Antimicrobial Resistance in Non-typhoidal Salmonella Collected From Pork Retail Outlets and Slaughterhouses in Vietnam Using Whole Genome Sequencing.

Non-typhoidal salmonella (TS) remains a significant health burden worldwide. In Vietnam, pork accounts for 70% of the total meat consumed, and contamination with Salmonella is high. High levels of antimicrobial resistance (AMR) have emerged among porcine NTS and of particular concern is the emergence of colistin resistance, a "last defense" antibioic against multi-drug resistant (MDR) Gram-negative pathogens. This study aimed to investigate the antibiotic susceptibility of 69 NTS isolates collected from the pork retail outlets and slaughterhouses in Vietnam during 2014 a nd 2018/19. Phenotypic testing and whole genome sequencing was used to assess the serotype and AMR gene profiles of the 69 NTS isolates. Seventeen different serotypes were identified, of which S. enterica subsp enterica serotype Typhimurium was the most common followed by S. ser. Rissen, S. ser. London, S. ser. Anatum, and S. ser. Derby. Phenotype AMR was common with 41 (59.4%) isolates deemed MDR. MDR strains were most common in slaughterhouses (83%) and supermarkets (75%) and lowest in traditional markets (38%) and convenience stores (40%). Colistin resistance was identified in 18 strains (15 resistant, three intermediate) with mcr-1 identified in seven isolates (S. ser. Meleagridis, S. Rissen, S. Derby) and mcr-3 in two isolates (S. Typhimurium). This includes the first mcr positive S. Meleagridis to our knowledge. Surprisingly, boutique stores had high levels (60%) of MDR isolates including 5/20 isolates with mcr-1. This study demonstrates that pork from modern retail stores classed as supermarkets or boutique (with pork claiming to be high quality, traceable, environmentally friendly marketed toward higher income consumers) still contained NTS with high levels of AMR

The Helicobacter pylori Genome Project : insights into H. pylori population structure from analysis of a worldwide collection of complete genomes

Helicobacter pylori, a dominant member of the gastric microbiota, shares co-evolutionary history with humans. This has led to the development of genetically distinct H. pylori subpopulations associated with the geographic origin of the host and with differential gastric disease risk. Here, we provide insights into H. pylori population structure as a part of the Helicobacter pylori Genome Project (HpGP), a multi-disciplinary initiative aimed at elucidating H. pylori pathogenesis and identifying new therapeutic targets. We collected 1011 well-characterized clinical strains from 50 countries and generated high-quality genome sequences. We analysed core genome diversity and population structure of the HpGP dataset and 255 worldwide reference genomes to outline the ancestral contribution to Eurasian, African, and American populations. We found evidence of substantial contribution of population hpNorthAsia and subpopulation hspUral in Northern European H. pylori. The genomes of H. pylori isolated from northern and southern Indigenous Americans differed in that bacteria isolated in northern Indigenous communities were more similar to North Asian H. pylori while the southern had higher relatedness to hpEastAsia. Notably, we also found a highly clonal yet geographically dispersed North American subpopulation, which is negative for the cag pathogenicity island, and present in 7% of sequenced US genomes. We expect the HpGP dataset and the corresponding strains to become a major asset for H. pylori genomics

Candlestick analysis in U.S. stock market.

In this thesis, we conduct the study of the predictive power of candlestick patterns. We use the daily prices (open, high, low, and close) of all active stocks that are listed on New York Stock Exchange (NYSE) for the 34-year period from 1973 to 2007 to perform various statistical tests.The results provide evidence that traders are influenced by price behaviours