BACKGROUND:Integrating evidence-based methamphetamine interventions into methadone programs is critical to address increasing methamphetamine use among methadone patients. This study examined the barriers and facilitators of implementing such integration in Vietnam. METHOD:We conducted a qualitative study nested within an adaptive trial, Screen, Treat and Retain Meth-Using People with Opioid Use Disorder in Methadone Clinics (STAR-OM), integrating evidence-based methamphetamine interventions into 15 methadone clinics. Seventy-six in-depth interviews were conducted with participants and methadone providers to seek their experience implementing or receiving the study interventions. Interview guides were based on the Consolidated Framework for Implementation Research. Data was analyzed using thematic analysis to identify and explore key themes. RESULTS:Results reflected a tension between strong clinical support for integrating methamphetamine interventions and substantial structural constraints. The main facilitator was the perceived impact of interventions driven by social accountability and engagement with peers, providers and family members. Key barriers operated primarily at structural levels and included: (1) restrictive policy environments despite local demand for intervention; (2) workforce precarity and limited financial resources, particularly for contingency management; and (3) logistical implementation challenges such as organizing group sessions, burdensome urine testing, falsified urine samples and limited use of SMS-based reminders. CONCLUSION:While evidence-based methamphetamine interventions were widely perceived as beneficial, major barriers existed at the policy and program levels. Macro-level actions - such as advocating for more harm reduction - oriented drug policies and strengthening workforce capacity - alongside pragmatic, clinic-level implementation strategies are essential for the sustainable adoption and scale-up of evidence-based methamphetamine interventions within Vietnam's methadone program.

This pilot study aimed to evaluate the Vietnamese version of the cognitive emotion regulation questionnaire – short version (CERQ-S) among patients receiving methadone treatment in Ho Chi Minh City. A pilot study was conducted in 2025, recruited participants from four methadone treatment centers. Content validity was assessed using the Content Validity Index (CVI). Internal consistency was measured by Cronbach’s alpha. Test-retest reliability over a one-month interval was evaluated using the intra-class correlation coefficient (ICC). Descriptive statistics were applied to examine score distributions, floor and ceiling effects. The mean age of 80 participants was 44.3 years (SD=5.5), and the majority were male (88%). All CERQ-S items demonstrated excellent content validity (CVI=1.00). The total scale showed high internal consistency at both time points, and test–retest analyses indicated acceptable short-term temporal stability (overall ICC=0.72). Subscale-level ICCs ranged from moderate to good, with lower stability observed for some domains. Descriptive analyses showed that all subscales covered the full possible score range, with notable floor effects for Catastrophizing and Other-Blame, and generally limited ceiling effects. Exploratory analyses suggested variations in emotion regulation scores across selected sociodemographic characteristics; these findings were interpreted as preliminary. The findings indicate that the instrument is feasible for pilot and descriptive research, while further studies with larger samples are needed to fully evaluate its psychometric properties.

Background:Methamphetamine (MA) co-use with opioids has increased in Vietnam, hindering methadone maintenance therapy (MMT) through non-adherence and returning to opioid use. This study reports the primary outcomes of the "Screen, Treat and Retain people with opioid use disorders who use MA in methadone clinics" (STAR-OM) trial to integrate evidence-based behavioral interventions into MMT clinics and reduce MA co-use. Methods:STAR-OM was a sequential multiple assignment randomized trial (ClinicalTrials.gov Identifier: NCT04706624) with two 12-week intervention stages across 15 MMT clinics in Hanoi and Ho Chi Minh City, Vietnam. In the frontline intervention stage, 665 MMT patients who co-use MA were randomized to either a low-intensity frontline intervention of six weeks of contingency management (CM) followed by six weeks of group education, or a high-intensity frontline intervention of 12 weeks of CM. Participants who responded to treatment at the end of the frontline intervention stage-having 4 MA-negative urine drug screens (UDS) out of a possible 4 in Weeks 11 to 12-were reassigned to 12-weeks of theory-based text messaging for maintenance. Within each frontline intervention, those who did not have a treatment response were re-randomized to an adaptive intervention of either Matrix only or Matrix + CM for another 12 weeks. Segmented, two-level mixed effects logistic regression compared intervention effects on testing MA-negative over time. Findings:By Week 25, the low-intensity frontline intervention increased by 15.1% in the expected percentage of MA-negative UDS and the high-intensity frontline intervention increased by 16.9%. The high-intensity condition increased more rapidly in MA-negative UDS than the low intensity condition in the first 12 weeks. Participants who were reassigned to text messaging maintained a high percentage of MA-negative UDS-between 87.9% and 92.4%-from Week 14-25. Those re-randomized to Matrix + CM had a greater increase in MA-negative UDS than the Matrix only condition by 10.1 percentage-points. Interpretation:The STAR-OM trial provides a model of evidence-based adaptive interventions to reduce MA co-use in patients receiving MMT for opioid use disorder in Vietnam and globally. Consistent exposure to CM predicted greater reductions in MA use, emphasizing the importance of positive reinforcement in substance use intervention. Combining CM with the Matrix model may improve outcomes in those who do not initially respond to CM. Theory-based, unidirectional text messaging may support behavioral maintenance in people who respond to frontline intervention. Funding:This trial was funded by the National Institute of Drug Abuse and National Institute of Mental Health.

Rising temperatures have raised concerns about impacts on mental health, including suicide. However, how climate change will affect global temperature-related suicide remains unclear. Using data from 751 locations across 26 countries, combined with climate projections under 3 emissions scenarios, we estimated temperature-suicide associations and projected temperature-related suicide mortality through the 2050s, assuming no adaptation, demographic shifts or changes in suicide rate. Here we show that climate change is projected to increase suicide mortality attributable to temperature across all studied regions, with the magnitude depending on both the emissions scenario and geographic location. Warmer regions-including Central and South America, South Europe, Southeast Asia and South Africa-show larger increases, while temperate and colder regions such as North America, North Europe, East Asia and Australia show smaller but meaningful rises. These findings highlight the potential of climate change to exacerbate suicide and underscore the importance of adaptive mitigation strategies.

Mục tiêu: Đánh giá hiệu quả của phương pháp lọc rửa vi lưu và thang nồng độ đến chất lượng tinh trùng sau trữ đông bằng phương pháp thủy tinh hóa. Đối tượng và phương pháp: Các mẫu tinh dịch đạt chuẩn của Tổ chức Y tế Thế giới (2021). Mỗi mẫu được chia làm hai phần, xử lý song song bằng phương pháp lọc rửa vi lưu và thang nồng độ, sau đó trữ đông bằng phương pháp thủy tinh hóa. Đánh giá chất lượng tinh trùng sau lọc, sau rã đông qua chỉ số sống sót tinh trùng (CSF). Kết quả: Sau lọc rửa, nhóm xử lý bằng phương pháp vi lưu có mật độ, tỷ lệ sống, di động và di động tiến tới cao hơn có ý nghĩa so với nhóm thang nồng độ. Sau trữ đông bằng phương pháp thủy tinh hóa, chất lượng tinh trùng ở cả hai nhóm đều giảm; nhưng nhóm vi lưu vẫn duy trì các thông số cao hơn. CSF của mật độ, tỷ lệ sống và di động không có khác biệt có ý nghĩa giữa hai phương pháp, trong khi CSF tỷ lệ di động tiến tới cao hơn ở nhóm thang nồng độ. Kết luận: Phương pháp vi lưu giúp cải thiện và duy trì chất lượng tinh trùng tốt hơn sau trữ đông so với phương pháp thang nồng độ, cho thấy tiềm năng ứng dụng trong lựa chọn tinh trùng trước trữ đông trong hỗ trợ sinh sản.

Cảnh quan làng cổ là một loại hình cảnh quan văn hóa đặc thù, kết tinh từ lịch sử cư trú, sản xuất và tổ chức xã hội của cộng đồng. Không gian kiến trúc cảnh quan của làng cổ gắn chặt với môi trường tự nhiên, hệ thống sản xuất truyền thống, tín ngưỡng và đời sống thường nhật. Bảo tồn cảnh quan làng cổ trong bối cảnh hiện nay đòi hỏi một mô hình quản lý dựa trên sự tham gia thực chất của cộng đồng – những chủ thể trực tiếp sáng tạo, duy trì và phát huy giá trị di sản. Tiếp cận bảo tồn có sự tham gia cộng đồng đã được chứng minh là phù hợp với các dạng cảnh quan văn hóa sống, nơi mà giá trị cảnh quan không chỉ nằm ở yếu tố vật thể mà còn thể hiện trong đời sống, tập quán và sinh kế của cư dân. Bài báo này tổng hợp các nghiên cứu điển hình ở các quốc gia châu Âu, châu Á và trong nước liên quan đến bảo tồn cảnh quan làng cổ có sự tham gia của cộng đồng và mô hình đồng quản lý. Trên cơ sở phân tích so sánh các mô hình tại Nhật Bản, Trung Quốc, Romania, Úc và các bài học kinh nghiệm ở Việt Nam, bài viết đề xuất định hướng công tác quản lý cảnh quan làng cổ Việt Nam có sự tham gia cộng đồng, đồng quản lý gắn bảo tồn với sinh kế cộng đồng đảm bảo sự hài hòa giữa bảo tồn – phát triển bền vững.

Minimum mortality temperature (MMT) is an important feature of temperature-mortality relationship, defined as the temperature at which mortality risk is lowest. Although numerous studies have estimated MMT for all-cause mortality, few have explored differences by age or cause of death. We analyzed daily mean temperature and mortality data from 667 communities across 39 countries. Mortality was classified by age and cause of death (cardiovascular, respiratory, or non-cardiorespiratory). A two-stage meta-analytic approach was applied to estimate the MMT and its corresponding percentile (MMTP) by age and cause of death. In the overall population, MMT was the highest for cardiovascular mortality (22.1 °C, 95% CI: 20.9-23.4 °C), whereas respiratory and non-cardiorespiratory causes were 0.87 °C and 0.66 °C lower, respectively, than that for cardiovascular causes. Similar patterns were observed for MMTP, which was highest for cardiovascular mortality (75%, 95% CI: 73-78%) and lower by 5% and 4% for respiratory and non-cardiorespiratory causes, respectively. MMT increased with age for cardiovascular (0.19 °C per 10 years, 95% CI: 0.14-0.23) and non-cardiorespiratory causes (0.13 °C per 10 years, 95% CI: 0.09-0.16). These patterns were generally consistent across geographical regions. Overall, both MMT and MMTP differed by cause of death and age, indicating that the optimal temperature varies across population subgroups.

Introduction:Engaging young people in health research offers mutual benefits for both participants and research teams. While a variety of approaches have been used globally to involve youth, few studies have evaluated their effectiveness and impact. Methods:From 2020 to 2023, we conducted the SEED project to explore attitudes toward clinical research involving human participants among 539 Vietnamese health professions students. The project concluded with an evaluation of the students' experiences as project participants, using a mixed-methods journey mapping approach. For this we conducted in-depth exit interviews with 18 purposively selected students and analyzed 231 study completion questionnaires, as well as 815 feedback forms collected during the life of the project. Results:Findings are presented in three areas: (1) Students' motivations to join and views about their experiences as participants; (2) Their evaluation of organizational factors; and (3) Their overall views about the project and scientific research generally. As well as having an interest in research (195/231, 84%), for many students the potential for personal benefit, such as gaining new knowledge (161/231, 70%), enhancing soft skills (161/231, 70%), and exposure to networking opportunities (126/231, 55%), were major motivating factors. However, factors such as receiving a project attendance certificate, the financial compensation offered, the reputation of the research institution, and encouragement by friends, were not considered important by many students (42-46%). Among students who attended at least one event, 217/220 (99%) reported high satisfaction with the project implementation, engagement approaches and activity topics, and generally preferred offline to online events. Suggested improvements included incorporating more interactive games, using smaller discussion groups, and strengthening communication via social media to support retention. 145/231 (63%) of the students mentioned at least one barrier to participation, with a busy schedule being the most common(127/145, 87%). For some of the interviewed participants, altruistic motivation- the sense of contributing to science and community-influenced their continuing participation. Conclusion:This comprehensive participant-centered evaluation of the experiences of Vietnamese healthcare students enrolled in a longitudinal cohort study emphasizes the value of engaging with students to co-develop scientific activities, thereby providing important benefits for the students, the academic institutions, and the broader research community.

BackgroundRecruiting and retaining adequate numbers of eligible participants remain the key challenges in clinical research. Understanding the factors associated with participants’ motivations is essential to support recruitment efforts, reduce early withdrawals, and consolidate commitment. The Oxford University Clinical Research Unit conducted a longitudinal study, named the SEED project, with a cohort of first- and third-year students at the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. ObjectiveThis paper describes the findings of the SEED project related to students’ understanding of clinical research and characterizes factors influencing their motivation to participate. MethodsWe used a mixed methods approach, incorporating surveys, in-depth interviews, and focus group discussions to collect insights from students on ethical and practical aspects of clinical research participation. ResultsA total of 437 students were enrolled, with the majority coming from the general medicine faculty. Of these participants, 74 students contributed to qualitative data. Over 95% of the students agreed that clinical research could make an important contribution to science (430/435, 99%) and the health of society by increasing disease awareness (422/436, 97%) and potential access to more effective treatments (415/435, 95%). Few students (81/435, 19%) expressed concerns about the negative impacts of clinical research on the environment. In terms of risk, most students emphasized unpredictable or serious side effects (226/434, 52%) or inconveniences (257/435, 59%) as major concerns, whereas small proportions worried about the risk of disclosure of personal information (94/436, 22%) or the risk of being treated like an “experimental subject, not human being” (33/434, 8%). In in-depth interviews and focus group discussions, health-related benefits, opportunities for intellectual growth, time requirements, and altruistic attitudes built on the perceived social value of clinical research were highlighted as key factors influencing students’ participation. ConclusionsStudents in this study expressed favorable attitudes toward clinical research. By highlighting altruistic motivations built on the perceived social value of clinical research and personal motivations based on perceived health-related benefits for participants, this study provides insights to inform recruitment efforts for clinical studies involving student participants or other young, healthy individuals.

BACKGROUND:In Vietnam, research on palliative care, particularly for cancer patients, remains limited. This gap reduces the practical relevance of research findings in shaping policies and strategies for palliative care tailored to Vietnam's healthcare system. This study aimed to assess health outcomes in cancer patients receiving palliative care over a one-year period using the APCA African Palliative Outcome Scale (IPOS). METHODS:The prospective cohort study was conducted over one year, with monthly interviews using IPOS scale to measure patient health outcomes. A multilevel linear mixed model was used to analyze changes in IPOS scores over time, and a Bonferroni-adjusted pairwise comparisons test was applied to compare mean IPOS scores of patients before death. RESULTS:Among the 134 patients included, mean IPOS scores along with physical, emotional, and communication symptoms decreased over time. The total IPOS score declined from 32.2 (95% CI: 30.3-34.1) to 11.4 (95% CI: 9.6-13.3) after one year, with the greatest reduction observed in physical symptoms. Patients in the 0-2 months before death group had significantly higher scores than those in the 3-5 months and 6 months before death groups. Physical symptoms, including pain, dyspnea, and weakness, worsened the most, while communication issues remained stable, peaking at 2 months and reaching their lowest point at 6 months before death. CONCLUSION:This study provides evidence of the benefits of palliative care in improving the health of cancer patients. Quality of life declines most in the final months, highlighting the need for early symptom management. This study also paves the way for further research into symptom progression before death.

Introduction:Cigarette smoking is common among individuals with substance use disorders and those undergoing addiction treatment. Cigarette use is highly comorbid with methamphetamine use, and among individuals who co-use methamphetamine and opioids, nicotine dependence may further complicate smoking cessation efforts. This study examines nicotine dependence levels and associated factors among people who use methamphetamine undergoing methadone maintenance treatment (MMT) in Vietnam. Methods:This cross-sectional analysis utilized baseline data from 667 participants enrolled in a randomized controlled trial designed to evaluate the effectiveness of various combinations of behavioral evidence-based interventions for methamphetamine use among patients on MMT in Vietnam (STAR-OM R01DA050486). Data on levels of nicotine dependence and other covariates including demographic, health status, treatment characteristics and substance use were collected. Nicotine dependence was measured using the Fagerström Test for Nicotine Dependence, with a score of 6 or higher indicating high dependence. Logistic regression estimated the association between nicotine dependence and various psychosocial and behavioral factors. Results:Overall, 96.7% of the participants were current smokers with 247 of them (38.3%) exhibiting high nicotine dependence. Greater severity of methamphetamine withdrawal symptoms (OR: 1.03; 95% CI: 1.01-1.05) and a high risk of depression, anxiety or stress (OR: 1.76; 95% CI: 1.14-2.72) were associated with increased odds of high nicotine dependence. Conversely, older age at onset of methamphetamine use was associated with lower odds of high nicotine dependence. Conclusions:Cigarette smoking was highly prevalent among individuals using methamphetamine during MMT, with many exhibiting high nicotine dependence. Providing smoking cessation support with efforts to manage methamphetamine withdrawal symptoms, could help improve cessation outcomes.

Đặt vấn đề: Những người sử dụng chất kích thích thường xuyên gặp phải các rối loạn liên quan đến giấc ngủ, đặc biệt là chất lượng giấc ngủ kém và tình trạng buồn ngủ quá mức vào ban ngày, được xem là những yếu tố nguy cơ tiềm ẩn có thể góp phần làm tăng tỷ lệ tái nghiện ở người sử dụng ma túy. Mục tiêu: Đánh giá đặc tính đo lường chất lượng giấc ngủ của thang đo PSQI trên những bệnh nhân đang điều trị Methadone tại Thành phố Hồ Chí Minh (TpHCM). Đối tượng và phương pháp nghiên cứu: Nghiên cứu dẫn đường được thực hiện vào tháng 3/2025 trên 80 bệnh nhân đang điều trị Methadone tại 4 trung tâm y tế ở TpHCM. Chỉ số CVI được sử dụng để đánh giá tính giá trị về nội dung. Độ tin cậy được đánh giá bằng chỉ số Cronbach’s alpha và hệ số ICC để đánh giá tương quan giữa 2 lần đo lường. Các kiểm định được xem là có ý nghĩa thống kê khi giá trị p <0,05. Kết quả: Tỷ lệ chất lượng giấc ngủ kém là 37,5%. Chỉ số CVI của tất cả các câu đều đạt 1,00. Hệ số tin cậy nội tại cao với giá trị Cronbach’s alpha dao động từ 0,80 đến 0,84 cho từng câu và đạt 0,83 cho toàn bộ câu hỏi. Chỉ số ICC cũng ở mức từ trung bình đến cao cho từng câu và đạt 0,77 cho toàn bộ câu hỏi. Kết luận: Thang đo PSQI có cấu trúc đo lường đáng tin cậy, phù hợp để sử dụng trong các nghiên cứu đo lường chất lượng giấc ngủ ở bệnh nhân Methadone. Từ khóa: chất lượng giấc ngủ; Methadone; PSQI

BACKGROUND AND AIMS:Identifying those who use methamphetamine or are at high risk of using methamphetamine is essential so that early, appropriate intervention can be made. This study evaluated the use of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for identifying methamphetamine use among people on methadone maintenance treatment (MMT) in Vietnam. METHODS:From June 2021 to May 2023, all people on MMT at 15 methadone clinics in Hanoi and Ho Chi Minh City, Vietnam, were invited to participate in this study. Participants underwent a face-to-face interview to complete the 8-item ASSIST. Participants also had a urine drug test (UDT) for methamphetamine use. Discriminant properties of the ASSIST were evaluated using UDT as the reference. RESULTS:Among 6709 participants, 10.7% (n = 717) tested positive for methamphetamine use via UDT. The ASSIST demonstrated robust discriminant abilities to identify those who used methamphetamine [area under the curve (AUC) = 0.872; 95% confidence interval (CI) = 0.856-0.887]. At the commonly used cutoff of 4, the ASSIST had a sensitivity of 83.8% and a specificity of 82.0%. At this cutoff, 82.2% of the ASSIST results aligned with UDT outcomes (kappa coefficient = 0.41, P < 0.001) and the ASSIST identified a prevalence of 25.0%. At higher cutoffs, the sensitivity of the ASSIST decreased but both the specificity and the agreement with the UDT results increased. CONCLUSIONS:The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) appears to be reliable and valid in identifying methamphetamine use among people on methadone treatment in Vietnam. Cutoff adjustments may help to reduce false positive rates.

INTRODUCTION:The global rise of concurrent use of opioids and methamphetamine presents challenges to stable methadone maintenance treatment (MMT). We assessed non-adherence to treatment and concurrent opioid use, along with associated factors, among people on MMT using methamphetamine in Vietnam. METHODS:This analysis utilized baseline data from a randomized clinical trial designed to investigate the effectiveness of various combinations of behavioral evidence-based interventions for methamphetamine use among patients on MMT in Vietnam (STAR-OM R01DA050486). We used data from 498 participants on MMT who self-reported using methamphetamine in the past 30 days and had been in MMT treatment for at least three months. The study determined adherence to MMT through medical record review and assessed concurrent opioid use via urine testing and documented test results in medical records. RESULTS:Within the last three months, 145 (29.1 %) did not adhere to MMT, and 212 (42.6 %) concurrently used opioids. Non-adherence to MMT were strongly associated with living at a considerable distance from the clinic (aOR = 1.80, 95 % CI: 1.10-2.90), being HIV positive (aOR = 0.51, 95 % CI: 0.27-0.97), and were marginally associated with using methamphetamine to reduce emotional distress (aOR = 1.56, 95 % CI: 0.99-2.45). Concurrent opioid use was associated with receiving treatment at clinics established during the scale-up period (aOR = 1.80, 95 % CI: 1.13-2.87), an extended duration of treatment at current clinics (aOR = 0.98, 95 % CI: 0.97-0.99), male gender (aOR = 2.09, 95 % CI: 1.05-4.13), and ever injecting methamphetamine (aOR = 1.98, 95 % CI: 1.13-3.46), besides MMT non-adherence (aOR = 2.71, 95 % CI: 1.72-4.29). CONCLUSION:Non-adherence to MMT and concurrent opioid use are prevalent among methamphetamine-using patients on methadone in Vietnam. Alongside well-documented factors influencing methadone program, the rise in methamphetamine adds further complexity to these challenges. Future intervention strategies must address both the underlying issues and methamphetamine use behaviors to effectively improve treatment outcomes. TRIAL REGISTRATION:NCT04706624. Registered 13 January 2021. https://clinicaltrials.gov/ct2/show/NCT04706624.

Background:The presence of benzene, toluene, ethylbenzene, and xylene isomers (BTEX) in the environment is of increasing concern due to their toxicity and ubiquity. Although the adverse health effects of BTEX exposure have been documented, robust epidemiological evidence from large-scale, multicountry studies using advanced exposure assessment methodologies remains scarce. We aimed to assess the association of short-term ambient exposure to individual BTEX components and their mixture with daily total, cardiovascular, and respiratory mortality on a global scale. Methods:Daily data on mortality, meteorological factors, and air pollution were collected from 757 locations across 46 countries or regions. Data on individual chemicals (ie, benzene, toluene, xylenes [summation of ethylbenzene, m-xylene, p-xylene, and o-xylene]) and the aggregate mixture (ie, BTEX) were estimated using a chemistry-climate model. We examined the short-term associations of each individual chemical as well as the BTEX mixture with daily total, cardiovascular, and respiratory mortality in a multicountry framework. Using a two-stage time-series design, we first applied generalised additive models with a quasi-Poisson distribution to obtain location-specific associations, which were subsequently pooled using random-effects meta-analysis. Two-pollutant models were used to assess the independent effects of BTEX after adjusting for co-pollutants (PM2⋅5, PM10, nitrogen dioxide, sulphur dioxide, ozone, and carbon monoxide). Additionally, we assessed the overall exposure-response curves with spline terms. Findings:An IQR increment of BTEX concentration on lag 0-2 days (3-day moving average of the present day and the previous 2 days) was associated with increases of 0⋅57% (95% CI 0⋅49-0⋅65), 0⋅42% (0⋅30-0⋅54), and 0⋅68% (0⋅50-0⋅86) in total, cardiovascular, and respiratory mortality, respectively. The corresponding effect estimates for an IQR increment in individual chemicals (benzene, toluene, and xylenes) were 0⋅38-0⋅61%, 0⋅44-0⋅70%, and 0⋅41-0⋅65%, respectively. The associations remained significant after adjusting for co-pollutants, with a general decline in magnitude, except for a slight increase after adjustment for ozone. The shape of the exposure-response curves for all pollutants and causes of death was almost linear, with steeper slopes at low concentrations and no discernible thresholds. Interpretation:This global study provides novel evidence linking short-term exposure to ambient BTEX, both individually and as a mixture, with increased daily total, cardiovascular, and respiratory mortality. Our findings underscore the need for comprehensive air pollution mitigation policies, including stringent controls on BTEX emissions, to protect public health. Funding:Noncommunicable Chronic Diseases-National Science and Technology Major Project, National Natural Science Foundation of China, Shanghai Municipal Science and Technology Major Project, Shanghai B&R Joint Laboratory Project, and Shanghai International Science and Technology Partnership Project.

Hỗ trợ tâm lý xã hội ngày càng được xem là yếu tố quan trọng góp phần vào cải thiện sức khỏe tinh thần, chất lượng cuộc sống và các kết cuộc điều trị ở bệnh nhân ung thư nói chung. Tuy nhiên, các nghiên cứu tìm hiểu về nhu cầu hỗ trợ xã hội của bệnh nhân ung thư tại Việt Nam vẫn còn nhiều hạn chế. Nghiên cứu này được thực hiện nhằm xác định nhu cầu hỗ trợ tâm lý xã hội và các yếu tố dự báo liên quan đến nhu cầu này ở bệnh nhân ung thư điều trị tại Bệnh viện Ung Bướu TPHCM. Nghiên cứu cắt ngang được thực hiện trên 370 bệnh nhân ung thư từ đủ 18 tuổi trở lên đang điều trị tại Bệnh viện ung bướu TPHCM từ tháng 06 đến tháng 10 năm 2022. Sử dụng bộ câu hỏi có cấu trúc được soạn sẵn gồm đặc tính về nhân khẩu học, đặc điểm về tình trạng bệnh và thang đo kết cuộc là thang đo nhu cầu hỗ trợ tâm lý xã hội PNI (Psychosocial Need Inventory). Kết quả từ mô hình đa biến cho thấy các yếu tố liên quan đến nhu cầu hỗ trợ tâm lý xã hội gồm giới, học vấn, hôn nhân, bệnh kèm theo, con dưới 18 tuổi và hình thức điều trị có thể cho thấy nhóm đối tượng nào có điểm nhu cầu hỗ trợ tâm lý xã hội cao với phương trình hồi quy tuyến tính đa biến y = 3.13 +0.25*giới + 0.13*học vấn + 0.16*hôn nhân + 0,20*bệnh kèm theo + 0.12*con dưới 18 tuổi + 0.12*hình thức điều trị. Trong đó, điểm nhu cầu cao nhất được dự đoán cho bệnh nhân nữ, học vấn cấp 3 trở lên, có tình trạng hôn nhân là góa hoặc ly thân, có từ hai con <18 tuổi cần chăm sóc, có bệnh mạn tính kèm theo và điều trị nội trú. Các điểm số nhu cầu thay đổi tùy thuộc vào từng đặc tính nền của từng bệnh nhân. Tuy nhiên, điều này vẫn cho thấy, nhìn chung trên toàn thể các bệnh nhân ung thư trong mẫu, nhu cầu hỗ trợ tâm lý xã hội tổng quát là cao, trong đó việc hỗ trợ cho bệnh nhân có thể được gợi ý nhiều hơn ở một số đối tượng có đặc tính khác nhau.

Objective: To examine the associations between characteristics of daily rainfall (intensity, duration, and frequency) and all cause, cardiovascular, and respiratory mortality. Design: Two stage time series analysis. Setting: 645 locations across 34 countries or regions. Population: Daily mortality data, comprising a total of 109 954 744 all cause, 31 164 161 cardiovascular, and 11 817 278 respiratory deaths from 1980 to 2020. Main outcome measure: Association between daily mortality and rainfall events with return periods (the expected average time between occurrences of an extreme event of a certain magnitude) of one year, two years, and five years, with a 14 day lag period. A continuous relative intensity index was used to generate intensity-response curves to estimate mortality risks at a global scale. Results: During the study period, a total of 50 913 rainfall events with a one year return period, 8362 events with a two year return period, and 3301 events with a five year return period were identified. A day of extreme rainfall with a five year return period was significantly associated with increased daily all cause, cardiovascular, and respiratory mortality, with cumulative relative risks across 0-14 lag days of 1.08 (95% confidence interval 1.05 to 1.11), 1.05 (1.02 to 1.08), and 1.29 (1.19 to 1.39), respectively. Rainfall events with a two year return period were associated with respiratory mortality only, whereas no significant associations were found for events with a one year return period. Non-linear analysis revealed protective effects (relative risk <1) with moderate-heavy rainfall events, shifting to adverse effects (relative risk >1) with extreme intensities. Additionally, mortality risks from extreme rainfall events appeared to be modified by climate type, baseline variability in rainfall, and vegetation coverage, whereas the moderating effects of population density and income level were not significant. Locations with lower variability of baseline rainfall or scarce vegetation coverage showed higher risks. Conclusion: Daily rainfall intensity is associated with varying health effects, with extreme events linked to an increasing relative risk for all cause, cardiovascular, and respiratory mortality. The observed associations varied with local climate and urban infrastructure.

Research capacity is increasing in low- and middle-income countries (LMICs), with progressive development in the range and complexity of studies being undertaken, often in collaboration with high-income country partners. Although senior local stakeholders are typically involved in ensuring that research is conducted according to accepted standards for ethical and scientific quality, to date there has been little exploration of the views of younger generations around the ethics of research involving human subjects. We present our protocol to establish a longitudinal mixed-methods student cohort at the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam, that is investigating students' views around the ethics of clinical and public-health oriented research. We use a synergistic approach involving initial deliberative engagement activities ( e.g. science cafes, debates) to inform participants about complex concepts, prior to formal quantitative and qualitative methods (surveys, focus group discussions and in-depth interviews) that are designed to explore the students' views in detail. We focus in particular on dengue research, i.e. research that addresses a locally relevant disease with which the students are likely familiar, and probe their thoughts on such themes as appropriate remuneration for research participants, involvement of vulnerable groups, use of human challenge trials in LMICs etc. A snapshot of the cohort and its activities after one year is also presented; among 429 active students, primarily from the Faculty of Medicine, the proportions of male and female students were similar, the majority were from southern or central Vietnam where dengue is endemic, and available data indicates the cohort to be representative of the expected spectrum of socioeconomic groups. The cohort provides a unique resource to investigate the views of young people on medical ethics, an important but hitherto underrepresented group in such discussions. Feedback indicates a clear interest in contributing thoughts and ideas to the development of clinical research in Vietnam.

Background: Heterogeneity in temperature-mortality relationships across locations may partly result from differences in the demographic structure of populations and their cause-specific vulnerabilities. Here we conduct the largest epidemiological study to date on the association between ambient temperature and mortality by age and cause using data from 532 cities in 33 countries. Methods: We collected daily temperature and mortality data from each country. Mortality data was provided as daily death counts within age groups from all, cardiovascular, respiratory, or noncardiorespiratory causes. We first fit quasi-Poisson regression models to estimate location-specific associations for each age-by-cause group. For each cause, we then pooled location-specific results in a dose-response multivariate meta-regression model that enabled us to estimate overall temperature-mortality curves at any age. The age analysis was limited to adults. Results: We observed high temperature effects on mortality from both cardiovascular and respiratory causes compared to noncardiorespiratory causes, with the highest cold-related risks from cardiovascular causes and the highest heat-related risks from respiratory causes. Risks generally increased with age, a pattern most consistent for cold and for nonrespiratory causes. For every cause group, risks at both temperature extremes were strongest at the oldest age (age 85 years). Excess mortality fractions were highest for cold at the oldest ages. Conclusions: There is a differential pattern of risk associated with heat and cold by cause and age; cardiorespiratory causes show stronger effects than noncardiorespiratory causes, and older adults have higher risks than younger adults.