Physical activity during pregnancy is associated with a lower prevalence of gestational diabetes mellitus in Vietnam.

AIMS: To assess the association between physical activity (PA) during pregnancy and the prevalence of gestational diabetes mellitus (GDM) accounting for sitting time. METHODS: The study used data from a cohort study of 2030 pregnant women in Vietnam. Women were recruited from six hospitals in Ha Noi, Hai Phong, and Ho Chi Minh City. Baseline measurements including PA and GDM were taken at 24-28 weeks of gestation. PA was assessed during the past 3 months before the interview using the interviewer-administered Pregnancy Physical Activity Questionnaire. GDM was diagnosed at 24-28 weeks of gestation using the 2013 World Health Organization criteria. RESULTS: 1987 out of 2030 pregnant women were included in the final analysis, of which 432 had GDM (21.7%). Women undertaking the highest level (upper tertile) of PA during pregnancy appeared to have a lower risk of GDM [odds ratio (OR) 0.70, 95% confidence interval (CI) 0.53-0.94, Ptrend 0.017] when compared to those at the lowest tertile of PA. Similarly, women with increased levels of moderate-intensive activity and household/caregiving activity during pregnancy were associated with reduced risks of GDM (OR 0.66, 95% CI 0.50-0.86, Ptrend 0.002 and OR 0.72, 95% CI 0.55-0.95, Ptrend 0.020, respectively). These apparent inverse associations were not attenuated by their sitting time. There were no significant associations between sitting time, light-intensity activity, vigorous-intensity activity, occupation, sports/exercise, commuting, or meeting exercise guidelines and GDM risk. CONCLUSIONS: High levels of PA, particularly moderate-intensity and household/caregiving activities during pregnancy were associated with a lower prevalence of GDM independent of sitting time.

Correlates of non-adherence to antiretroviral therapy in a cohort of HIV-positive drug users receiving antiretroviral therapy in Hanoi, Vietnam.

The HIV epidemic in Vietnam is concentrated, with high prevalence estimates among injection drug users and commercial sex workers. Socio-demographics, substance use and clinical correlates of antiretroviral therapy non-adherence were studied in 100 HIV-1 infected drug users receiving antiretroviral therapy for at least 6 months in Hanoi, Vietnam. All study participants were men with a mean age of 29.9 ± 4.9 years. The median duration on antiretroviral therapy was 16.2 ± 12.7 months; 83% reported 'very good' or 'perfect' adherence in the past 30 days on a subjective one-item Likert scale at time of study enrollment; 48% of participants reported drug use within the previous 6 months, with 22% reporting current drug use. Injection drug use with or without non-injection drug use in the past 6 months (95% C.I. 2.19, 1.30-3.69) and years on antiretroviral therapy (95% C.I. 1.43, 1.14-1.78) were correlated with suboptimal adherence. These findings support Vietnam's ongoing scale-up of harm reduction programmes for injection drug users and their integration with antiretroviral therapy delivery. Moreover, results highlight the need to identify and implement new ways to support high levels of antiretroviral therapy adherence as duration on antiretroviral therapy increases.

Laparoscopic cholecystectomy under field conditions in Asiatic black bears (Ursus thibetanus) rescued from illegal bile farming in Vietnam.

Nine adult Asiatic black bears (Ursus thibetanus) previously rescued from illegal bile farming in Vietnam were examined via abdominal ultrasound and exploratory laparoscopy for liver and gall bladder pathology. Three bears demonstrated notable gall bladder pathology, and minimally invasive cholecystectomies were performed using an open laparoscopic access approach, standard 10 to 12 mmHg carbon dioxide pneumoperitoneum and a four-port technique. A single bear required insertion of an additional 5 mm port and use of a flexible liver retractor due to the presence of extensive adhesions between the gall bladder and quadrate and left and right medial liver lobes. The cystic duct was dissected free and this and the cystic artery were ligated by means of extracorporeal tied Meltzer knot sutures. The gall bladder was dissected free of the liver by blunt and sharp dissection, aided by 3.8 MHz monopolar radiosurgery. Bears that have had open abdominal cholecystectomies are reported as taking four to six weeks before a return to normal activity postoperatively. In contrast, these bears demonstrated rapid unremarkable healing, and were allowed unrestricted access to outside enclosures to climb trees, swim and interact normally with other bears within seven days of surgery.

Correlates of HIV-1 viral suppression in a cohort of HIV-positive drug users receiving antiretroviral therapy in Hanoi, Vietnam.

Injection drug users bear the burden of HIV in Vietnam and are a focus of national treatment programmes. To date, determinants of successful therapy in this population are unknown. Substance use and clinical correlates of viral suppression were studied in 100 HIV-1-infected drug users receiving antiretroviral therapy (ART) for at least six months in Hanoi, Vietnam. The mean age of the cohort was 29.9 + 4.9 years; all were men. A majority of patients (73%) achieved viral suppression (HIV-RNA <1000 copies/mL). Correlates of viral suppression include self-reported > or = 95% adherence (P < 0.01) and current use of trimethoprim/sulphamethoxazole (P < 0.01); current or ever diagnosed with tuberculosis was associated with viral non-suppression (P = 0.006). Tobacco use was prevalent (84%), and surprisingly 48% of patients reported active drug use; neither was associated with viral non-suppression. This is the first study to document successful ART treatment in a population of Vietnamese drug users; rates of viral suppression are comparable to other international populations. The 28% of patients without HIV-1 suppression highlight the need for adherence promotion, risk reduction programmes, and population-based surveillance strategies for assessing the emergence of HIV drug resistance in settings where access to viral load and drug resistance testing is limited.

Contraception within six-month postpartum in rural Vietnam: implications on family planning and maternity services.

OBJECTIVES: This longitudinal study documents contraception practice and factors influencing contraception decision within the first six months postpartum, amongst women residing in the rural Northern Central region of Vietnam. METHODS: A sample of 463 rural women who gave birth during August-October 2002 were recruited and interviewed at one, 16 and 24 weeks postpartum. RESULTS: The proportion of contraceptive users at weeks 16 and 24 were 17% and 43% respectively. At week 24, of contraceptive users, 57% used IUD, 25% used condom, and 14% used traditional methods. Logistic regression analysis found age, sufficient knowledge on contraceptives and husband/partner opinion can significantly affect the contraception decision. CONCLUSIONS: In order to improve the situation, health authorities should be encouraged to provide counselling on postpartum contraceptive methods during ante- and postnatal care visits. Health education on family planning and breastfeeding should also involve the husband/partner group taking into account local socio-cultural features.

A system of IAC neural networks as the basis for self-organization in a sociological dynamical system simulation.

This sociological simulation uses the ideas of semiotics and symbolic interactionism to demonstrate how an appropriately developed associative memory in the minds of individuals on the microlevel can self-organize into macrolevel dissipative structures of societies such as racial cultural/economic classes, status symbols and fads. The associative memory used is based on an extension of the IAC neural network (the Interactive Activation and Competition network). Several IAC networks act together to form a society by virtue of their human-like properties of intuition and creativity. These properties give them the ability to create and understand signs, which lead to the macrolevel structures of society. This system is implemented in hierarchical object oriented container classes which facilitate change in deep structure. Graphs of general trends and an historical account of a simulation run of this dynamical system are presented.