Knowledge on emergency management for burn and mass burn injuries amongst physicians working in emergency and trauma departments.

A survey was conducted on 397 physicians working in Emergency and Trauma Departments of district and provincial hospitals in Vietnam. The contents of the survey were emergency care for burn and mass burn injuries. Results showed that only 39.8% of participants gave more than 50% correct answers. In the case of mass burn injuries, only 10.3% of participants gave correct answers for triage, and 71.8% of participants considered oral fluid resuscitation to be an appropriate method. In addition, intubation for suspected inhalational injury was indicated by 51.9% of doctors. Bivariate analysis showed that working experience did not remarkably affect knowledge level. A significantly higher knowledge level was recorded among doctors working at provincial hospitals compared to those working at district hospitals (47.9 ± 13.5% correct answers vs. 42.2 ± 14.8% respectively, p = .0001). Moreover, physicians who had attended training courses in the past had a significantly higher knowledge level compared to the others (53.1 ± 13.6% vs. 44.5 ± 14.2% respectively; p = .0003). Multivariate logistic analysis indicated that both these variables were independent factors that affect the knowledge of healthcare providers with p < .01. Further continuing medical education on burn management and mass burn injury response needs to be conducted for physicians, especially doctors working at primary hospitals.

Une étude a été réalisée auprès de 397 médecins travaillant dans des services d'urgence et de traumatologie vietnamiens, concernant leurs connaissances de la prise en charge en urgence des brûlés, isolément ou en cas de catastrophe. Seuls 39,8% auraient eu la moyenne s'ils avaient été notés. En cas de catastrophe, seuls 10,3% des réponses concernant le triage étaient bonnes et 71,8% des participants considéraient que la voie orale était utile pour l'hydratation initiale. L'indication d'intubation en cas d'inhalation de fumées était posée par 51,9% des répondants. En analyse univariée, l'expérience n'améliorait pas fondamentalement les connaissances. Les connaissances étaient meilleures chez ceux travaillant dans des hôpitaux régionaux (47,9 +/- 13,5% de bonnes réponses) que dans des hôpitaux locaux (42,2 +/- 14,8%), p=0,0001. Les médecins ayant reçu par le passé une formation à ces sujets avaient un niveau de connaissances supérieur (53,1 +/- 13,6% VS 44,5 +/- 14,2%; p=0,0003). En analyse multivariée, ces variables étaient indépendantes. De ce fait, la formation continue de ces praticiens doit comprendre la prise en charge des brûlés et des catastrophes.

Nurse knowledge of emergency management for burn and mass burn injuries.

A survey was conducted on 353 registered nurses working in Emergency and Trauma departments of district and provincial hospitals in Vietnam. Contents of the survey included first aid and initial care for burn and mass burn injuries. Only 15.3% of participants correctly answered over 50% of the items. The average percentage of correct answers was 39.7%. For cases of mass burn injuries, 53.6% of nurses recognized oral fluid resuscitation to be an appropriate method. Pre-transportation intubation for suspected inhalation injury was indicated by 44.6% of participants. Meanwhile, only 5.4% of nurses gave the correct answer regarding burn triage. A significantly higher knowledge level was recorded among nurses who had attended training courses in the past (54.8 ± 10.5% vs. 38 ± 9.7% respectively; p < .001). Meanwhile, work experience and place did not influence knowledge level. To improve the burn emergency management of nurses, further and continuing education is highly recommended.

Une étude a été réalisée auprès de 353 IDE travaillant dans des services d'urgences d'hôpitaux vietnamiens. Le questionnaire portait sur le secourisme et les soins initiaux aux brûlés, se présentant isolément ou dans le cadre d'une catastrophe. Seuls 15,3% des participants avaient plus de 50% de bonnes réponses, la moyenne étant de 39,7%. Cependant, 53,6% des IDE attestent que la réhydratation orale est utilisable en cas d'afflux massif mais seuls 5,4% des réponses sur le triage étaient correctes. L'intubation prophylactique avant transport en cas d'inhalation de fumées était validée par 44,6% des répondants. Les réponses étaient meilleures chez les IDE ayant bénéficié par le passé d'une formation (54,8 +/- 10,5% VS 38 +/- 9,7% ; p<0,001) alors que ni l'expérience ni le lieu d'exercice n'influençaient les connaissances. Ainsi, des plans de formation sont nécessaires pour améliorer les connaissances des IDE sur la prise en charge des brûlés.

Preparation for major burns incidents: evaluation of continuing medical education training courses for professionals.

The purpose of this study was to identify changes in the competence of healthcare providers who underwent training courses on the management of burns incidents. Theoretical and practical simulation training courses were conducted for 305 healthcare providers from emergency and trauma departments of general hospitals in Vietnam. Pre- and post-tests were conducted using questionnaires and with simulated practical skill evaluation by burns specialists. Results showed a significant improvement in knowledge of emergency management of burns incidents, with an increase in percentage of correct answers from 48.2% to 71.6% (p < .01). There was an average increase from 10.5% to 95.1% for the correct calculation of total body surface area involvement, and from 33.8% to 67.2% for using the Parkland formula. Increases in knowledge of resuscitation and management of inhalation injury were also noted (p < .01). For the management of major burns incidents, sufficient knowledge of the command system increased from 58.4% to 81.9%. A better understanding was gained of the missions of the Emergency Medical Team, triage and air evacuation after training (p < .001). Emergency practical skills such as CPR, ET intubation, splinting of bone fractures, burn wound dressing and using emergency medical devices also improved remarkably (p < .001) after practical simulation training. In conclusion, these results indicate that a significant improvement in the capabilities and competence of medical staff in the emergency management of burn injuries can be achieved by conducting training courses with combined theory components and practical simulation models.

Le but de cet étude était d'évaluer les changements de compétence des professionnels de santé ayant suivi une formation à la prise en charge des brûlés en situation de catastrophe. Une formation théorique et pratique (simulation) a été réalisée au profit de 305 professionnels de santé de services d'urgence et de traumatologie vietnamiens. Des questionnaires ont été remplis avant et après formation et les simulations ont été évaluées par des brûlologues. Les bonnes réponses aux questionnaires passent de 48,2 à 71,6% après formation (p<0,01). L'exactitude de l'évaluation de la SB est passé de 10,5 à 95,1%, l'adéquation du remplissage (Parkland) de 33,8 à 67,2%. La prise en charge de l'inhalation de fumées a aussi été améliorée (p<0,01). Pour ce qui est de la catastrophe, les connaissances sur les échelons de commandement étaient correctes dans 58,4% des cas avant, 81,9% après. De même, la compréhension du rôle de l'équipe médicale, du triage et de l'évacuation aéroportée s'est améliorée (p<0,001). L'amélioration est nette aussi (p<0,001) concernant les gestes d'urgences comme le massage cardiaque, l'intubation trachéale, l'immobilisation des fractures, les pansements de brûlure et l'utilisation du matériel. Cette étude montre qu'une nette amélioration des compétences des équipes dans la prise en charge en urgence des brûlés peut être améliorée au moyen d'une formation mixte théorique et pratique.

Mass burn injuries: an analysis of characteristics and outcomes in a developing country.

Our aim was to investigate characteristics and outcomes of patients with mass burn injuries admitted to the National Institute of Burns (NIB), Hanoi, Vietnam. A retrospective note audit was conducted on 83 episodes of mass burn injury (MBI) resulting in 332 patients being admitted to the NIB from 1/2009 to 1/2015. Evaluated criteria included occurrence time, causal agents, place, MBI size, and demographic information such as patient age, gender, burn surface area, full thickness burn area, inhalation injury, prehospital management and outcome. Single and multiple variable logistic analyses were performed to find out independent factors affecting the mortality rate of these patients. 66.3% of MBI were work-related accidents. Incidents were mainly located indoors (72.2%). The predominant groups appeared to be adult (92.3%) and male (74.9%). Average burn surface area was 31% total body surface area (TBSA) and average full thickness area was 12% TBSA. Inhalation injury was diagnosed in 24.6% of patients. More than half of the total victims were classified as having moderate and major burns with an overall mortality rate of 19.2%. According to available information, initial management prior to admission to NIB was not efficient. Full thickness burn area and inhalation injury were found to be independent factors affecting the mortality rate of mass burn injury patients. Our results indicate that most mass burn injury patients in Vietnam are male adults in the working environment. Inhalation injury and full thickness burn area were independent factors affecting mortality rate. Continuing medical education should be conducted to eliminate limitations in prehospital care.

Cette étude a pour but d'évaluer les caractéristiques et le devenir des patients brûlés dans un contexte de catastrophe (BCC) admis dans l'institut national de brûlologie d'Hanoi. Une étude rétrospective sur dossiers de patients hospitalisés entre janvier 2009 et janvier 2015 a été réalisée. Elle concernait 332 patients et 83 catastrophes. Les données évaluées étaient le moment de survenue, l'agent causal, le lieu, l'ampleur de la catastrophe, l'âge, le sexe, les surfaces totale et profonde, l'inhalation de fumées, la prise en charge pré hospitalière et le devenir. Des analyses uni et multivariées ont été réalisées pour trouver des facteurs prédictifs de mortalité. Les BCC étaient pour 66,3% des accidents industriels, en milieu fermé (72,2%). Les hommes (74,9%) adultes (92,3%) représentaient la majeure partie des victimes. La surface brûlée moyenne était de 31% dont 12% profond. Une inhalation était retrouvée chez 24,6% des patients. La mortalité globale était de 19,2%, plus de la moitié des patients ayant des brûlures considérée comme modérées ou étendues. Nous avons considéré que la prise en charge pré hospitalière était inadaptée, justifiant des mesures de formation initiale et continue ciblées. L'existence de brûlure profonde et l'inhalation de fumées sont des facteur indépendants de mortalité dans ce contexte.

Coalition building by drug user and sex worker community-based organizations in Vietnam can lead to improved interactions with government agencies: a qualitative study.

BACKGROUND: Drug users and female sex workers are among the groups most vulnerable to HIV infection in Vietnam. To address the HIV epidemic within these communities, former drug users and sex workers established the first community-based organizations (CBOs) in 2009. The study provides a focused assessment of CBOs' expanding efforts to advocate for their members that identifies existing collaborations with Vietnamese government programs. This assessment explores the barriers to and facilitators of expansion in order to propose recommendations to improve the working relationship between CBOs and government programs. METHODS: Thirty-two individuals from drug user and sex worker CBOs (n = 24) and relevant government programs (n = 8) participated in face-to-face interviews in Hanoi, Ho Chi Minh City, and Hai Phong. Coded interview transcripts were analyzed qualitatively concerning the purpose of CBOs, the interactions between CBOs and government programs, and the perceived barriers, facilitators, and feasibility of future CBO-government program collaborations. RESULTS: Services provided by the CBOs were considered to improve members' quality of life. The formation of coalitions among CBOs increased efficiency in meeting members' specific service needs, in addition to internal capacity building. Government field staff interacted with CBOs by providing CBOs with technical and legal support. CBOs and methadone maintenance treatment (MMT) clinics collaborated to help the clinics meet patient enrollment quotas and facilitate entry into treatment for CBO members. Barriers to CBO-government program collaboration included perceived conflicting missions on how to address drug use and sex work in the community, limited CBO-government program communication, CBO mistrust of the MMT system, and lack of legal status for CBOs. CONCLUSION: To reduce these barriers, we recommend (1) introduction of CBO consultative services at government healthcare centers, (2) enlistment of CBO outreach to ensure full access to the imminent scaled-up MMT program, and (3) establishment of standards by which CBOs can obtain legal status.

Preference and Expectation for Treatment Assignment in a Randomized Controlled Trial of Once- vs Twice-weekly Yoga for Chronic Low Back Pain.

BACKGROUND: In studies involving nonpharmacological complementary and alternative medicine interventions, participant blinding is very difficult. Participant expectations may affect perceived benefit of therapy. In studies of yoga as treatment for chronic low back pain, little is known about the relationship between patient expectations and preferences on outcomes. This study was designed to identify baseline predictors of preference and to determine if expectations and preferences for different doses of yoga affect back-related function and low back pain intensity. METHODS: This was a secondary data analysis of a 12-week randomized controlled trial comparing once-weekly vs twice-weekly yoga for treatment of chronic low back pain in 93 adults from a predominantly low-income minority population. At baseline, participants were asked about back function, back pain, treatment expectations, and treatment preferences. We created a variable "concordance" to describe the matching of participant preference to randomized treatment. Our outcome variables were change in back function and pain intensity after 12 weeks of yoga instruction. We performed logistic regression to identify predictors of preference for once- or twice-weekly yoga instruction. We created linear regression models to identify independent associations between expectations, preference, concordance, and outcomes. RESULTS: Worse back function at baseline was associated with 20% higher odds of preferring twice-weekly yoga (OR 1.2, CI 1.1, 1.3). Individuals with higher expectation scores for twice-weekly yoga had 90% higher odds of preferring twice-weekly vs once-weekly yoga (OR 1.9, CI 1.3, 2.7). Individuals with higher expectation scores for once-weekly yoga had 40% less odds of preferring twice-weekly yoga (OR 0.6, CI 0.5, 0.9). After controlling for baseline characteristics, we found no statistically significant relationship between treatment outcomes, preference, expectation scores, or concordance. CONCLUSION: In a population of predominantly low-income minority participants with chronic low back pain, worse back function was associated with preference for more frequent yoga classes. Those who preferred more yoga classes had higher expectations for those classes. Twelve-week change in back pain intensity and back function were not affected by dosing preference, expectation score, or concordance. More research is needed to better measure and quantify preference, expectations, and their relationship to outcomes in yoga research.

Antecedentes: En estudios que incluyen intervenciones complementarias no farmacológicas y de medicina alternativa es muy difícil realizar estas de manera ciega para los participantes. Las expectativas de los participantes pueden afectar el beneficio percibido de la terapia. En estudios del yoga como tratamiento del dolor lumbar crónico, se sabe poco de la relación entre las expectativas del paciente y las preferencias sobre los resultados. Este estudio se diseñó para identificar los predictores iniciales de preferencia y para determinar si las expectativas y preferencias para dosis diferentes de yoga afectaban la funcionalidad relativa a la espalda y la intensidad de dolor lumbar.Métodos: Este fue un análisis de datos secundarios de un ensayo aleatorio controlado de 12 semanas que comparó yoga una vez a la semana frente a dos veces a la semana para el tratamiento del dolor lumbar crónico en 93 adultos de una población minoritaria predominantemente de ingresos bajos. En el momento inicial, se les preguntó a los participantes sobre el dolor y la funcionalidad de sus espaldas, las expectativas del tratamiento y las preferencias del mismo. Creamos una "concordancia" variable para describir la correspondencia entre las preferencias del paciente y el tratamiento aleatorizado. Nuestras variables de resultados fueron el cambio de la funcionalidad de la espalda y la intensidad del dolor después de 12 semanas de sesiones de yoga. Realizamos una regresión logística para identificar los predictores de preferencias para las sesiones semanales o bisemanales de yoga. Creamos modelos de regresión lineal para identificar las asociaciones independientes entre expectativas, preferencias, concordancia y resultados.Resultados: Una peor funcionalidad de la espalda en el inicio se asoció con un 20% de mayor probabilidad de preferir yoga dos veces a la semana (TP 1,2, IC 1,1, 1,3). Los individuos con mayores escalas de expectativas de yoga dos veces a la semana tuvieron un 90% más de probabilidades de preferir yoga dos veces a la semana que una vez a la semana (TP 1,9, IC 1,3, 2,7). Los individuos con mayores escalas de expectativas de yoga una vez a la semana tuvieron un 40% menos de probabilidades de preferir yoga dos veces a la semana (TP 0,6, IC 0,5, 0,9). Después de controlar las características iniciales, no hallamos relación estadísticamente significativa entre los resultados del tratamiento, preferencias, escalas de expectativas o concordancia.Conclusión: En una población de participantes de minorías predominantemente con bajos ingresos con dolor lumbar crónico, se asoció una peor funcionalidad de la espalda con la preferencia por una mayor frecuencia de clases de yoga. Aquellos que prefirieron más clases de yoga tenían más expectativas para esas clases. El cambio de doce semanas en la intensidad del dolor de espalda y la funcionalidad de la misma no se vio afectado por la preferencia de dosis, escala de expectativas o concordancia. Se necesita realizar más investigaciones para medir mejor y cuantificar las preferencias, las expectativas y su relación con los resultados en la investigación del yoga.

Experience with corrective surgery for postburn contractures in Mumbai, India.

Postburn contracture is a source of significant morbidity in India, even though its occurrence can be reduced significantly by comprehensive postburn injury care, including surgical intervention. This study investigates whether limited access to initial medical care after burn injury has been associated with increased contracture formation among lower socioeconomic class patients in Mumbai, India. During a surgical mission in Mumbai, India, patients presenting with functionally debilitating burn contractures and minimal income were surveyed for initial care received immediately after burn injury. The survey consisted of questions regarding the history of burn injury and details of any initial treatment. Demographic data were collected by chart review. Thirty-eight patients from the state of Maharashtra participated in the study (mean age 28.1 years). The most common etiology of burn injury was from kerosene stove blasts (74%), and the most common morbidities were contractures of the neck and upper extremity. On average, time elapsed since the original injury was 2.8 years. Nearly all patients sought initial medical care at hospitals (97%) with the majority receiving only dressing changes for their full-thickness or deep-dermal burns (61%). The most common reason for not seeking out delayed burn reconstruction was perceived cost (65%). Ultimately, 60 operations were performed, of which 9 (15%) developed postsurgical complications. These data suggest that a subset of lower socioeconomic class burn patients in Maharashtra received suboptimal initial intervention. Comprehensive initial therapy after burn injury may provide better outcomes and limit the number of patients requiring delayed reconstruction.

EGFR, p16, HPV Titer, Bcl-xL and p53, sex, and smoking as indicators of response to therapy and survival in oropharyngeal cancer.

PURPOSE: To prospectively identify markers of response to therapy and outcome in an organ-sparing trial for advanced oropharyngeal cancer. PATIENTS AND METHODS: Pretreatment biopsies were examined for expression of epidermal growth factor receptor (EGFR), p16, Bcl-xL, and p53 as well as for p53 mutation. These markers were assessed for association with high-risk human papillomavirus (HPV), response to therapy, and survival. Patient variables included smoking history, sex, age, primary site, tumor stage, and nodal status. RESULTS: EGFR expression was inversely associated with response to induction chemotherapy (IC) (P = .01), chemotherapy/radiotherapy (CRT; P = .055), overall survival (OS; P = .001), and disease-specific survival (DSS; P = .002) and was directly associated with current smoking (P = .04), female sex (P = .053), and lower HPV titer (P = .03). HPV titer was significantly associated with p16 expression (P < .0001); p16 was significantly associated with response to IC (P = .008), CRT (P = .009), OS (P = .001), and DSS (P = .003). As combined markers, lower HPV titer and high EGFR expression were associated with worse OS (rho(EGFR) = 0.008; rho(HPV) = 0.03) and DSS (rho(EGFR) = 0.01; rho(HPV) = 0.016). In 36 of 42 biopsies, p53 was wild-type, and only one HPV-positive tumor had mutant p53. The combination of low p53 and high Bcl-xL expression was associated with poor OS (P = .005) and DSS (P = .002). CONCLUSION: Low EGFR and high p16 (or higher HPV titer) expression are markers of good response to organ-sparing therapy and outcome, whereas high EGFR expression, combined low p53/high Bcl-xL expression, female sex, and smoking are associated with a poor outcome. Smoking cessation and strategies to target EGFR and Bcl-xL are important adjuncts to the treatment of oropharyngeal cancer.

Targeting apoptosis to overcome cisplatin resistance: a translational study in head and neck cancer.

PURPOSE: Cisplatin resistance remains a barrier to organ-sparing and survival of patients with advanced head and neck squamous cell carcinoma (HNSCC). Targeted therapies to overcome cisplatin-resistant HNSCC are being developed. METHODS AND MATERIALS: Cisplatin-sensitive parental HNSCC cell lines and cisplatin-resistant progeny were studied. Pretreatment HNSCC biopsies were used to construct tissue microarrays which were stained for p53 and Bcl-xL. RESULTS: HNSCC cell lines selected for cisplatin resistance had wild-type p53 and high levels of Bcl-xL. Expression of wild-type p53 in cell lines with low Bcl-xL enhanced cisplatin sensitivity. Expression of both Bcl-xL and wild-type p53 caused tumor cells to become cisplatin resistant. Patients whose tumors expressed low levels of p53 and Bcl-xL enjoyed the best organ preservation and disease-free survival whereas patients whose tumors expressed low levels of p53 and high levels of Bcl-xL had the worst outcome. Novel agents that inhibit Bcl-xL or activate p53 function may target cisplatin-resistant HNSCC. CONCLUSION: Cisplatin resistance in HNSCC is mediated, at least in part, by high Bcl-xL and functional p53.

Response to therapy and outcomes in oropharyngeal cancer are associated with biomarkers including human papillomavirus, epidermal growth factor receptor, gender, and smoking.

Induction chemotherapy and concurrent chemoradiation for responders or immediate surgery for non-responders is an effective treatment strategy head and neck squamous cell carcinoma (HNSCC) of the larynx and oropharynx. Biomarkers that predict outcome would be valuable in selecting patients for therapy. In this study, the presence and titer of high risk human papilloma virus (HPV) and expression of epidermal growth factor receptor (EGFR) in pre-treatment biopsies, as well as smoking and gender were examined in oropharynx cancer patients enrolled in an organ sparing trial. HPV16 copy number was positively associated with response to therapy and with overall and disease specific survival, whereas EGFR expression, current or former smoking behavior, and female gender (in this cohort) were associated with poor response and poor survival in multivariate analysis. Smoking cessation and strategies to target EGFR may be useful adjuncts for therapy to improve outcome in the cases with the poorest biomarker profile.

Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial.

OBJECTIVE: Surgery induces a catabolic response with stress hormone release and insulin resistance. The aim of this study was to assess the effect of pre-operative carbohydrate administration on grip strength, gastrointestinal function and hospital stay following elective colorectal surgery. METHODS: Thirty-six patients undergoing elective colonic resection were randomized into one of three groups. Group 1 were fasted; Group 2 were given pre-operative oral water, Group 3 received equivalent volumes of a Maltodextrin drink. Time to first flatus, first bowel movement and hospital stay were recorded. Muscle strength was measured pre-operatively, and on alternate days thereafter until discharge using a grip strength dynamometer. RESULTS: Patients in the carbohydrate group had a median postoperative hospital stay of 7.5 days compared with 13 days in the water group (P > 0.01) and 10 days in the fasted group (P = 0.06). The median time postsurgery to first flatus was 3 days for both the fasted and water groups compared with 1.5 days in the carbohydrate group (P = 0.13). First bowel movement occurred on day 3 in the carbohydrate group, day 4 in the fasting group and day 5 in the water group. The fasted group showed a significant reduction in postoperative grip strength (P < 0.05) with a median drop of 10% at discharge. Neither the water nor the carbohydrate groups showed significant reductions in muscle strength. CONCLUSION: We found that pre-operative administration of oral carbohydrate leads to a significantly reduced postoperative hospital stay, and a trend towards earlier return of gut function when compared with fasting or supplementary water.

Matching of sarcoplasmic reticulum and contractile properties in rat fast- and slow-twitch muscle fibres.

1. The twitch characteristics (fast-twitch or slow-twitch) of skeletal muscle fibres are determined not only by the contractile apparatus properties of the fibre, but also by the time-course of Ca2+ release and re-uptake by the sarcoplasmic reticulum (SR). The present study examined, in individual fibres from non-transforming muscle of the rat, whether particular SR properties are matched to the contractile apparatus properties of the fibre, in particular in the case of fibres with fast-twitch contractile apparatus located in a slow-twitch muscle, namely the soleus. 2. Force was recorded in single, mechanically skinned fibres from extensor digitorum longus (EDL), gastrocnemius, peroneus longus and soleus muscles. Using repeated cycles in which the SR was emptied of all releasable Ca2+ and then reloaded, it was possible to determine the relative amount of Ca2+ present in the SR endogenously, the maximum SR capacity and the rate of Ca2+ loading. The sensitivity of the contractile apparatus to Ca2+ and Sr2+ was used to classify the fibres as fast-twitch (FT), slow-twitch (ST) or mixed (< 3% of the fibres examined) and thereby identify the likely troponin C and myosin heavy chain types present. 3. There was no significant difference in SR properties between the groups of FT fibres obtained from the four different muscles, including soleus. Despite some overlap in the SR properties of individual fibres between the FT and ST groups, the properties of the FT fibres in all four muscles studied were significantly different from those of the ST and mixed fibres. 4. In general, in FT fibres the SR had a larger capacity and the endogenous Ca2+ content was a relatively lower percentage of maximum compared with ST fibres. Importantly, in terms of their SR properties, FT fibres from soleus muscle more closely resembled FT fibres from other muscles than they did ST fibres from soleus muscle.

[Health indicators among students from Hô Chi Minh-Ville (Vietnam): comparison with other countries]. / Les représentations de la santé chez les lycéens à Hô Chi Minh-Ville (Vietnam): comparaison avec d'autres pays.

In Vietnam, as in most developing countries, adolescent health is not considered a priority, yet this population faces many health problems. This study aims to describe perceptions of health among high school students in Ho Chi Ming City, Vietnam. The study was carried out with a representative sample of 543 students between the ages of 16 and 19, using a tool adapted from a questionnaire that was created and validated by the Centre for Preventive Medicine in Nancy, France. The adolescents who participated in the study described their perceptions of health in diverse ways: on the one hand they described them in a classic manner (absence of sickness) and on the other hand they described them in a more comprehensive, positive way (fitness, strength, development, happiness). A comparison with other studies in Algeria and France that used the same questionnaire shows certain similarities across cultures with regard to perceptions of health, as well as certain characteristics that are particular to each society and each culture.