Adverse childhood experiences and the health of university students in eight provinces of Vietnam

Recent systematic reviews have emphasized the need for more research into the health and social impacts of adverse childhood experiences (ACEs) in the Asia-Pacific region. This cross-sectional study was conducted with 2099 young adult students in 8 medical universities throughout Vietnam. An anonymous, self-report questionnaire included the World Health Organization ACE-International Questionnaire and standardized measures of mental and physical health. Three quarters (76%) of the students reported at least one exposure to ACEs; 21% had 4 or more ACEs. The most commonly reported adversities were emotional abuse, physical abuse, and witnessing a household member being treated violently (42.3%, 39.9%, and 34.6%, respectively). Co-occurrence of ACEs had dose–response relationships with poor mental health, suicidal ideation, and low physical health–related quality of life. This first multisite study of ACEs among Vietnamese university students provided evidence that childhood adversity is common and is significantly linked with impaired health and well-being into the early adult years

Environmental health risk assessment of dioxin in foods at the two most severe dioxin hot spots in Vietnam

Background Bien Hoa and Da Nang airbases were bulk storages for Agent Orange during the Vietnam War and currently are the two most severe dioxin hot spots. Objectives This study assesses the health risk of exposure to dioxin through foods for local residents living in seven wards surrounding these airbases. Methods This study follows the Australian Environmental Health Risk Assessment Framework to assess the health risk of exposure to dioxin in foods. Forty-six pooled samples of commonly consumed local foods were collected and analyzed for dioxin/furans. A food frequency and Knowledge–Attitude–Practice survey was also undertaken at 1000 local households, various stakeholders were involved and related publications were reviewed. Results Total dioxin/furan concentrations in samples of local “high-risk” foods (e.g. free range chicken meat and eggs, ducks, freshwater fish, snail and beef) ranged from 3.8 pg TEQ/g to 95 pg TEQ/g, while in “low-risk” foods (e.g. caged chicken meat and eggs, seafoods, pork, leafy vegetables, fruits, and rice) concentrations ranged from 0.03 pg TEQ/g to 6.1 pg TEQ/g. Estimated daily intake of dioxin if people who did not consume local high risk foods ranged from 3.2 pg TEQ/kg bw/day to 6.2 pg TEQ/kg bw/day (Bien Hoa) and from 1.2 pg TEQ/kg bw/day to 4.3 pg TEQ/kg bw/day (Da Nang). Consumption of local high risk foods resulted in extremely high dioxin daily intakes (60.4–102.8 pg TEQ/kg bw/day in Bien Hoa; 27.0–148.0 pg TEQ/kg bw/day in Da Nang). Conclusions Consumption of local “high-risk” foods increases dioxin daily intakes far above the WHO recommended TDI (1–4 pg TEQ/kg bw/day). Practicing appropriate preventive measures is necessary to significantly reduce exposure and health risk.

Dioxin risk reduction programme at the most severe dioxin hot spot in Vietnam: Residual knowledge, attitude and practices five years post intervention

Bien Hoa Airbase was one of the bulk storage and supply facilities for defoliants during the Vietnam War. Environmental and biological samples taken around the airbase have elevated levels of dioxin. In 2007, a pre-intervention knowledge, attitude and practice (KAP) survey of local residents living in Trung Dung and Tan Phong wards was undertaken regarding appropriate strategies to reduce dioxin exposure. A risk reduction programme was implemented in 2008 and post-intervention KAP surveys were undertaken in 2009 and 2013 to evaluate the longer term impacts. Quantitative assessment was undertaken via a KAP survey in 2013 among 600 local residents randomly selected from the two intervention wards and one control ward (Buu Long). Eight in-depth interviews and two focus group discussions were also undertaken for qualitative assessment. Most programme activities had ceased and dioxin risk communication activities had not been integrated into local routine health education programmes; however, main results generally remained and were better than that in Buu Long. In total, 48.2% of households undertook measures to prevent exposure, higher than those in pre- and post-intervention surveys (25.8% and 39.7%) and the control ward (7.7%). Migration and the sensitive nature of dioxin issues were the main challenges for the programme's sustainability

Relationship between malnutrition and selected risk factors in two hospitals in Vietnam

Aim: The purpose of this study was to determine the percentage of patients assessed as malnourished using the Subjective Global Assessment in two hospitals in Ho Chi Minh City and Can Tho across multiple wards; and to investigate the association with factors including gender, age, days since admission, medical diagnosis and number of medications used. Methods: This cross-sectional study involved 205 inpatients from a hospital in Ho Chi Minh City and 78 inpatients and 89 outpatients from a hospital in Can Tho. Malnutrition status was assessed using Subjective Global Assessment. Ward, gender, age, medical diagnosis, time since admission and medication number were extracted from medical records. Results: 35.6% of inpatients and 9.0% of outpatients were malnourished. Multivariate analysis revealed factors predicting malnutrition status within inpatients (OR (95%CI)) were: age (OR = 1.03 (1.01-1.06)); cancer diagnosis (OR = 34.25 (3.16-370.89)); respiratory ward (11.49 (1.05-125.92)); or general medicine ward (20.34 (2.10-196.88)). Conclusions: Results indicate that malnutrition is a common problem in hospitals in Vietnam. Further research is needed to confirm this finding across a wider range of hospitals and to investigate the feasibility and efficacy of implementation of nutrition interventions in hospital settings.

Developing improved supply chains for temperate fruits in transitional Asian economies of Thailand and Vietnam.

Asia's increasing demand for both tropical and temperate fruit is projected to grow significantly. Compared with most developed countries, the production of temperate fruits (peach, nectarine, plum and apple) has expanded rapidly in China over the past 20 years. In contrast, current production of plums and peaches in neighbouring countries (Thailand and Vietnam) is very low but their fruit enters the market earlier. Thailand and Vietnam have enormous potential to satisfy a market window in the northern hemisphere period from March to May inclusive when there is little or no stone fruit on the Asian market. In Vietnam, fruit is harvested in an immature state to avoid disease and fruit fly problems and consequently lacks size and flavour. Approximately 30-40% of locally produced fruit in Vietnam does not reach market due to disease and poor handling during picking and transport. In Thailand, much of the infrastructure needed to transport, store, process and market temperate fruits successfully are now in place. However, there are currently no cool chain management or quality assurance systems to ensure a fresh product reaches the consumer with minimal deterioration. In Vietnam, growing stone fruit under the traditional system with little or minimal inputs, the farmer may receive between AUD3,000-5,000 per ha. In comparison, under higher input systems incorporating fertiliser, irrigation and pest and disease management, net returns can be increased seven-fold. Strengths and weaknesses of the current supply chains in these two countries are discussed.

Motivation or demotivation of health workers providing maternal health services in rural areas in Vietnam: findings from a mixed-methods study

Background Motivation is an important driver for health professionals to maintain professional competencies, continue in a workforce and contribute to work tasks. While there is some research about motivation in health workers in low to middle income countries, maternal morbidity and mortality remains high in many low and middle income countries and this can be improved by improving the quality of maternal services and the training and skills maintenance of maternal health workers. This study examines the impact of motivation on maintenance of professional competence among maternal health workers in Vietnam using mixed methods. Methods The study consisted of a survey using a self-administered questionnaire of 240 health workers in 5 districts across two Vietnamese provinces and in-depth interviews with 43 health workers and health managers at the commune, district and provincial level to explore external factors that influenced motivation. The questionnaire includes a 23 item motivation instrument based on Kenyan health context, modified for Vietnamese language and culture. Results The 240 responses represented an estimated 95% of the target sample. Multivariate analysis showed that three factors contributed to the motivation of health workers: access to training (β = -0.14, p=0.03), ability to perform key tasks (β = 0.22, p=0.001), and shift schedule (β = -0.13, p=0.05). Motivation was higher in health workers self-identifying as competent or enabled to provide more care activities. Motivation was lower in those who worked more frequent night shifts and those who had received training in the last 12 months. The interviews identified that the latter was because they felt the training was irrelevant to them, and in some cases, they do not have opportunity to practice their learnt skills. The qualitative data also showed other factors relating to service context and organisational management practices contributed to motivation. Conclusions The study demonstrates the importance of understanding the motivations of health workers and the factors that contribute to this and may contribute to more effective management of the health workforce in low and middle income countries.

Tree-ring based hydroclimate reconstruction over northern Vietnam from Fokienia hodginsii: eighteenth century mega-drought and tropical Pacific influence

We present here the first statistically calibrated and verified tree-ring reconstruction of climate from continental Southeast Asia.The reconstructed variable is March-May (MAM) Palmer Drought Severity Index (PDSI) based on ring widths from 22 trees (42 radial cores) of rare and long-lived conifer, Fokienia hodginsii (Po Mu as locally called) from northern Vietnam. This is the first published tree ring chronology from Vietnam as well as the first for this species. Spanning 535 years, this is the longest cross-dated tree-ring series yet produced from continental Southeast Asia. Response analysis revealed that the annual growth of Fokienia at this site was mostly governed by soil moisture in the pre-monsoon season. The reconstruction passed the calibration-verification tests commonly used in dendroclimatology, and revealed two prominent periods of drought in the mid-eighteenth and late-nineteenth enturies. The former lasted nearly 30 years and was concurrent with a similar drought over northwestern Thailand inferred from teak rings, suggesting a ``mega-drought'' extending across Indochina in the eighteenth century. Both of our reconstructed droughts are consistent with the periods of warm sea surface temperature (SST)anomalies in the tropical Pacific. Spatial correlation analyses with global SST indicated that ENSO-like anomalies might play a role in modulating droughts over the region, with El Nio (warm) phases resulting in reduced rainfall. However, significant correlation was also seen with SST over the Indian Ocean and the north Pacific,suggesting that ENSO is not the only factor affecting the climate of the area. Spectral analyses revealed significant peaks in the range of 53.9-78.8 years as well as in the ENSO-variability range of 2.0 to 3.2 years.

Healthy plantations. A field guide to pests and pathogens of Acacia, Eucalyptus and Pinus in Vietnam.

This book is a resource for those involved ‘on-the-ground’ with growing plantation trees in Vietnam, identifying the pests and diseases found on them, and managing the impacts of these organisms. The book, supported by AusAID’s Vietnam CARD (Cooperation for Agricultural and Rural Development) Program, and draws on the collective, long-standing experience of forest health scientists in Vietnam, Australia and South Africa. The book provides illustrations and information on 23 pests and 25 diseases of Acacia, Eucalyptus and Pinus for Vietnam; four of these species are important biosecurity threats not yet present in Vietnam.

Lobster aquaculture development in Indonesia, Vietnam and Australia

This project will support the sustainable development of lobster farming in Indonesia to meet global demand for tropical lobsters at high prices (>$US60 /kg). It will also address sustainability issues for the lobster farming industry in Vietnam and provide verification of lobster growout at commercial scale in Australia. The project will adapt technologies developed in Vietnam and apply them in Indonesia to establish a village-based industry for impoverished coastal communities. The Australian component will assess land-based growout systems to prepare for the likely availability of hatchery-reared lobster seed. Hatchery technology is currently being commercialised in Queensland through a partnership between DEEDI and Lobster Harvest Pty Ltd.

Spiny lobster aquaculture development in eastern Indonesia, Vietnam and Australia

The project was successful across all objectives, making demonstrable progress in support of establishing tropical lobster farming in Indonesia. The industry remains most active in Lombok where lobster seed resources are most abundant, and impact has been greatest there. Nevertheless, project activities have established activity and interest in lobster farming in other provinces and particularly Aceh and, South and Southeast Sulawesi. The project met all of its 23 milestones with the exception of publishing a production manual, which has been held over until 2017. For several milestone activities, further research will be required to build on the outcomes generated and reach practical commercial outputs. The research was instigated to address the opportunity to establish a significant small-holder based industry in Indonesia that could alleviate poverty in coastal communities. The premise was that such an industry – lobster farming, had been established in Vietnam, with ACIAR involvement, and it could be replicated in Indonesia where the availability of necessary basic requirements had been confirmed through a previous ACIAR project focussed in Vietnam (FIS/2001/058). The broad aim was to assess, develop and expand the resources of naturally settling lobster seed (puerulus), and develop grow out of those seed to meet export market demand. This was to be achieved by adapting and transferring to Indonesia technology from Vietnam, where lobster farming had become a successful industry producing 1,500 tonnes of export quality lobsters valued at $A100 million.

Promoting innovation and development by rethinking the role of copyright limitations and exceptions in Vietnam

This thesis examines how Vietnamese copyright law should develop to promote innovation and development in the digital age. It focuses on the important role of limitations and exceptions to copyright in encouraging access to and reuse of copyright material. This research provide important recommendations for how the scope of copyright limitations and exceptions might be expanded by adopting fair use in order to embrace new opportunities provided by the digital economy. Furthermore, it suggests that Vietnam should extend the scope of some important provisions that provide privileges for education, libraries and people with disabilities.

Estimates of genetic parameters for growth and wood properties in Eucalyptus pellita F. Muell. to support tree breeding in Vietnam

Key message Eucalyptus pellita demonstrated good growth and wood quality traits in this study, with young plantation grown timber being suitable for both solid and pulp wood products. All traits examined were under moderate levels of genetic control with little genotype by environment interaction when grown on two contrasting sites in Vietnam. Context Eucalyptus pellita currently has a significant role in reforestation in the tropics. Research to support expanded of use of this species is needed: particularly, research to better understand the genetic control of key traits will facilitate the development of genetically improved planting stock. Aims This study aimed to provide estimates of the heritability of diameter at breast height over bark, wood basic density, Kraft pulp yield, modulus of elasticity and microfibril angle, and the genetic correlations among these traits, and understand the importance of genotype by environment interactions in Vietnam. Methods Data for diameter and wood properties were collected from two 10-year-old, open-pollinated progeny trials of E. pellita in Vietnam that evaluated 104 families from six native range and three orchard sources. Wood properties were estimated from wood samples using near-infrared (NIR) spectroscopy. Data were analysed using mixed linear models to estimate genetic parameters (heritability, proportion of variance between seed sources and genetic correlations). Results Variation among the nine sources was small compared to additive variance. Narrow-sense heritability and genetic correlation estimates indicated that simultaneous improvements in most traits could be achieved from selection among and within families as the genetic correlations among traits were either favourable or close to zero. Type B genetic correlations approached one for all traits suggesting that genotype by environment interactions were of little importance. These results support a breeding strategy utilizing a single breeding population advanced by selecting the best individuals across all seed sources. Conclusion Both growth and wood properties have been evaluated. Multi-trait selection for growth and wood property traits will lead to more productive populations of E. pellita both with improved productivity and improved timber and pulp properties.

Understandings of higher education curriculum in Vietnam

The Vietnamese higher education context is characterised by state control including the state’s development of curriculum frameworks and materials. Institutional autonomy has been ratified by the government, however, in practice universities seem to have little control over curriculum. In order for universities to develop more ownership of curriculum, it is necessary to explore the foundational understandings of curriculum held by stakeholders. Thus, this paper explores the understandings of curriculum expressed by a group of senior staff, academics and students at a Vietnamese university. We found a diversity of understandings that tended to be product-focused, teacher-focused and textbook-driven. We propose that our findings can be used as a starting point for developing more innovative and student-focused understandings of curriculum.

A pilot education on heart failure self-management and introduction of the teach-back method to cardiac nurses in Vietnam

It is recognised that patients with chronic disease are unable to remembercorrectly information provided by health care profesionals. The teach-back method is acknowledgedas a technique to improve patients’ understanding. Yet it is not used in nursing practice in Vietnam. Objectives This study sought to examine knowledge background of heart failure among cardiac nurses, introduce a education about heart failure self-management and the teach-back method to assist teaching patients on self-care. The study also wanted to explore if a short education could benefit nurses’ knowledge so they would be qualified to deliver education to patients. Methods A pre/post-test design was employed. Cardiac nurses from 3 hospitals (Vietnam National Heart Institute, E Hospital, Huu Nghi Hospital) were invited to attend a six-hour educational session which covered both the teach-back method and heart failure self-management. Role-play with scenarios were used to reinforce educational contents. The Dutch Heart Failure Knowledge Scale was used to assess nurses’ knowledge of heart failure at baseline and after the educational session. Results 20 nurses from3 selected hospitals participated. Average age was 34.5±7.9 years and years of nursing experience was 11.6±8.3. Heart failure knowledge score at the baseline was 12.7±1.2 and post education was 13.8±1.0. There was deficiency of nurses knowledge regarding fluid restriction among heart failure people, causes of worsening heart failure. Heart failure knowledge improved significantly following the workshop (p < 0.001). All nurses achieved an overall adequate knowledge score (≥11 of the maximum 15) at the end. 100% of nurses agreed that the teach-back method was effective and could be used to educate patients about heart failure self-management. Conclusions The results of this study have shown the effectiveness of the piloteducaiton in increasing nurses’ knowledge of heart failure. The teach-back method is accepted for Vietnamese nurses to use in routine cardiac practice.