Spontaneous pulmonary herniation in COVID-19.

Spontaneous pulmonary hernia (SPH) is a rare condition. We report a case secondary to extreme coughing and COVID-19 infection. The patient displayed several clinical features typical of this diagnosis; difficult to manage pain on coughing, flank haematoma and bulging of the chest wall on coughing. Clinicians should be aware of the risk factors and clinical features of SPH to aid diagnosis of this rare condition.

The Psychological Science Accelerator's COVID-19 rapid-response dataset.

In response to the COVID-19 pandemic, the Psychological Science Accelerator coordinated three large-scale psychological studies to examine the effects of loss-gain framing, cognitive reappraisals, and autonomy framing manipulations on behavioral intentions and affective measures. The data collected (April to October 2020) included specific measures for each experimental study, a general questionnaire examining health prevention behaviors and COVID-19 experience, geographical and cultural context characterization, and demographic information for each participant. Each participant started the study with the same general questions and then was randomized to complete either one longer experiment or two shorter experiments. Data were provided by 73,223 participants with varying completion rates. Participants completed the survey from 111 geopolitical regions in 44 unique languages/dialects. The anonymized dataset described here is provided in both raw and processed formats to facilitate re-use and further analyses. The dataset offers secondary analytic opportunities to explore coping, framing, and self-determination across a diverse, global sample obtained at the onset of the COVID-19 pandemic, which can be merged with other time-sampled or geographic data.

Survey Result for E-labeling Initiatives in Asia.

Under the COVID-19 pandemic, various electronic labeling initiatives have accelerated worldwide in the healthcare and pharmaceutical fields as part of a wider digital transformation [1, 2]. Although there is no universal definition of electronic labeling (e-labeling) globally, it is widely understood that e-labeling refers to the product information that is distributed via electronic means. There are 5 factors to be considered in e-labeling, and these are discussed in this publication. APAC is an industry-driven initiative with 13 R&D-based pharmaceutical associations joining from 11 markets in Asia. e-labeling was discussed as a new topic starting in 2020, and a 22-question survey was conducted in November 2021 to understand the current e-labeling status. The survey results showed that e-labeling initiatives were at different levels of maturity in the Asian region, although most markets have started to discuss e-labeling initiatives. Various challenges exist around e-labeling initiatives due to a variety of different approaches being taken in the region. It would be advisable to develop regional guidance on how to proceed with e-labeling initiatives in the Asian region to have a consistent and efficient approach. The close collaboration between agencies, Health Care Professionals (HCPs), patients, and industry associations is important to move e-labeling initiatives forward in Asia.

Factors Influencing Online Learner Performance during Coronavirus Disease Pandemic: A Case Study in Vietnamese Universities

Vietnam has a reputation for being a successful nation in preventing the Coronavirus disease (COVID-19) outbreak in 2020, with a lower number of illnesses than other ASEAN countries. However, to ensure that students are safe and informed about the coronavirus outbreak, Vietnamese higher education has developed online learning (OL). During the COVID-19 epidemic, this paper explores the relationship between elements such as learning readiness, learning strategies, and learning performance in the Vietnamese OL setting. Four hundred undergraduate students were randomly selected from Hong Duc universities, and Saigon University participated in this study in different zones. Analyzed data has applied structural equation modeling (SEM) using partial least squares (SmartPLS-SEM). The findings found that Vietnamese students were much more likely to believe in interaction in OL, to feel comfortable using a computer with their computer efficacy, and to have confidence in communicating in the digital environment, all of which were important variables in assuring the success of using OL. The factors of "motivation" and "test preparation" show a poor relationship with learning performance. Therefore, the OL process in Vietnamese, on the other hand, needs to be more inventive, with a greater focus on lecturers' awareness and practice of online teaching pedagogies such as motivation, techniques, and test arrangement. During OL, students' readiness in terms of learning control, self-directed learning, and engagement must be considered and supported.

Impact of COVID-19 anxiety on functional foods consuming intention: role of electronic word of mouth.

Purpose: The COVID-19 pandemic, which involving mass quarantines in many nations, has affected consumer health consciousness behaviors, including food consumption. This study aimed to investigate the impact of COVID-19 anxiety on functional food consumption within the framework of changes in health concerns and electronic word-of-mouth communication through digital platforms, paying special attention to the moderating effect of trust on eWOM information. Design: /methodology/approach: This cross-sectional study included 527 participants. The data were analyzed using a structural equation modeling approach. Mediating moderating effects were tested using bootstrapping and multigroup methods. Findings: Anxiety about the COVID-19 virus has a great impact on individuals' health concerns, word-of-mouth information seeking, and functional food consumption intention. Mediating effects of health consciousness and eWOM on functional food consumption intention were also observed. The anxiety about the COVID-19 virus and health consciousness triggers eWOM communication, and is a strong driver of intention to purchase functional foods if people trust the eWOM information source. Originality/value: While scholars have demonstrated the impact of COVID-19 on human behavior, a largely uninvestigated issue is the effect of COVID-19 virus anxiety on health product consumption. This is one of the first studies to examine the interrelationships among COVID-19 anxiety, health consciousness, eWOM, and functional food consumption intention.This study provides valuable insights into consumer behavior during the COVID-19 pandemic. Future research should consider the effect of COVID-19 virus anxiety on health-related issues and nutritional behavioral consequences. Based on the results, implications for managers and researchers are proposed.

An instrument for measuring job satisfaction (VIJS): A validation study for community pharmacists in the context of the COVID-19 pandemic in Vietnam.

BACKGROUND: Job satisfaction is one of the main factors creating and bringing about work motivation, productivity, and efficiency as well as decreasing job-hopping and job turnover. No previous studies have been conducted to assess job satisfaction for community pharmacists in Vietnam. OBJECTIVE: This research was conducted to develop and validate an instrument used to measure community pharmacists' job satisfaction in the context of the COVID-19 pandemic in Vietnam. METHODS AND RESULTS: A total of 351 pharmacists participated in this survey. Data were analyzed using R software version 4.2.0. The final instrument (VIJS) has 34 items divided into six factors which were determined via a parallel analysis (including physical working conditions, work nature, income and other benefits, management policies and managers, relationships with coworkers and customers, and learning and advancement opportunities). VIJS's internal consistency was excellent (Cronbach's alpha = 0.97, Omega total = 0.98, split-half reliability = 0.985, and composite reliability>0.8). Two-week test-retest reliability results (intraclass correlation coefficient for the overall instrument: 0.97, for six factors: 0.865-0.938) demonstrated the consistency of the VIJS when the same test was repeated on the same sample (62 pharmacists) at different points in time. The Confirmatory Factor Analysis was employed to assess the construct validity. The VIJS was a good fit to a six-factor model (Chisq/df = 2.352, Comparative Fit Index = 0.937, Tucker-Lewis Index = 0.929, Standardized Root Mean Square Residual = 0.042, and Root Mean Square Error of Approximation = 0.062). VIJS's good convergent and discriminant validity was demonstrated via Average Variance Extrated>0.5 and the Heterotrait-Monotrait ratio of correlations<0.85. CONCLUSIONS: The VIJS possesses good reliability and validity and can be used to measure community pharmacists' job satisfaction.

Effects of social distancing policy on labor market outcomes

US workers receive unemployment benefits if they lose their job, but not for reduced working hours. In alignment with the benefits incentives, we find that the labor market responded to COVID-19 and related closure-policies mostly on the extensive (12 pp outright job loss) margin. Exploiting timing variation in state closure-policies, difference-in-differences (DiD) estimates show, between March 12 and April 12, 2020, employment rate fell by 1.7 pp for every 10 extra days of state stay-at-home orders (SAH), with little effect on hours worked/earnings among those employed. Forty percentage of the unemployment was due to a nationwide shock, rest due to social-distancing policies, particularly among "non-essential" workers.

A descriptive case report of telesupervision and online case-based learning for speech and language therapy students in Vietnam during the COVID-19 pandemic.

BACKGROUND:  Vietnam's first speech and language therapy (SLT) degrees commenced in 2019 utilising international educators. Continuity of the degrees was impacted by travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES:  This article presents a descriptive case report exploring the viability of online learning to continue clinical education (CE) of SLT students in Vietnam during the pandemic. METHOD:  Students were scheduled for face to face placements throughout 2021. International SLT educators were to travel to Vietnam and work with interpreters and locally trained certificate level therapists to provide placement supervision. When travel became impossible, tele-supervision by international therapists working remotely and in partnership with local therapists and interpreters was arranged. The second wave of Covid-19 excluded students from healthcare settings early in their placements. To conclude these placements, tele-supervisors led online case-based discussions with students. For subsequent placements, Vietnamese and international therapists facilitated two to three weeks of online case-based group discussions for students, using cases with videos or avatars. RESULTS:  Learning outcomes for students, as evidenced in written and oral assessments demonstrated attainment of many of the learning objectives of the placements. Satisfaction for all participants (students, tele-supervisors, online group facilitators) was high. Students will undertake face to face placements in the future; however they will commence these placements with heightened clinical reasoning and planning skills. CONCLUSION:  Online CE is possible in LMIC and, as part of a program which includes face to face placements, can support essential CE outcomes and enhance preparation for subsequent direct experiences with patients.

Safety and immunogenicity of a trivalent virus-like particle vaccine against western, eastern, and Venezuelan equine encephalitis viruses: a phase 1, open-label, dose-escalation, randomised clinical trial.

BACKGROUND: Western (WEEV), eastern (EEEV), and Venezuelan (VEEV) equine encephalitis viruses are mosquito-borne pathogens classified as potential biological warfare agents for which there are currently no approved human vaccines or therapies. We aimed to evaluate the safety, tolerability, and immunogenicity of an investigational trivalent virus-like particle (VLP) vaccine, western, eastern, and Venezuelan equine encephalitis (WEVEE) VLP, composed of WEEV, EEEV, and VEEV VLPs. METHODS: The WEVEE VLP vaccine was evaluated in a phase 1, randomised, open-label, dose-escalation trial at the Hope Clinic of the Emory Vaccine Center at Emory University, Atlanta, GA, USA. Eligible participants were healthy adults aged 18-50 years with no previous vaccination history with an investigational alphavirus vaccine. Participants were assigned to a dose group of 6 µg, 30 µg, or 60 µg vaccine product and were randomly assigned (1:1) to receive the WEVEE VLP vaccine with or without aluminium hydroxide suspension (alum) adjuvant by intramuscular injection at study day 0 and at week 8. The primary outcomes were the safety and tolerability of the vaccine (assessed in all participants who received at least one administration of study product) and the secondary outcome was immune response measured as neutralising titres by plaque reduction neutralisation test (PRNT) 4 weeks after the second vaccination. This trial is registered at ClinicalTrials.gov, NCT03879603. FINDINGS: Between April 2, 2019, and June 13, 2019, 30 trial participants were enrolled (mean age 32 years, range 21-48; 16 [53%] female participants and 14 [47%] male participants). Six groups of five participants each received 6 µg, 30 µg, or 60 µg vaccine doses with or without adjuvant, and all 30 participants completed study follow-up. Vaccinations were safe and well tolerated. The most frequently reported symptoms were mild injection-site pain and tenderness (22 [73%] of 30) and malaise (15 [50%] of 30). Dose-dependent differences in the frequency of pain and tenderness were found between the 6 µg, 30 µg, and 60 µg groups (p=0·0217). No significant differences were observed between dosing groups for any other reactogenicity symptom. Two adverse events (mild elevated blood pressure and moderate asymptomatic neutropenia) were assessed as possibly related to the study product in one trial participant (60 µg dose with alum); both resolved without clinical sequelae. 4 weeks after second vaccine administration, neutralising antibodies were induced in all study groups with the highest response seen against all three vaccine antigens in the 30 µg plus alum group (PRNT80 geometric mean titre for EEEV 60·8, 95% CI 29·9-124·0; for VEEV 111·5, 49·8-249·8; and for WEEV 187·9, 90·0-392·2). Finally, 4 weeks after second vaccine administration, for all doses, the majority of trial participants developed an immune response to all three vaccine components (24 [83%] of 29 for EEEV; 26 [90%] of 29 for VEEV; 27 [93%] of 29 for WEEV; and 22 [76%] of 29 for EEEV, VEEV, and WEEV combined). INTERPRETATION: The favourable safety profile and neutralising antibody responses, along with pressing public health need, support further evaluation of the WEVEE VLP vaccine in advanced-phase clinical trials. FUNDING: The Vaccine Research Center of the National Institute of Allergy and Infectious Diseases, National Institutes of Health funded the clinical trial. The US Department of Defense contributed funding for manufacturing of the study product.

Racial and Ethnic Disparities in Buprenorphine and Extended-Release Naltrexone Filled Prescriptions During the COVID-19 Pandemic.

Importance: COVID-19 disrupted delivery of buprenorphine and naltrexone treatment for opioid use disorder (OUD), and during the pandemic, members of racial and ethnic minority groups experienced increased COVID-19 and opioid overdose risks compared with White individuals. However, whether filled buprenorphine and naltrexone prescriptions varied across racial and ethnic groups during the COVID-19 pandemic remains unknown. Objective: To investigate whether disruptions in filled buprenorphine and naltrexone prescriptions differed by race and ethnicity and insurance status or payer type. Design, Setting, and Participants: This cross-sectional study used retail pharmacy claims from May 2019 to June 2021 from the Symphony Health database, which includes 92% of US retail pharmacy claims, with race and ethnicity data spanning all insurance status and payer categories. Interrupted time series were used to estimate levels and trends of dispensed buprenorphine and naltrexone prescriptions before and after pandemic onset. Included individuals were those who filled buprenorphine and extended-release naltrexone prescriptions. Data were analyzed from July 2021 through March 2022. Main Outcomes and Measures: Weekly rates of dispensed buprenorphine and extended-release naltrexone prescription fills per 1000 patients and proportion of longer (ie, ≥14 days' supply) buprenorphine prescription fills were calculated. Analyses were stratified by patient race and ethnicity and further by insurance status and payer type for White and Black patients. Results: A total of 1 556 860 individuals who filled buprenorphine prescriptions (4359 Asian [0.3%], 94 657 Black [6.1%], 55 369 Hispanic [3.6%], and 664 779 White [42.7%]) and 127 506 individuals who filled extended-release naltrexone prescriptions (344 Asian [0.3%], 8186 Black [6.4%], 5343 Hispanic [4.2%], and 53 068 White [41.6%]) from May 6, 2019, to June 5, 2021, were analyzed. Prepandemic increases in buprenorphine fill rate flattened for all groups after COVID-19 onset (30.5 percentage point difference in trend; P < .001) compared with prepandemic trends. Significant level decreases in buprenorphine fills (ranging from 2.5% for Black patients; P = .009 to 4.0% for Hispanic patients; P = .009) at pandemic onset were observed for members of racial and ethnic minority groups but not White patients. At pandemic onset, rate of buprenorphine fills decreased in level for Medicare and cash-paying patients but with greater decreases for Black patients (Medicare: 10.0%; P < .001; cash: 20.0%; P < .001) than White patients (Medicare: 3.5%; P = .004; cash: 15.0%; P < .001). No decreases were found among Medicaid patients. Unlike buprenorphine, extended-release naltrexone had uniform level (from 10.0% for White patients with private insurance; P < .001 to 23.3% for Black patients with Medicare; P < .001) and trend (from 15.5 percentage points for White patients with Medicaid; P = .001 to 52.0 percentage points for Black patients with private insurance; P < .001) decreases across groups. Conclusions and Relevance: This study found that the COVID-19 pandemic was associated with immediate decreases in filled buprenorphine prescriptions by members of racial and ethnic minority groups but not White individuals. These findings suggest that members of racial and ethnic minority groups had larger losses in buprenorphine access during the pandemic across payer types.

New onset of psoriasis following COVID-19 vaccination.

The cutaneous side effects of COVID-19 vaccines are being studied and their immunogenicity is most likely linked to the pathophysiology of psoriasis. Although uncommon, several cases of exacerbation and new onset of psoriasis have been reported globally after vaccination. To contribute to the literature on this intriguing topic, we present three cases of de novo psoriasis in adult patients following COVID-19 vaccination. Our observations and a literature review show that this occurrence is independent of the type and brand of vaccines.

Safety and immunogenicity of Nanocovax, a SARS-CoV-2 recombinant spike protein vaccine: Interim results of a double-blind, randomised controlled phase 1 and 2 trial.

Background: Nanocovax is a recombinant severe acute respiratory syndrome coronavirus 2 subunit vaccine composed of full-length prefusion stabilized recombinant SARS-CoV-2 spike glycoproteins (S-2P) and aluminium hydroxide adjuvant. Methods: We conducted a dose-escalation, open label trial (phase 1) and a randomized, double-blind, placebo-controlled trial (phase 2) to evaluate the safety and immunogenicity of the Nanocovax vaccine (in 25 mcg, 50 mcg, and 75 mcg doses, aluminium hydroxide adjuvanted (0·5 mg/dose) in 2-dose regime, 28 days apart (ClinicalTrials.gov number, NCT04683484). In phase 1, 60 participants received two intramuscular injection of the vaccine following dose-escalation procedure. The primary outcomes were reactogenicity and laboratory tests to evaluate the vaccine safety. In phase 2, 560 healthy adults received either vaccine doses similar in phase 1 (25 or 50 or 75 mcg S antigen in 0·5 mg aluminium per dose) or adjuvant (0·5 mg aluminium) in a ratio of 2:2:2:1. One primary outcome was the vaccine safety, including solicited adverse events for 7 day and unsolicited adverse events for 28 days after each injection as well as serious adverse event or adverse events of special interest throughout the study period. Another primary outcome was anti-S IgG antibody response (Index unit/ml). Secondary outcomes were surrogate virus neutralisation (inhibition percentage), wild-type SARS-CoV-2 neutralisation (dilution fold), and T-cell responses by intracellular staining for interferon gamma (IFNg). Anti-S IgG and neutralising antibody levels were compared with convalescent serum samples from symptomatic Covid-19 patients. Findings: For phase 1 study, no serious adverse events were observed for all 60 participants. Most adverse events were grade 1 and disappeared shortly after injection. For phase 2 study, after randomisation, 480 participants were assigned to receive the vaccine with adjuvant, and 80 participants were assigned to receive the placebo (adjuvant only). Reactogenicity was absent or mild in the majority of participants and of short duration (mean ≤3 days). Unsolicited adverse events were mild in most participants. There were no serious adverse events related to Nanocovax. Regarding the immunogenicity, Nanocovax induced robust anti-S antibody responses. In general, there humoral responses were similar among vaccine groups which reached their peaks at day 42 and declined afterward. At day 42, IgG levels of vaccine groups were 60·48 [CI95%: 51·12-71·55], 49·11 [41·26-58·46], 57·18 [48·4-67·5] compared to 7·10 [6·32-13·92] of convalescent samples. IgG levels reported here can be converted to WHO international standard binding antibody unit (BAU/ml) by multiplying them to a conversion factor of 21·8. Neutralising antibody titre of vaccine groups at day 42 were 89·2 [52·2-152·3], 80·0 [50·8-125.9] and 95·1 [63·1-143·6], compared to 55·1 [33·4-91·0] of the convalescent group. Interpretation: Up to day 90, Nanocovax was found to be safe, well tolerated, and induced robust immune responses. Funding: This work was funded by the Coalition for Epidemic Preparedness Innovations (CEPI), the Ministry of Science and Technology of Vietnam, and Nanogen Pharmaceutical Biotechnology JSC.

US Health Care Workforce Changes During the First and Second Years of the COVID-19 Pandemic.

This article quantifies changes in employment and average wages of employees of 6 key health care organizations during the COVID-19 pandemic.

US Health Care Workforce Changes During the First and Second Years of the COVID-19 Pandemic

This article quantifies changes in employment and average wages of employees of 6 key health care organizations during the COVID-19 pandemic.

Enabling customer co-creation behavior at a distance: the case of patients using self-monitoring handheld devices in healthcare

The inherent feature of inseparability causes significant sufferings for the service sector. In the case of diabetes disease in healthcare, this problem is reduced by asking patients to self-monitor blood glucose at home (SMBG). Despite the task’s importance, many patients do not fully accomplish. This study investigates what factors of patients affect their adherence to SMBG and how physician consultation fosters their adherence. Empirical results show that the adherence level is driven by patients’ capability and self-efficacy, both of which are fostered by the knowledge acquired from physicians. These findings provide insights to support strategies to reduce the service inseparability.

Exploratory Investigation of Gender Differences in School Psychology Publishing Before and During the Initial Phase of COVID-19

Although many disciplines saw increases in manuscript submissions coinciding with lockdown measures, numerous studies have documented widening gender gaps in academic productivity. Chi-squared analyses of gendered trends in first author manuscript submission in three school psychology journals during the initial phase of COVID-19 compared to the same time frame in the preceding 3?years did not reveal any significant associations. There was a significant increase over time in the gender gap, with a trend of more female authors than male authors. Women school psychology researchers may not have experienced similar detriments to productivity as in other disciplines, or such detriments were not reflected in submission patterns during this time frame. Limitations of the study and implications for school psychology are provided.

Virological characteristics of cases of COVID-19 in northern Viet Nam, January-May 2020.

Background: Viet Nam confirmed its first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on 23 January 2020 among travellers from Wuhan, China, and experienced several clusters of community transmission until September. Viet Nam implemented an aggressive testing, isolation, contact tracing and quarantine strategy in response to all laboratory-confirmed cases. We report the results of SARS-CoV-2 testing during the first half of 2020 in northern Viet Nam. Methods: Between January and May 2020, 15 650 upper respiratory tract specimens were collected from 14 470 suspected cases and contacts in northern Viet Nam. All were tested for SARS-CoV-2 by real-time RT-PCR. Individuals with positive specimens were tested every three days until two tests were negative. Positive specimens from 81 individuals were cultured. Results: Among 14 470 tested individuals, 158 (1.1%) cases of SARS-CoV-2 infection were confirmed; 89 were imported and 69 were associated with community transmission. Most patients (122, 77%) had negative results after two tests, while 11 and 4 still tested positive when sampled a third and fourth time, respectively. SARS-CoV-2 was isolated from 29 of 81 specimens (36%) with a cycle threshold (Ct) value < 30. Seven patients who tested positive again after testing negative had Ct values > 30 and negative cultures. Conclusion: Early, widespread testing for SARS-CoV-2 in northern Viet Nam identified very few cases, which, when combined with other aggressive strategies, may have dramatically contained the epidemic. We observed rapid viral clearance and very few positive results after clearance. Large-scale molecular diagnostic testing is a critical part of early detection and containment of COVID-19 in Viet Nam and will remain necessary until vaccination is widely implemented.

Reactogenicity and immunogenicity of heterologous prime-boost immunization with COVID-19 vaccine.

BACKGROUND: The objective of the present work was to assess the reactogenicity and immunogenicity of heterologous COVID-19 vaccination regimens in clinical trials and observational studies. METHODS: PubMed, Cochrane Library, Embase, MedRxiv, BioRxiv databases were searched in September 29, 2021. The PRISMA instruction for systemic review was followed. Two reviewers independently selected the studies, extracted the data and assessed risk of bias. The quality of studies was evaluated using the New Castle-Ottawa and Cochrane risk of instrument. The characteristics and study outcome (e.g., adverse events, immune response, and variant of concern) were extracted. RESULTS: Nineteen studies were included in the final data synthesis with 5 clinical trials and 14 observational studies. Heterologous vaccine administration showed a trend toward more frequent systemic reactions. However, the total reactogenicity was tolerable and manageable. Importantly, the heterologous prime-boost vaccination regimens provided higher immunogenic effect either vector/ mRNA-based vaccine or vector/ inactivated vaccine in both humoral and cellular immune response. Notably, the heterologous regimens induced the potential protection against the variant of concern, even to the Delta variant. CONCLUSIONS: The current findings provided evidence about the higher induction of robust immunogenicity and tolerated reactogenicity of heterologous vaccination regimens (vector-based/mRNA vaccine or vector-based/inactivated vaccine). Also, this study supports the application of heterologous regimens against COVID-19 which may provide more opportunities to speed up the global vaccination campaign and maximize the capacity to control the pandemic.

DOMESTIC TOURIST SATISFACTION: IMPLICATIONS FOR "ONE COMMUNE ONE PRODUCT" ECO-TOURISM DEVELOPMENT IN THE MEKONG DELTA OF VIETNAM

Eco-tourism being one of six groups of OCOP products plays a key role in the rural economic development. However, there are limited empirical evidences on the impacts of destination attributes of OCOP tourism on tourist satisfaction. Thus, the objective of this current study is to investigate the impacts of OCOP eco-tourism destination attributes on tourist satisfaction. The study conducted face-to-face interviews with 200 eco-tourists and employed exploratory factor analysis and multiple regression. The study found that the shared social and environmental responsibilities - core characteristics of OCOP tourism have the highest effect on tourist satisfaction. The study also provides some policy implications for sustainable development of OCOP eco-tourism destinations in the Mekong Delta.