Evaluation of Dihydroartemisinin-Piperaquine Efficacy and Molecular Markers in Uncomplicated Falciparum Patients: A Study across Binh Phuoc and Dak Nong, Vietnam.

Background and Objectives: Malaria continues to be a significant global health challenge. The efficacy of artemisinin-based combination therapies (ACTs) has declined in many parts of the Greater Mekong Subregion, including Vietnam, due to the spread of resistant malaria strains. This study was conducted to assess the efficacy of the Dihydroartemisinin (DHA)-Piperaquine (PPQ) regimen in treating uncomplicated falciparum malaria and to conduct molecular surveillance of antimalarial drug resistance in Binh Phuoc and Dak Nong provinces. Materials and Methods: The study included 63 uncomplicated malaria falciparum patients from therapeutic efficacy studies (TES) treated following the WHO treatment guidelines (2009). Molecular marker analysis was performed on all 63 patients. Methods encompassed Sanger sequencing for pfK13 mutations and quantitative real-time PCR for the pfpm2 gene. Results: This study found a marked decrease in the efficacy of the DHA-PPQ regimen, with an increased rate of treatment failures at two study sites. Genetic analysis revealed a significant presence of pfK13 mutations and pfpm2 amplifications, indicating emerging resistance to artemisinin and its partner drug. Conclusions: The effectiveness of the standard DHA-PPQ regimen has sharply declined, with rising treatment failure rates. This decline necessitates a review and possible revision of national malaria treatment guidelines. Importantly, molecular monitoring and clinical efficacy assessments together provide a robust framework for understanding and addressing detection drug resistance in malaria.

Understanding the barriers to integrating maternal and mental health at primary health care in Vietnam.

The prevalence of common perinatal mental disorders in Vietnam ranges from 16.9% to 39.9%, and substantial treatment gaps have been identified at all levels. This paper explores constraints to the integration of maternal and mental health services at the primary healthcare level and the implications for the health system's responsiveness to the needs and expectations of pregnant women with mental health conditions in Vietnam. As part of the RESPONSE project, a three-phase realist evaluation study, we present Phase 1 findings, which employed systematic and scoping literature reviews and qualitative data collection (focus groups and interviews) with key health system actors in Bac Giang province, Vietnam, to understand the barriers to maternal mental healthcare provision, utilization and integration strategies. A four-level framing of the barriers to integrating perinatal mental health services in Vietnam was used in reporting findings, which comprised individual, sociocultural, organizational and structural levels. At the sociocultural and structural levels, these barriers included cultural beliefs about the holistic notion of physical and mental health, stigma towards mental health, biomedical approach to healthcare services, absence of comprehensive mental health policy and a lack of mental health workforce. At the organizational level, there was an absence of clinical guidelines on the integration of mental health in routine antenatal visits, a shortage of staff and poor health facilities. Finally, at the provider level, a lack of knowledge and training on mental health was identified. The integration of mental health into routine antenatal visits at the primary care level has the potential help to reduce stigma towards mental health and improve health system responsiveness by providing services closer to the local level, offering prompt attention, better choice of services and better communication while ensuring privacy and confidentiality of services. This can improve the demand for mental health services and help reduce the delay of care-seeking.

New Solasodine-Type Glycoalkaloids Isolated from Solanum nigrum and Their Cytotoxic Activity.

Three undescribed solalodine-type glycoalkaloids, named solanigrinoside A-C (1-3), and six known compounds (4-9) were isolated from the whole plants of Solanum nigrum. Their structures were elucidated based on analysis of HR-ESI-MS, 1D- and 2D-NMR spectral data, and comparison with those reported in literatures. The solanigrinoside A-C (1-3), solasodine (4), and 3-acetoxysolasodine (5) exhibited cytotoxic effects against LU-1, Hep-G2, and MCF-7 cells with IC50 values in range from 4.6 µM to 56.2 µM. Compound 2 showed the significant cytotoxic activity with corresponding IC50 values of 5.7 µM, 7.9 µM, and 4.6 µM, respectively.

Role of Calprotectin, IL-6, and CRP in Distinguishing Between Inflammatory Bowel Disease and Diarrhea Predominant Irritable Bowel Syndrome.

Background: The early establishment of prophylaxis and immediate administration of anticoagulant therapy upon the diagnosis of venous thromboembolism should be the treatment objectives in these patients. Objective: The study aimed to determine the optimal cut-off point of Calprotectin, IL-6 (interleukin-6), CRP (C reactive protein) to differentiate UC, IBS-D. Methods: A cross-sectional descriptive study of 335 individuals ≥15 years old was performed, including 31 healthy controls, 215 with IBS-D, 71 diagnosed with UC, and 18 diagnosed with CD. Receiver Operating Characteristics (ROC), sensitivity, specificity, and area under curve (AUC) were computed. Results: The results showed that the median value of calprotectin (IQR) in healthy participants was 20.0 (6.0 - 34.0) µg/g; 17,7 (8,7-38,9) µg/g in IBS-D group; 1710.0 (588 - 4260,0) µg/g in UC group; and 560.5 (177.8 - 1210.0) µg/g in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of CRP (range IQR) was 1,3 (0,9 - 2,3) mg/L in IBS-D group; 7.0 (2.4 -16.6) mg/L in UC group; and 10.1 (2.2 - 42.5) mg/L in CD group. CRP concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The median value of IL-6 (range IQR) was 2.3 (1.6 - 5.7) pg/mL in IBS-D group; 16.8 (9.4 - 47.0) pg/mL in UC group; and 9.4 (7.9 - 11.0) pg/mL in CD group. Calprotectin concentration in IBD group including UC and CD was higher than IBS-D with p<0.05. The optimal cut-off point of calprotectin that differentiated IBS-D from IBD was 110.5 µg/g, with sensitivity and specificity of 93.3% and 91.4%, respectively; of IL-6 was 7.2 pg/mL with sensitivity and specificity of 92.0% and 78.0%, respectively; of CRP of 2.4 mg/L had specific sensitivities of 83.3% and 86.0%, respectively. Conclusion: The Calprotectin immunoassay has the best value in discriminating between IBD and IBS-D.

Anger and disgust shape judgments of social sanctions across cultures, especially in high individual autonomy societies.

When someone violates a social norm, others may think that some sanction would be appropriate. We examine how the experience of emotions like anger and disgust relate to the judged appropriateness of sanctions, in a pre-registered analysis of data from a large-scale study in 56 societies. Across the world, we find that individuals who experience anger and disgust over a norm violation are more likely to endorse confrontation, ostracism and, to a smaller extent, gossip. Moreover, we find that the experience of anger is consistently the strongest predictor of judgments of confrontation, compared to other emotions. Although the link between state-based emotions and judgments may seem universal, its strength varies across countries. Aligned with theoretical predictions, this link is stronger in societies, and among individuals, that place higher value on individual autonomy. Thus, autonomy values may increase the role that emotions play in guiding judgments of social sanctions.

A study on a broadband photodetector based on hybrid 2D copper oxide/reduced graphene oxide.

These days, photodetectors are a crucial part of optoelectronic devices, ranging from environmental monitoring to international communication systems. Therefore, fabricating these devices at a low cost but obtaining high sensitivity in a wide range of wavelengths is of great interest. This report introduces a simple solution-processed hybrid 2D structure of CuO and rGO for broadband photodetector applications. Particularly, 2D CuO acts as the active material, absorbing light to generate electron-hole pairs, while 2D rGO plays the role of a transport layer, driving charge carriers between two electrodes. Our device exhibits remarkable sensitivity to a wide wavelength range from 395 nm to 945 nm (vis-NIR region). Interestingly, our devices' responsivity and photoconductive gain were calculated (under 395 nm wavelength excitation) to be up to 8 mA W-1 and 28 fold, respectively, which are comparable values with previous publications. Our hybrid 2D structure between rGO and CuO enables a potential approach for developing low-cost but high-performance optoelectronic devices, especially photodetectors, in the future.

Novel melanin-derived stationary phase for immobilized metal ion affinity chromatography in recombinant His-tagged protein purification.

The matrix of the stationary phase is a crucial element in affinity chromatography for protein purification. Various materials, including polymer or magnetic materials, have been employed as the matrix in the purification of His-tagged protein. Here, for the first time, we utilized a combination of melanin and alginate, both natural polymer materials, to synthesize Ni-melanin/alginate (Ni-M/A) beads for His-tagged protein purification. We investigated the binding of His-tagged Mpro on the Ni-M/A beads, referred to as Ni-M/A-Mpro, and assessed the elution efficiency of Mpro from the beads. Our examination involved FTIR, EDS, XRD, SDS-PAGE, and Western blotting methods. FTIR spectra revealed notable changes in the stretching patterns and intensities of hydroxyl, amine, carbonyl, imine and amide chemical groups, when Mpro protein was present in the Ni-M/A sample. XRD spectra demonstrated the occurrence of two Nickel peaks at 35-40 deg and 40-45 deg in Ni-M/A, but only one nickel peak at 35-40 deg in Ni-M/A-Mpro, indicating the binding of Mpro on the Nickel ions. EDS analysis reported a decrease in the concentration of Nickel on the surface of Ni-M/A from 16% to 7% when Mpro protein was loaded into the stationary phase. Importantly, our data indicated that the purity of the His-tagged protein Mpro after purification reached 97% after just one-step purification using the Ni-M/A stationary phase. Moreover, the binding capacity of Ni-M/A for Mpro was approximately 5.2 mg/g with recovery efficiency of 40%. Our results suggested Ni-M/A as a highly potential solid phase for affinity chromatography in the purification of His-tagged protein.

Integration of machine learning in 3D-QSAR CoMSIA models for the identification of lipid antioxidant peptides.

The comparative molecular similarity indices analysis (CoMSIA) method is a widely used 3D-quantitative structure-activity relationship (QSAR) approach in the field of medicinal chemistry and drug design. However, relying solely on the Partial Least Square algorithm to build models using numerous CoMSIA indices has, in some cases, led to statistically underperforming models. This issue has also affected 3D-CoMSIA models constructed for the ferric thiocyanate (FTC) dataset from linoleic antioxidant measurements. In this study, a novel modeling routine has been developed incorporating various machine learning (ML) techniques to explore different options for feature selection, model fitting, and tuning algorithms with the ultimate goal of arriving at optimal 3D-CoMSIA models with high predictivity for the FTC activity. Recursive Feature Selection and SelectFromModel techniques were applied for feature selection, resulting in a significant improvement in model fitting and predictivity (R2, RCV2, and R2_test) of 24 estimators. However, these selection methods did not fully address the problem of overfitting and, in some instances, even exacerbated it. On the other hand, hyperparameter tuning for tree-based models resulted in dissimilar levels of model generalization for four tree-based models. GB-RFE coupled with GBR (hyperparameters: learning_rate = 0.01, max_depth = 2, n_estimators = 500, subsample = 0.5) was the only combination that effectively mitigated overfitting and demonstrated superior performance (RCV2 of 0.690, R2_test of 0.759, and R2 of 0.872) compared to the best linear model, PLS (with RCV2 of 0.653, R2_test of 0.575, and R2 of 0.755). Therefore, it was subsequently utilized to screen potential antioxidants among a range of Tryptophyllin L tripeptide fragments, leading to the synthesis and testing of three peptides: F-P-5Htp, F-P-W, and P-5Htp-L. These peptides exhibited promising activity levels, with FTC values of 4.2 ± 0.12, 4.4 ± 0.11, and 1.72 ± 0.15, respectively.

Ultrasensitive Monitoring of Cyanide Concentrations in Water Using a Aucore-Agshell Hybrid-Coating-Based Fiber Optical Sensor.

Cyanides, which are extremely toxic chemicals that are rapidly absorbed into the human body and interact with cytochrome oxidase, strongly inhibit cellular respiration to body death with convulsions. Cyanide ions that exist in many forms in nature such as those found in apricot kernels, cassava roots, and bamboo shoots as cyanogenic glycosides are inevitably used in various industries, including gold and silver mining as well as in dyes and plastic industries. In this study, for the sake of developing ultrahigh-sensitive sensors for cyanide monitoring in a simple manner, we chemically synthesize Aucore-Agshell hybrid nanomaterials of different core/shell thicknesses for colorimetric sensors and fiber optical sensors. Their sensing principle relies on the formation of the Ag/Au cyanocomplex upon cyanide injection. The generated metal cyanocomplex induced changes in refractive indices, causing changes in properties of localized surface plasmon resonance (LSPR), i.e., optical absorbance change for the colorimetric sensors. For fiber optical sensors, the hybrid metal nanoparticles were immobilized on the fiber core surface and the metal cyanocomplex formation induced changes in the fiber cladding refractive index, enabling quantitative cyanide detection with ultrahigh sensitivity. The LSPR-based colorimetric sensor provided the lowest detectable cyanide concentration of 5 × 10-6 M, whereas the value for the fiber-based sensor was 8 × 10-11 M.

Isocucurbic Acid Derivatives and Soluble Epoxide Hydroxylase Inhibitors from the Flowers of Chrysanthemum indicum L.

Soluble epoxide hydrolase (sEH) inhibitory activity guided fractionation and isolation of two new isocucurbic acid derivatives (1 and 2) and nine known compounds (3-11) from the flowers of Chrysanthemum indicum L. Their structures were elucidated on the basis of spectroscopic data interpretation and comparison with those reported in previous studies. Luteolin (3), acacetin-7-O-ß-D-glucopyranoside (6), and methyl 3,4-di-O-caffeoylquinate (10) displayed sEH inhibitory activities with IC50 values ranging from 13.7±3.6 to 20.8±0.4 µM. Enzyme kinetic analysis revealed that 3, 6, and 10 were non-competitive inhibitors with Ki values of 14.8±0.5, 31.2±0.8, and 3.9±0.2 µM, respectively. Additionally, molecular docking studies indicated compound 10 had the ability to form six hydrogen bonds at sEH active site, resulting binding energy as low as -9.58 Kcal/mol.

Ante-, Peri-, and Neonatal Factors Associated with Autism Spectrum Disorders in Vietnam: A Population-Based Cross-Sectional Survey.

Background: Autism Spectrum Disorders (ASDs) are common behavioral syndromes but limited critical evidence in Vietnam. This study aimed to identify ante-, peri- and neonatal factors for ASDs amongst children in Vietnam. Methods: This population-based study applied the cross-sectional design with a multistage sampling in 21 urban and rural districts in seven cities/provinces in Vietnam during 2017-2018. Overall, 42,551 children age 18 to 30 months were enrolled in the study. Two phases of assessment using Modified Checklist for Autism in Toddlers (M-CHAT) for screening and diagnostic assessment using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for confirmation. We employed univariate and binary logistic regression to identify. Results: Our study showed a fast-growing trend of ASDs amongst children age 18 and 30 months (75.8 per 10,000 individuals). Nine ante-, peri-, and neonatal factors were associated with ASDs: five factors of antenatal period (history of miscarriage/abortion or stillbirth, children conceived by assisted reproduction technologies, having cold, flu or acquiring virus during pregnancy, having gestational diabetes, toxemia, high blood pressure or pre-eclampsia during pregnancy, and having stress or mental disorders during pregnancy); one factors of perinatal period (mode of delivery); and three factors of neonatal period (jaundice, respiratory distress, and newborn seizures). Conclusion: This first large-scale survey in Vietnam confirms some prenatal, perinatal, and postnatal factors with ASDs amongst children age 18 and 30 months. Future interventions should focus on these factors to early diagnosis and intervention to improve functional outcomes for risky children.

Using the WHO Self-Reporting Questionnaire-20 (SRQ-20) to Detect Symptoms of Common Mental Disorders among Pregnant Women in Vietnam: a Validation Study.

Purpose: Detection of antenatal common mental disorders in low-resource settings like Vietnam is important and requires a reliable, valid and practical screening tool. Currently, there is no such tool validated for use among pregnant women in Vietnam. This study aims to assess the validity of the Vietnamese version of the 20-item Self Reporting Questionnaire (SRQ-20) by evaluating its reliability, factorial structure, and performance in detecting common mental disorder (CMD) symptoms, thereby identifying the optimum cut-off score for CMD screening among pregnant women in Vietnam. Participants and Methods: A total of 210 pregnant women from four rural communes participated in a face-to-face interview using the Vietnamese version of the SRQ-20, followed by a clinical diagnostic interview based on ICD-10 diagnostic criteria of CMDs. The reliability of the SRQ-20 was assessed by calculating the scale's Cronbach's alpha to measure internal consistency. Factor analyses were undertaken to examine the factor structure of the instrument. The Receiver Operating Characteristic (ROC) curve analysis was performed to assess the performance of the SRQ-20 against the clinical diagnosis and to identify the optimum cut-off score. Results: Internal consistency was good, with a Cronbach's alpha of 0.87. Factor analyses resulted in a 4-factor solution. The area under the ROC curve (AUC) for detection of CMDs was 0.90. The optimum cut-off score of the SRQ-20 for detection of CMD symptoms among Vietnamese pregnant women was 5/6. Conclusion: The Vietnamese version of the SRQ-20 has the capacity to detect CMDs among pregnant women effectively and is recommended for use as a screening tool for CMDs in antenatal care settings in Vietnam.

Histamine-degrading halophilic bacteria from traditional fish sauce: Characterization of Virgibacillus campisalis TT8.5 for histamine reduction.

Traditionally produced fish sauce can contain significant amounts of histamine. In some instances, the histamine concentration may be well above the limit recommended by the Codex Alimentarius Commission. The aim of this study was to discover new bacterial strains capable of growing under the stressful environmental conditions of fish sauce fermentation and metabolizing histamine. In this study, 28 bacterial strains were isolated from Vietnamese fish sauce products based on their ability to grow at high salt concentrations (23% NaCl) and tested for their ability to degrade histamine. Strain TT8.5 showed the highest histamine-degradation (45.1 ± 0.2% of initially 5 mM histamine within 7 days) and was identified as Virgibacillus campisalis TT8.5. Its histamine-degrading activity was shown to be localized intracellularly and the enzyme is a putative histamine dehydrogenase. The strain exhibited optimal growth and histamine-degrading activity at 37°C, pH 7%, and 5% NaCl in halophilic archaea (HA) histamine broth. It also showed pronounced histamine-degrading activity in HA histamine broth when cultivated at temperatures of up to 40 °C as well as in the presence of up to 23% NaCl. After treatment with immobilized cells, 17.6-26.9% of the initial histamine in various fish sauce products were reduced within 24 h of incubation, while no significant changes in other parameters of fish sauce quality were observed after this treatment. Our results indicate that V. campisalis TT8.5 is of potential interest to be applied in histamine degradation of traditional fish sauce.

Nurses' perceptions about patient safety culture in public hospital in Vietnam.

AIM: This paper is aimed to assess nurses' perceptions of patient safety culture in four public general hospitals in Hanoi, Vietnam. BACKGROUND: Patient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of nurses' perceptions on existing hospital patient safety culture (PSC) is the first step to promote PSC. METHODS: The cross-sectional study surveyed 705 nurses utilizing the validated Hospital Survey on Patient Safety Culture (HSOPSC) in an online format. RESULTS: The average positive response rate was high at 72.8 % and varied from 52.9 % to 93.4 %. The strongest areas are teamwork within units (93.7 %) and supervisor/manager expectations and actions promoting patient safety (85.0 %). The areas for improvement are staffing (52.9 %) and non-punitive response to error (57.6 %). The communication openness, staffing, frequency of events reported, lengths of services in hospital and unit are significant factors that predict the overall patient safety grade. CONCLUSIONS: Initiatives are necessary to improve response to errors, staffing, and error reporting. Nurse managers could develop and implement interventions and program to improve patient safety, including providing education related to patient safety culture, encouraging staff to notify incidents and avoiding punitive responses.

Characterization of thymol derivatives from Eupatorium fortunei Turcz. aerial parts.

From the aerial parts of Eupatorium fortunei, four thymol derivatives (1-4) were isolated and structurally elucidated by NMR and mass spectroscopic methods. Of which, a new dimeric thymol derivative (1) was characterized and its absolute configuration was established by electronic circular dichroism quantum method. In addition, the 1D and 2D NMR as well as HR-ESI mass spectral data of 2 were provided for the first time. Compounds 2-4 were evaluated for their inhibitory activity against α-glucosidase and acetylcholinesterase enzymes. All tested compounds showed weak inhibition at the concentration range of 1-256 µg/mL in both enzymatic assays.

Designing and developing a mobile app (BeBo) in a randomized controlled trial study to promote breastfeeding among Vietnamese mothers.

BACKGROUND: Breastfeeding should begin as soon as possible after birth and continue exclusively to 6 months of age. In Vietnam, as in many other countries, breastfeeding is decreasing because of modern lifestyles and the promotion of infant formula. It is important to provide mothers, family members, and the community with the knowledge and strategies to improve breastfeeding rates. Smartphones are almost ubiquitous in Vietnam and of the potential to provide information about breastfeeding. This study aimed to document the process of designing and developing a mobile app to increase breastfeeding rates in Vietnamese women. METHODS: We used a four-step mixed methods approach with a literature review, formative research (22 in-depth interviews and 49 self-administered online questionnaires), and testing of prototype apps (3 focus groups discussion and external experts). Formative research and focus group discussion involved 99 participants. Finally, the revisions of the app were tested. All of the formative research was undertaken in Hanoi in 2019-2020. Target behaviors followed by key determinants, to improve breastfeeding self-efficacy were studied and this information was then applied in developing the messages and library content. Barriers and facilitators to breastfeeding were identified from literature reviews and qualitative research. The messages were targeted at not only mothers but also included fathers, mothers-in-law, or families. RESULTS: Mothers were mostly concerned about the initiation of breastfeeding, preventing and reducing difficulties encountered during breastfeeding, and nutrition for breastfeeding mothers. Mental health and well-being in the postnatal period are also concerns. Three key features to be included in the app were identified from the formative research: (1) notifications; (2) an information library; and (3) a searching function. The research found that the app should be installed during pregnancy rather than after delivery (81% vs 17%, respectively). Notifications that convey breastfeeding messages should be sent 2-3 times per week. CONCLUSION: The development of the app followed a best practice approach, including the involvement of stakeholders and grounding in behavior change theory. The next step is to evaluate the effectiveness of the BeBo mobile app in a well-conducted randomized controlled trial. TRIAL REGISTRATION: ACTRN12619000531112.

Three new rotenoids from the stems of Derris elliptica and their anti-microbial activity.

Three new rotenoids, named derieliptosides A-C (1-3), were isolated from the stems of Derris elliptica (Wall.) Benth. Their structures were determined by HR-ESI-MS and NMR spectroscopic methods. Absolute configurations of them were elucidated by analysis of ECD spectra in comparison with TD-DFT calculation. Compounds 1-3 inhibited the growth of fungus Candida albicans and selectively inhibited bacterial strains. Of these, compound 1 showed selective inhibition on the growth of Enterococcus faecalis (MIC: 37.5 µM and IC50: 10.6 µM), Staphylococcus aureus (MIC: 75 µM and IC50: 22.7 µM), and C. albicans (MIC: 37.5 µM and IC50: 11.2 µM).

Disparities in Gynecological Healthcare Service Utilization Among Ethnic Minority Women in Vietnam.

The study aimed to investigate differences in the prevalence of gynecological healthcare service utilization in 12 ethnic minority groups and associated socio-demographic correlates with gynecological healthcare service utilization in Vietnam. Based on the national survey on healthcare utilization among 6912 people in 12 ethnic minorities, 900 women aged 21-49 years were included in the final analysis. Prevalence of gynecological healthcare service utilization in 12 ethnic minority groups was measured, based on the question "Have you ever used any gynecological healthcare services?" Socio-demographic characteristics including region, ethnicity, age, marital status, literacy level, education level, languages spoken, occupation, religion, household economy status, using contraception, and distance to the nearest healthcare facility were examined. The association between gynecological healthcare service utilization and socio-demographic characteristics was assessed by using logistic regression. The results showed that the prevalence of gynecological healthcare service utilization was 62.0% (95% CI: 58.7-65.2%), which ranged from 36.5 (Mnong) to 87.7% (Bru Van Kieu). Bru Van Kieu women had significantly higher odds of gynecological healthcare service utilization (OR = 9.42, 95% CI = 3.71-23.91), compared to those in Khmer ethnicity. Besides, Ba Na, Cham Ninh Thuan, and Dao women also had significantly higher odds of gynecological healthcare service utilization (Ba Na: OR = 5.73, 95% CI = 2.15-15.26; Cham Ninh Thuan: OR = 4.24, 95% CI = 1.79-10.06; Dao: OR = 3.43, 95% CI = 1.49-7.90), compared to those in Khmer ethnicity. Getting married, being older, being not poor, and using contraception had significantly higher odds of using gynecological healthcare services. Health education specialists and healthcare workers should be aware of these issues so that they can provide appropriate gynecological healthcare services and ensure high coverage of routine gynecological exams in ethnic minority women in reproductive age.

Comparison of Perceptions About Patient Safety Culture Between Physicians and Nurses in Public Hospitals in Vietnam.

Introduction: Patient safety culture (PSC) is a vital component in ensuring high-quality and safe patient care. Assessment of physicians' and nurses' perceptions of existing hospital PSC is the first step to promoting PSC. This paper is aimed to assess physicians' and nurses' perceptions of PSC in 5 public general hospitals in Hanoi, Vietnam. Methods: This cross-sectional study surveyed 410 physicians and 824 nurses utilizing the validated Hospital Survey on Patient Safety Culture in an online format. Results: The composite positive physician's perception of PSC varied from 47.8 to 89.6% with the lowest composite score of patient safety for "staffing" (47.8%) and the highest composite score for "teamwork within units" (89.6%). The composite positive responses for perception among nurses varied from 51.3 to 94.2% with the lowest composite score of patient safety for "staffing" (51.3%) and the highest composite score for "teamwork within units" (94.2%). Conclusion: The mean scores for "supervisor/manager expectations"; "staffing", "management support for patient safety", "teamwork across units", "handoffs and transitions" among nurses were significantly higher than that among physicians (p<0.05). About two-thirds of physicians and nurses reported no event in the past 12 months (62.8 and 71.7%, respectively). The nurses reported significantly higher patient grades (every good and excellent) than physicians (75% vs 67.1%, p <0.001). Hospitals could develop and implement intervention programs to improve patient safety, including providing interventions on teamwork and communication, encouraging staff to notify incidents, and avoiding punitive responses.