The prevalence of anxiety and related factors among primary and secondary school teachers in Hanoi, Vietnam, during the COVID-19 pandemic in 2020.

The working conditions for teachers in Vietnam were characterized by increased workload and pressure, burdening teachers' well-being. The study aims to investigate anxiety prevalence and identify some related factors among primary and secondary school teachers in Hanoi after the first COVID-19 outbreak in 2020. This paper analyzed data of 481 teachers working at ten primary and secondary schools in Hanoi city. Anxiety was measured using the anxiety component of the Depression, Anxiety, and Stress scale 42 items. Multivariable logistics regression was performed to examine anxiety-related factors using SPSS 20.0 at a significant level p less than 0.05. The prevalence of anxiety symptoms was 42.4% and similar between primary and secondary school teachers. More secondary teachers reported moderate to severe anxiety symptoms than primary teachers did (31.6% and 27.7%). Primary school teachers who felt discomfort with their supervisor's assessment, high responsibility for student safety, and ever thinking of leaving their current job were more likely to report anxiety symptoms (OR (95%CI) = 2.8 (1.2-6.5), 3.6 (1.0-12.8), and 2.6 (1.3-5.4), respectively). Meanwhile, the discomfort of caring for many students or problematic students, repetitive work, and disagreement with coworkers were risk factors of anxiety among secondary school teachers (OR (95%CI) = 2.6 (1.2-5.8), 3.2 (1.1-9.2), 3.4 (1.3-8.8), and 3.7 (1.1-12.6), respectively). In conclusion, the prevalence of teachers with anxiety symptoms is on the rise, caused by the characteristics of the job and professional relationships. Tailored support for teachers in different grades is necessary to improve and prevent teachers' anxiety.

Multimodal analysis of methylomics and fragmentomics in plasma cell-free DNA for multi-cancer early detection and localization.

Despite their promise, circulating tumor DNA (ctDNA)-based assays for multi-cancer early detection face challenges in test performance, due mostly to the limited abundance of ctDNA and its inherent variability. To address these challenges, published assays to date demanded a very high-depth sequencing, resulting in an elevated price of test. Herein, we developed a multimodal assay called SPOT-MAS (screening for the presence of tumor by methylation and size) to simultaneously profile methylomics, fragmentomics, copy number, and end motifs in a single workflow using targeted and shallow genome-wide sequencing (~0.55×) of cell-free DNA. We applied SPOT-MAS to 738 non-metastatic patients with breast, colorectal, gastric, lung, and liver cancer, and 1550 healthy controls. We then employed machine learning to extract multiple cancer and tissue-specific signatures for detecting and locating cancer. SPOT-MAS successfully detected the five cancer types with a sensitivity of 72.4% at 97.0% specificity. The sensitivities for detecting early-stage cancers were 73.9% and 62.3% for stages I and II, respectively, increasing to 88.3% for non-metastatic stage IIIA. For tumor-of-origin, our assay achieved an accuracy of 0.7. Our study demonstrates comparable performance to other ctDNA-based assays while requiring significantly lower sequencing depth, making it economically feasible for population-wide screening.

Psychometric properties and factor structure of the Vietnamese Copenhagen Burnout Inventory.

OBJECTIVES: This article examines the validity and reliability of the Vietnamese version of the Copenhagen Burnout Inventory (CBI-V) among hospital nurses in Vietnam in 2022. METHODS: This article examined data from 587 nurses in two city hospitals in Vietnam in 2022. The reliability was determined via internal consistency (Cronbach's alpha coefficient) and test-retest reliability (Intraclass correlation coefficient). Factorial and construct validity of CBI-V were explored with confirmation factor analysis (CFA), exploratory factor analysis (EFA), and correlations with other mental health outcomes (measured by the depression, anxiety, and stress scale), job performance (Work Health Performance Questionnaires), work engagement (Utrecht work engagement), and quality of life (EQ-5D-5L). Statistical analyses were performed using SPSS 20.0 and AMOS 20.0. RESULTS: Cronbach's alpha coefficients of CBI-V's three subscales showed good internal consistency (from 0.87 to 0.91). CFA showed a good fit of the three-factor model with the current data. EFA results showed that all items were loaded in accordance with the CBI's original three constructs, excluding work burnout item 7, forming the fourth factor with a single item. All of CBI-V's three subscales correlated with other constructs in expected directions. CONCLUSION: The CBI-V showed good validity and reliability among hospital nurses. It can be a reliable tool to measure burnout among nurses in a low- and middle-income country in Vietnam during such a crisis as COVID-19. Future studies should examine the construct of the Copenhagen Burnout Inventory in different occupation groups.

Multimodal analysis of genome-wide methylation, copy number aberrations, and end motif signatures enhances detection of early-stage breast cancer.

Introduction: Breast cancer causes the most cancer-related death in women and is the costliest cancer in the US regarding medical service and prescription drug expenses. Breast cancer screening is recommended by health authorities in the US, but current screening efforts are often compromised by high false positive rates. Liquid biopsy based on circulating tumor DNA (ctDNA) has emerged as a potential approach to screen for cancer. However, the detection of breast cancer, particularly in early stages, is challenging due to the low amount of ctDNA and heterogeneity of molecular subtypes. Methods: Here, we employed a multimodal approach, namely Screen for the Presence of Tumor by DNA Methylation and Size (SPOT-MAS), to simultaneously analyze multiple signatures of cell free DNA (cfDNA) in plasma samples of 239 nonmetastatic breast cancer patients and 278 healthy subjects. Results: We identified distinct profiles of genome-wide methylation changes (GWM), copy number alterations (CNA), and 4-nucleotide oligomer (4-mer) end motifs (EM) in cfDNA of breast cancer patients. We further used all three signatures to construct a multi-featured machine learning model and showed that the combination model outperformed base models built from individual features, achieving an AUC of 0.91 (95% CI: 0.87-0.95), a sensitivity of 65% at 96% specificity. Discussion: Our findings showed that a multimodal liquid biopsy assay based on analysis of cfDNA methylation, CNA and EM could enhance the accuracy for the detection of early- stage breast cancer.

A Real-Time Learning Analytics Dashboard for Automatic Detection of Online Learners' Affective States.

Students' affective states describe their engagement, concentration, attitude, motivation, happiness, sadness, frustration, off-task behavior, and confusion level in learning. In online learning, students' affective states are determinative of the learning quality. However, measuring various affective states and what influences them is exceedingly challenging for the lecturer without having real interaction with the students. Existing studies primarily use self-reported data to understand students' affective states, while this paper presents a novel learning analytics system called MOEMO (Motion and Emotion) that could measure online learners' affective states of engagement and concentration using emotion data. Therefore, the novelty of this research is to visualize online learners' affective states on lecturers' screens in real-time using an automated emotion detection process. In real-time and offline, the system extracts emotion data by analyzing facial features from the lecture videos captured by the typical built-in web camera of a laptop computer. The system determines online learners' five types of engagement ("strong engagement", "high engagement", "medium engagement", "low engagement", and "disengagement") and two types of concentration levels ("focused" and "distracted"). Furthermore, the dashboard is designed to provide insight into students' emotional states, the clusters of engaged and disengaged students', assistance with intervention, create an after-class summary report, and configure the automation parameters to adapt to the study environment.

Fragment length profiles of cancer mutations enhance detection of circulating tumor DNA in patients with early-stage hepatocellular carcinoma.

BACKGROUND: Late detection of hepatocellular carcinoma (HCC) results in an overall 5-year survival rate of less than 16%. Liquid biopsy (LB) assays based on detecting circulating tumor DNA (ctDNA) might provide an opportunity to detect HCC early noninvasively. Increasing evidence indicates that ctDNA detection using mutation-based assays is significantly challenged by the abundance of white blood cell-derived mutations, non-tumor tissue-derived somatic mutations in plasma, and the mutational tumor heterogeneity. METHODS: Here, we employed concurrent analysis of cancer-related mutations, and their fragment length profiles to differentiate mutations from different sources. To distinguish persons with HCC (PwHCC) from healthy participants, we built a classification model using three fragmentomic features of ctDNA through deep sequencing of thirteen genes associated with HCC. RESULTS: Our model achieved an area under the curve (AUC) of 0.88, a sensitivity of 89%, and a specificity of 82% in the discovery cohort consisting of 55 PwHCC and 55 healthy participants. In an independent validation cohort of 54 PwHCC and 53 healthy participants, the established model achieved comparable classification performance with an AUC of 0.86 and yielded a sensitivity and specificity of 81%. CONCLUSIONS: Our study provides a rationale for subsequent clinical evaluation of our assay performance in a large-scale prospective study.

E-Cigarette Use among University Students from One University in Hanoi, Vietnam, and Associated Factors.

OBJECTIVE: Describe the use of e-cigarettes and factors associated with e-cigarette use among university students from one university in Vietnam in 2021. METHODS: This cross-sectional study was conducted with a total of 554 full-time undergraduate students recruiting for the study. Data was collected using a structured self-administered questionnaire. A logistic regression analysis was performed to identify factors with significant association with students' use of e-cigarettes. RESULTS: The study revealed that 13.2% of students were current users. Students who had e-cigarette smokers in the family (aOR=6.1, 95% CI: 2.5-15.4; p<0.001), used traditional cigarettes (aOR=23.6, 95% CI: 10.5-53.4; p<0.001), consumed alcohol (aOR=5, 95%CI: 1.6 - 15.9; p<0.01), were exposed to e-cigarette advertising (aOR=2.6; 95%CI: 1.1-5.9; p<0.01), and  had inadequate knowledge about e-cigarettes (aOR=2.2; 95%CI: 1-4.7; p<0.01) were more likely to use e-cigarettes. CONCLUSION: This study updates the status of e-cigarette use among students in one university in Vietnam, thereby suggesting strategies to reduce the use of e-cigarettes among university students.

Psychological stress and associated factors among municipal solid waste collectors in Hanoi, Vietnam: A cross-sectional study.

INTRODUCTION: In low and middle-income countries, the manually operated municipal waste collection system prominently depended on the performance of waste collectors (WC). Most of the literature has focused on the impact of waste collection tasks on WCs' physical health, while little was known about the psychological effects of work-related stress. This study aimed to examine the prevalence of psychological stress and related factors among waste collectors in Hanoi, Vietnam. METHODS: A cross-sectional survey was conducted among 802 WCs in 2017. The questionnaire included the 7-item Stress component of the 21-item Depression, Anxiety and Stress Scale, and questions on demographics and work conditions. Descriptive and multivariate logistics regression analyses were conducted to examine the factors related to psychological stress among WCs. RESULTS: Results showed that 13.4% of WCs reported stress symptoms; among them, 3.3% of WCs experienced severe stress. Factors related to lower odds of self-reported psychological stress included self-perceived frequent exposure to high and low temperatures in the working environment (OR = 0.51 and 0.52, respectively). Factors associated with the increased likelihood of symptoms included frequent exposure to hot/flammable objects (OR = 2.41), working a night shift in the last three months (OR = 1.82), education lever lower than high school (OR = 1.82), and having an insufficient monthly income (OR = 1.99). CONCLUSION: The high percentage of workers with severe stress implies the need for mental health prevention and treatment for WCs who participated in this study.

Effect of smartphone-based stress management programs on depression and anxiety of hospital nurses in Vietnam: a three-arm randomized controlled trial.

There are growing concerns on stress among nurses in low- and middle-income countries (LMICs) in South-East Asia. It is important to improve mental health among nurses in these countries. The objective of this study was to examine the efficacy of two types of newly developed smartphone-based stress management programs in improving depressive and anxiety symptoms among hospital nurses in Vietnam. This study was a three-arm (including two intervention groups and one control group) randomized trial. Participants were recruited from nurses in a large general hospital in Hanoi, Vietnam. Two types (free-choice and fixed sequential order) of smartphone-based stress management programs were developed. Participants were randomly allocated to Program A (a free-choice, multimodule stress management), Program B (a fixed-order, internet cognitive behavioral therapy, iCBT), or a control group (treatment as usual). The depressive and anxiety symptoms were measured by using the Depression Anxiety and Stress Scales at baseline, 3-, and 7-month follow-up surveys. 951 participants were randomly allocated to each of the three groups. Program B showed a statistically significant effect on improving depressive symptoms at 3-month (p = 0.048), but not at 7-month (p = 0.92); Cohen's d was - 0.18 (95% CI - 0.34 to - 0.02) and 0.03 (95% CI - 1.00 to 1.05), respectively. Program A failed to show a significant intervention effect on any of the outcomes at 3- or 7-month follow-up (p > 0.05). Despite the small effect size, the present fixed-order iCBT program seems effective in improving depression of hospital nurses in Vietnam. A public health impact of the intervention can be scalable, when considering its accessibility and minimal cost.Trial registration number: The study protocol is registered at the UMIN Clinical Trials Registry (UMINCTR; ID = UMIN000033139). Registered date of the protocol is 1st Jul. 2018. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037796.

Effects of Smartphone-Based Stress Management on Improving Work Engagement Among Nurses in Vietnam: Secondary Analysis of a Three-Arm Randomized Controlled Trial.

BACKGROUND: Work engagement is important for employee well-being and work performance. However, no intervention study has investigated the effect of an eMental Health intervention on work engagement among workers in low- and middle-income countries (LMICs). OBJECTIVE: The aim of the study was to examine the effects of a newly developed smartphone-based stress management program (ABC Stress Management) on improving work engagement among hospital nurses in Vietnam, an LMIC. METHODS: Full-time registered nurses (n=949) were randomly assigned to one of 2 intervention groups or a control group. The intervention groups were a 6-week, 6-lesson program offering basic cognitive behavioral therapy (CBT-based stress management skills), provided in either free-choice (program A) or fixed order (program B). Work engagement was assessed at baseline and 3-month and 7-month follow-ups in each of the 3 groups. RESULTS: The scores of work engagement in both intervention groups improved from baseline to 3-month follow-up, and then decreased at the 7-month follow-up, while the score steadily increased from baseline to 7-month follow-up in the control group. Program B showed a significant intervention effect on improving work engagement at the 3-month follow-up (P=.049) with a small effect size (Cohen d= 0.16; 95% CI 0.001 to 0.43]). Program A showed nonsignificant trend (d=0.13; 95% CI -0.014 to 0.41; P=.07) toward improved engagement at 3 months. Neither program achieved effectiveness at the 7-month follow-up. CONCLUSIONS: The study demonstrated that a fixed order (program B) delivery of a smartphone-based stress management program was effective in improving work engagement in nurses in Vietnam. However, the effect was small and only temporary. Further improvement of this program is required to achieve a greater effect size and more sustained, longer lasting impact on work engagement. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry UMIN000033139; tinyurl.com/55gxo253. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2018-025138.

Reliability and validity of the Vietnamese version of the 9-item Utrecht Work Engagement Scale.

OBJECTIVES: The present study investigated the reliability and validity of a newly developed Vietnamese version of the 9-item Utrecht Work Engagement Scale (UWES-9-V) in a sample of hospital nurses in Hanoi, Vietnam. METHODS: The UWES-9 was translated into Vietnamese following a standard procedure. A survey was conducted of 949 registered nurses in a large tertiary general hospital in Hanoi, Vietnam, in 2018, using a self-administered questionnaire including the Vietnamese UWES-9, other scales measuring health status, work performance, job demand, job control, and workplace social support, and questions pertaining to demographic variables. Cronbach's alpha and interclass correlation coefficients (ICC) were calculated to assess reliability. Explanatory and confirmatory factor analyses were conducted to assess factorial validity. Convergent validity was tested based on associations between the UWES-9-V and subscales and other scales. RESULTS: The Cronbach's alpha coefficients of the UWES-9-V and the Vigor, Absorption, and Dedication subscales were 0.93, 0.86, 0.77, and 0.90, respectively. ICC of the UWES-9-V in a subsample after 3 months was 0.48. Confirmatory factor analyses indicated an acceptable fit of both one-factor and three-factor structures, with the three-factor model having the better fit. The UWES-9-V and its subscales correlated with depression, anxiety and stress, health-related quality of life and health condition, job performance, and psychosocial work environment. CONCLUSIONS: The study findings suggest that the UWES-9-V is a reliable and valid instrument to measure work engagement among hospital nurses in Vietnam, a low- and middle-income country. Future studies should confirm the validity and reliability of the UWES-9-V among various occupations.

Effects of two types of smartphone-based stress management programmes on depressive and anxiety symptoms among hospital nurses in Vietnam: a protocol for three-arm randomised controlled trial.

INTRODUCTION: Due to an increasing demand for healthcare in low-income and middle-income countries in Asia, it is important to develop a strategy to manage work-related stress in healthcare settings, particularly among nurses in these countries. The purpose of this three-arm randomised controlled trial (RCT) is to examine the effects of a newly developed smartphone-based multimodule stress management programme on reducing severity of depressive and anxiety symptoms as primary outcomes at 3-month and 7-month follow-ups among hospital nurses in Vietnam. METHODS AND ANALYSIS: The target study population will be registered nurses working in a large general hospital (which employs approximately about 2000 nurses) in Vietnam. They will be invited to participate in this study. Participants who fulfil the eligibility criteria will be randomly allocated to the free-choice, multimodule stress management (intervention group A, n=360), the internet cognitive behavioural therapy (iCBT), that is, fixed-order stress management (intervention group B, n=360), or a treatment as usual control group (n=360). Two types (free-choice and fixed sequential order) of smartphone-based six-module stress management programmes will be developed. Participants in the intervention groups will be required to complete one of the programmes within 10 weeks after the baseline survey. The primary outcomes are depressive and anxiety symptoms, measured by using the Depression Anxiety and Stress Scales (DASS) at 3-month and 7 month follow-ups. ETHICS AND DISSEMINATION: The study procedures have been approved by the Research Ethics Review Board of Graduate School of Medicine/Faculty of Medicine, the University of Tokyo (no 11991) and the Ethical Review Board for Biomedical Research of Hanoi University of Public Health (no 346/2018/YTCC-HD3). If a significant effect of the intervention programmes will be found in the RCT, the programmes will be made available to all nurses in the hospital including the control group. If the positive effects are found in this RCT, the e-stress management programmes will be disseminated to all nurses in Vietnam. TRIAL REGISTRATION NUMBER: UMIN000033139; Pre-results.

After-shift Musculoskeletal Disorder Symptoms in Female Workers and Work-related Factors: A Cross-sectional Study in a Seafood Processing Factory in Vietnam.

BACKGROUND: The seafood processing industry has been developing and providing marked contribution to Vietnam's economic growth in recent years. However, information on working conditions and their impacts to workers' health in this sector, focusing on musculoskeletal problems in female workers, has been poorly documented. OBJECTIVES: This paper examines the prevalence of after-shift musculoskeletal disorder symptoms (A-MSDS) and work-related factors in female workers in a seafood processing factory in Vietnam. MATERIALS AND METHODS: As part of a comprehensive study, a cross-sectional survey was implemented in one seafood processing factory in the center of Vietnam in 2014. A self-administered questionnaire was completed by 394 female workers to collect information about their A-MSDS state, demographic characteristics, health status and work conditions. Descriptive analysis and logistic regression were applied to describe and analyse the results. RESULTS: Nearly four-fifths of female workers experienced MSDs in at least one body part (77.7%) and 20.1% of them had MSDs in all investigated regions. The prevalence of A-MSDS in different body parts markedly varied, with the proportion of pain in the hips and lower extremities being as high as 53.3%, followed by pain in the shoulders and upper extremities (42.6%) and the neck (41.1%). A humid working environment, exposure to vibration and chemicals as well as taxing task demands and work organizations were found to significantly contribute to the increased risk of after-shift musculoskeletal disorders in female workers. CONCLUSION: Approximately 80% of female workers in the seafood processing factory experienced musculoskeletal pains after work, especially in the hips, extremities, neck and shoulders which were contributed by work conditions and task demands.

Housing for Female Factory Workers: The Association between Renting Accommodation and Satisfaction with Income and Living Conditions.

BACKGROUND: Vietnam has experienced a strong wave of migrants to urban and industrialized areas. This is a challenge for both local and national governments, which need to address the problems of the poor and socially marginalized, including providing housing for rural-to-urban migrants. Poor housing and the economic burden of house renting are increasingly recognized as determinants of both physical and mental health. OBJECTIVES: This paper examined the association between renting accommodation and income satisfaction and living conditions of female workers in light manufacturing industries in Vietnam. METHODS: A cross-sectional study was implemented with quantitative survey of 2,818 female workers in 10 light manufacturing factories in 3 industrial zones by a self-administered questionnaire. RESULTS: Over 38% of female workers had to rent accommodation. The average expense for accommodation, water and electricity accounted for 30.1% of renters' income, which is 7.2% (CI 95%, 5.3-9.3%) higher than for non-renters. A higher proportion of renters than non-renters considered their income was unstable and insufficient for living costs. In addition, only 7.2% of renters reported that their living conditions were suitable, notably lower than non-renters (22.4%). CONCLUSION: The study showed the economic burden of renting accommodation on workers' income satisfaction and living conditions. The findings have implications for an adequate housing access strategy for workers including the integration of housing development in the planning and development of industrial zones and factories.