Is Social Support Associated with Colorectal Cancer Care Utilization? A Multilevel Mixed-Effects Model of a Cross-Sectional Cohort Study in Vietnam.

OBJECTIVE: To investigate the relationship between the social support (SS) and colorectal cancer (CRC) care utilization of patients in the central region of Vietnam. METHODS: This was a cross-sectional cohort study in which the cohort was defined as all residential patients diagnosed with CRC in a tertiary hospital, Hue Central Hospital (HCH), in central Vietnam from 2013 to 2019. Social support was considered the main independent variable and was evaluated using the Medical Outcomes Study Social Support Survey (MOS-SSS), a self-administered 19-item SS survey. MOS-SSS is a widely used scale for assessing social support in CRC patients because it is brief, easy to use, reliable, and valid. In this study, we considered a data framework with a multilevel structure that included the patient level and duration of diagnosis as the second level. We estimated the magnitude of SS and CRC-specific treatment modalities using multilevel mixed-effects (MM) models under a hierarchical approach. RESULTS: The findings indicated that CRC care utilization rates were 89.9%, 48.5%, and 30.6% for surgical resection, chemotherapy, and radiation therapy, respectively. The overall trend of SS decreased significantly and affected the CRC care utilization. We found a positive effects of overall SS, as well as emotional and tangible support, on the number of hospitalization admissions and chemotherapy utilization. CONCLUSION: This study suggests that the use of the MOS-SSS should be continued in the long term for CRC patients to enhance medical accessibility and care utilization.

An integrative taxonomic revision of slug-eating snakes (Squamata: Pareidae: Pareineae) reveals unprecedented diversity in Indochina.

Slug-eating snakes of the subfamily Pareinae are an insufficiently studied group of snakes specialized in feeding on terrestrial mollusks. Currently Pareinae encompass three genera with 34 species distributed across the Oriental biogeographic region. Despite the recent significant progress in understanding of Pareinae diversity, the subfamily remains taxonomically challenging. Here we present an updated phylogeny of the subfamily with a comprehensive taxon sampling including 30 currently recognized Pareinae species and several previously unknown candidate species and lineages. Phylogenetic analyses of mtDNA and nuDNA data supported the monophyly of the three genera Asthenodipsas, Aplopeltura, and Pareas. Within both Asthenodipsas and Pareas our analyses recovered deep differentiation with each genus being represented by two morphologically diagnosable clades, which we treat as subgenera. We further apply an integrative taxonomic approach, including analyses of molecular and morphological data, along with examination of available type materials, to address the longstanding taxonomic questions of the subgenus Pareas, and reveal the high level of hidden diversity of these snakes in Indochina. We restrict the distribution of P. carinatus to southern Southeast Asia, and recognize two subspecies within it, including one new subspecies proposed for the populations from Thailand and Myanmar. We further revalidate P. berdmorei, synonymize P. menglaensis with P. berdmorei, and recognize three subspecies within this taxon, including the new subspecies erected for the populations from Laos and Vietnam. Furthermore, we describe two new species of Pareas from Vietnam: one belonging to the P. carinatus group from southern Vietnam, and a new member of the P. nuchalis group from the central Vietnam. We provide new data on P. temporalis, and report on a significant range extension for P. nuchalis. Our phylogeny, along with molecular clock and ancestral area analyses, reveal a complex diversification pattern of Pareinae involving a high degree of sympatry of widespread and endemic species. Our analyses support the "upstream" colonization hypothesis and, thus, the Pareinae appears to have originated in Sundaland during the middle Eocene and then colonized mainland Asia in early Oligocene. Sundaland and Eastern Indochina appear to have played the key roles as the centers of Pareinae diversification. Our results reveal that both vicariance and dispersal are responsible for current distribution patterns of Pareinae, with tectonic movements, orogeny and paleoclimatic shifts being the probable drivers of diversification. Our study brings the total number of Pareidae species to 41 and further highlights the importance of comprehensive taxonomic revisions not only for the better understanding of biodiversity and its evolution, but also for the elaboration of adequate conservation actions.

Digital Health Literacy About COVID-19 as a Factor Mediating the Association Between the Importance of Online Information Search and Subjective Well-Being Among University Students in Vietnam.

Introduction: Digital health literacy (DHL) has recently been proposed as a means of enabling healthy decisions for protective behavior, preventive measures, and adherence with COVID-19 policies and recommendations especially in the era of the "infodemic". This study aimed to (1) identify COVID-19 related DHL and its association with online information seeking; (2) to elucidate COVID-19 related DHL as a mediator predictor between the importance of online information search and its association with subjective well-being among Vietnamese university students. Methods: A cross-sectional web-based survey was used to elicit the responses of Vietnamese students over 2 consecutive weeks (from April 25 to May 9, 2020, n = 1,003, 70.1% female students, mean age 21.4 ± 3.1). The online survey questionnaire collected data on the sociodemographic characteristics of participants, DHL about COVID-19, information seeking behavior, and subjective well-being. Mediation analysis was conducted using the importance of searching COVID-19 related information as independent variables, subjective well-being as a dependent variable, and DHL as a mediator variable. Results: Among 1,003 students, the mean (SD) of DHL related to COVID-19 was 2.87 ± 0.32. In the survey, 87.2% of the students reported sufficient well-being, while almost 13% reported low or very low well-being. The findings also indicated that search engines were the most popular platform for information seeking by Vietnamese students (95.3%) and 92.8% of participants had searched for information related to the current spread of COVID-19. Not searching for hygiene regulation as part of infection control and an average level of information satisfaction were associated with limited DHL (p < 0.05). The importance of online information searching related to COVID-19 increased the subjective well-being of students significantly and limited DHL (p < 0.05). DHL was found to mediate the relationship between the importance of online information searching and the subjective well-being of students. Conclusion: The finding provides insight into DHL about COVID-19 among university students, and their ability to find, understand, appraise, and use online health related information during lockdown throughout the first COVID-19 pandemic wave. DHL should be highlighted as a mediating factor that enhances the positive effect of the importance of information seeking on psychological well-being. However, further studies are needed to better define the mediating role of DHL across other factors.

Indigenous knowledge in relation to climate change: adaptation practices used by the Xo Dang people of central Vietnam.

Even though indigenous knowledge (IK) is considered as one of the most effective strategies in response to climate change issues, this form is not being sufficiently integrated into the climate change planning and policy at both local and national levels in Vietnam. This study investigates the role of the traditional agricultural practices of the Xo Dang ethnic minority groups in Central Vietnam and provides insights into the factors that influence farmers to adopt these practices in response to climate change. Primary data was obtained through three focus group discussions and 87 household surveys involving the Xo Dang people through face-to-face semi-structured interviews in the Tra Doc commune, Bac Tra My district, Quang Nam province, Central Vietnam. The binary logistic regression model was used to examine the factors which have influenced the choices made by this community in response to climate change. The results showed that Xo Dang people were highly aware of climate change risks and had, in response, employed their current adaptation practices. The major adaptation strategies implemented by the Xo Dang people included the use of flora and fauna indicators, native plant varieties, the adjustment of planting calendars, irrigation practices, and the application of intercropping. The results indicated that the living years, their monthly farm incomes, and farmer's perceptions of ongoing climate change effects on their environment were the factors that significantly affected farmers' adaptation decisions. Understanding indigenous knowledge plays a fundamental role in the processes of deciding the appropriate adaptation techniques more effectively and making use of human resources. Therefore, policy makers should pay much attention to indigenous knowledge to combat climate change in future national policies and projects.

A new species of Oligodon Fitzinger, 1826 from the Langbian Plateau, southern Vietnam, with additional information on Oligodon annamensis Leviton, 1953 (Squamata: Colubridae).

We describe a new species of Oligodon from the highlands of the Langbian Plateau, southern Truong Son Mountains, Vietnam, based on morphological and molecular phylogenetic analyses. The new species, Oligodon rostralis sp. nov is distinguished from its congeners by the following morphological characters: medium size in adults (male TL = 582 mm); small and broad head with long protruding snout; dorsal scale row formula 15-15-13; 167 ventrals, 47 subcaudals; single preocular, single postocular; loreal and presubocular absent; six supralabials, third and fourth entering orbit; six infralabials, anterior four contacting first pair of chin shields; internasals separate from prefrontals; nasal divided; single anterior and two posterior temporals; cloacal plate undivided; hemipenes short, bilobed, bifurcating in anterior one third of their length, extending to 8th subcaudal, lacking spines and papillae, with a prominent transverse flounces and distal calyces; six maxillary teeth, the posterior three enlarged; dorsal pattern consisting of 14+4 large dark-brown blotches and a bright-orange vertebral stripe on tail and dorsum; and ventral surfaces in life cream laterally with dark quadrangular spots; dark temporal streak present, edged with white. We also provide additional information on O. annamensis, including a morphological dataset of all specimens known from natural history collections and confirmation of an earlier record of O. annamensis from Cambodia. We also provide the first record of O. annamensis for Dak Lak Province. Phylogenetic analyses of mtDNA genes (3,131 bp of 12S rRNA, 16S rRNA and cyt b) suggest sister relationships of Oligodon rostralis sp. nov. and O. annamensis and place them in one clade with the O. cyclurus and O. taeniatus species groups, which is concordant with previous studies on the phylogenetic relationships of Oligodon. Our study demonstrates high level of herpetofaunal diversity and endemism of Langbian Plateau and further supports the importance of this area for conservation herpetofaunal diversity in Indochina.