A fully automated self-help biopsychosocial transdiagnostic digital intervention to reduce anxiety and/or depression and improve emotional regulation and well-being: pre-follow-up single-arm feasibility trial
- Authors: Klein, Britt , Nguyen, Huy , McLaren, Suzanne , Andrews, Brooke , Shandley, Kerrie
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Formative Research Vol. 7, no. (2023), p.
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- Description: Background: Anxiety disorders and depression are prevalent disorders with high comorbidity, leading to greater chronicity and severity of symptoms. Given the accessibility to treatment issues, more evaluation is needed to assess the potential benefits of fully automated self-help transdiagnostic digital interventions. Innovating beyond the current transdiagnostic one-size-fits-all shared mechanistic approach may also lead to further improvements. Objective: The primary objective of this study was to explore the preliminary effectiveness and acceptability of a new fully automated self-help biopsychosocial transdiagnostic digital intervention (Life Flex) aimed at treating anxiety and/or depression, as well as improving emotional regulation; emotional, social, and psychological well-being; optimism; and health-related quality of life. Methods: This was a real-world pre-during-post-follow-up feasibility trial design evaluation of Life Flex. Participants were assessed at the preintervention time point (week 0), during intervention (weeks 3 and 5), at the postintervention time point (week 8), and at 1- and 3-month follow-ups (weeks 12 and 20, respectively). Results: The results provided early support for the Life Flex program in reducing anxiety (Generalized Anxiety Disorder 7), depression (Patient Health Questionnaire 9), psychological distress (Kessler 6), and emotional dysregulation (Difficulties in Emotional Regulation 36) and increasing emotional, social, and psychological well-being (Mental Health Continuum-Short Form); optimism (Revised Life Orientation Test); and health-related quality of life (EQ-5D-3L Utility Index and Health Rating; all false discovery rate [FDR] < .001). Large within-group treatment effect sizes (range |d|=0.82 to 1.33) were found for most variables from pre- to postintervention assessments and at the 1- and 3-month follow-up. The exceptions were medium treatment effect sizes for EQ-5D-3L Utility Index (range Cohen d=
A robust ensemble regression model for reconstructing genetic networks
- Authors: Gamage, Hasini , Chetty, Madhu , Lim, Suryani , Hallinan, Jennifer , Nguyen, Huy
- Date: 2023
- Type: Text , Conference paper
- Relation: 2023 International Joint Conference on Neural Networks, IJCNN 2023 Vol. 2023-June
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- Description: Genetic networks contain important information about biological processes, including regulatory relationships and gene-gene interactions. Numerous methods, using high-dimensional gene expression data have been developed to capture these interactions. These gene expression data, generated using high-throughput technologies, are prone to noise. However, most existing network inference methods are unable to cope with noisy data, making genetic network reconstruction challenging. In this paper, we propose a novel ensemble regression model combining quantile regression and cross-validated Ridge regression, RidgeCV, to infer interactions from noisy gene expression data. The application of quantile regression to GRN inference is novel, and its design makes it appropriate for noisy data. RidgeCV also addresses other important issues, such as data overfitting and multicollinearity. First, each regression method is independently applied to gene expression data and the output of these methods, in the form of ranked gene lists, is aggregated using a novel gene score-based method by considering the gene rank and model importance. The model importance score is evaluated based on an adjusted coefficient of determination. This method implicitly includes majority voting by averaging each gene score value across all models. The proposed model was tested on the DREAM4 datasets and publicly available small-scale real-world network datasets. Experiments with noisy datasets showed that the proposed ensemble model is more accurate and efficient than other state-of-the-art methods. © 2023 IEEE.
Efficacy of a digital mental health biopsychosocial transdiagnostic intervention with or without therapist assistance for adults with anxiety and depression : adaptive randomized controlled trial
- Authors: Andrews, Brooke , Klein, Britt , Nguyen, Huy , Corboy, Denise , McLaren, Suzanne , Watson, Shaun
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 25, no. (2023), p.
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- Description: Background: Digital mental health (DMH) interventions incorporating elements that adapt to the evolving needs of consumers have the potential to further our understanding of the optimal intensity of therapist assistance and inform stepped-care models. Objective: The primary objective was to compare the efficacy of a transdiagnostic biopsychosocial DMH program, with or without therapist assistance for adults with subthreshold symptoms or a diagnosis of anxiety or depression. Methods: In a randomized adaptive clinical trial design, all participants had access to the DMH program, with eligibility to have their program augmented with therapist assistance determined by program engagement or symptom severity. Participants who met stepped-care criteria were randomized to have their treatment program augmented with either low-intensity (10 min/week of video chat support for 7 weeks) or high-intensity (50 min/week of video chat support for 7 weeks) therapist assistance. A total of 103 participants (mean age 34.17, SD 10.50 years) were assessed before (week 0), during (weeks 3 and 6), and after the intervention (week 9) and at the 3-month follow-up (week 21). The effects of 3 treatment conditions (DMH program only, DMH program+low-intensity therapist assistance, and DMH program+high-intensity therapist assistance) on changes in the 2 primary outcomes of anxiety (7-item Generalized Anxiety Disorder Scale [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were assessed using the Cohen d, reliable change index, and mixed-effects linear regression analyses. Results: There were no substantial differences in the outcome measures among intervention conditions. However, there were significant time effect changes in most outcomes over time. All 3 intervention conditions demonstrated strong and significant treatment effect changes in GAD-7 and PHQ-9 scores, with absolute Cohen d values ranging from 0.82 to 1.79 (all P<.05). The mixed-effects models revealed that, in the Life Flex program–only condition at week 3, mean GAD-7 and PHQ-9 scores significantly decreased from baseline by 3.54 and 4.38 (all P<.001), respectively. At weeks 6, 9, and 21, GAD-7 and PHQ-9 scores significantly decreased from baseline by at least 6 and 7 points (all P<.001), respectively. Nonresponders at week 3 who were stepped up to therapist assistance increased program engagement and treatment response. At the postintervention time point and 3-month follow-up, 67% (44/65) and 69% (34/49) of the participants, respectively, no longer met diagnostic criteria for anxiety or depression. Conclusions: The findings highlight that early detection of low engagement and non–treatment response presents an opportunity to effectively intervene by incorporating an adaptive design. Although the study findings indicate that therapist assistance was no more effective than the DMH intervention program alone for reducing symptoms of anxiety or depression, the data highlight the potential influence of participant selection bias and participant preferences within stepped-care treatment models. ©Brooke Andrews, Britt Klein, Huy Van Nguyen, Denise Corboy, Suzanne McLaren, Shaun Watson.
Exploration of the preliminary effectiveness and acceptability of a self-help digital intervention to support benzodiazepine cessation and improve mental health and wellbeing : a one-group pilot trial
- Authors: Klein, Britt , Oldenhof, Erin , Nguyen, Huy , Schattner, Peter , Shandley, Kerrie
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Behavioral and Cognitive Therapy Vol. 33, no. 3 (2023), p. 179-193
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- Description: Introduction: Benzodiazepines (BDZs) are often inappropriately prescribed to manage anxiety and insomnia for longer-term use, despite guidelines recommending short-term use (i.e., <4 weeks). A range of harms can occur rapidly with regular use, and dependence can make stopping BDZs challenging. Evidence shows that a combination of BDZ tapering and psychological support are effective interventions, yet are not widely accessible. Methods: This was a one-group pilot trial of a 6-week fully automated self-help BDZ digital intervention (‘BDZ digital health’), providing guidance on how to safely taper BDZs as well as psychological support. The trial was undertaken with Australian adults considering a reduction and/or withdrawal from their BDZ (N = 43). Participants were assessed at pre-intervention (Week 0), during intervention (Week 3), post-intervention (Week 6), and at a 3- and 6-month follow-up (Week 18 and 30 respectively). Results: Reductions in BDZ use and self-reported dependency were observed over the course of the intervention. Significant symptom reductions in anxiety, insomnia, depression, psychological distress, and emotional dysregulation, as well as improvements in mental wellbeing and quality of life were observed when looking across all timepoints. However, the specific assessment timepoint changes for depression and psychological distress did not reach significance from the pre- to post-intervention timepoint. The intervention acceptability ratings were in the moderately high to high range. Discussion: The preliminary results of the pilot trial suggest that BDZ digital health is an acceptable and promising self-help digital intervention to assist adults reducing and withdrawing from their BDZs, and to improve their mental health and wellbeing. Trial registration: ACTRN12617000574347 (24/04/2017). © 2023 Association Française de Therapie Comportementale et Cognitive
Gambling-related suicide in Victoria, Australia : a population-based cross-sectional study
- Authors: Rintoul, Angela , Dwyer, Jeremy , Millar, Ciara , Bugeja, Lyndal , Nguyen, Huy
- Date: 2023
- Type: Text , Journal article
- Relation: The Lancet Regional Health - Western Pacific Vol. 41, no. (2023), p.
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- Description: Background: Gambling is associated with serious harms to health, including suicide. Yet public health systems for recording the role of gambling in suicide deaths are relatively underdeveloped. This study contributes to the understanding of this relationship. Methods: A population-based cross-sectional study of suicides reported to the Coroners Court of Victoria between 2009 and 2016 was performed to identify the incidence and characteristics of gambling-related suicides (GRS). Findings: From 2009 to 2016 there were 4788 suicide deaths in Victoria. Of these, 184 were identified as direct GRS and a further 17 were GRS by ‘affected others’. Together, these GRS comprise 4.2% of all suicides in Victoria over this eight-year period. Direct GRS account for an annual average rate of 5.13 GRS per million Victorian adults. GRS were significantly more likely to be male (n = 153, 83%), than the Victorian population of total suicide deaths and significantly more likely to occur among those most disadvantaged. Family members and friends were more likely than clinicians to know about the deceased gambling. Interpretation: Given that gambling is not routinely investigated by coroners and may be hidden from family, friends, and health professionals, this is an underestimate of the true scale of the GRS in Victoria. A range of measures should be introduced to prevent, screen, support, and treat gambling harm. Family members and friends should also be provided with help services. Preventing gambling-related harm through public health measures could significantly reduce suicidality and suicide, both in Australia and globally. Funding: Federation University Australia, Coroners Court of Victoria, Suicide Prevention Australia. © 2023 The Authors
Pairwise approach for analysis and reporting of child's free sugars intake from a birth cohort study
- Authors: Nguyen, Huy , Ha, Diep , Dao, An , Golley, Rebecca , Scott, Jane , Spencer, John , Bell, Lucinda , Devenish-Coleman, Gemma , Do, Loc
- Date: 2023
- Type: Text , Journal article
- Relation: Community Dentistry and Oral Epidemiology Vol. 51, no. 5 (2023), p. 820-828
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- Description: Objectives: The prospective cohort design is an important research design, but a common challenge is missing data. The purpose of this study is to compare three approaches to managing missing data, the pairwise (n = 1386 children), the partial or modified pairwise (n = 1019) and the listwise (n = 546), to characterize the trajectories of children's free sugars intake (FSI) across early childhood. Methods: By applying the Group-based Trajectory Model Technique to three waves of data collected from a prospective cohort study of South Australian children, this study examined the three approaches in managing missing data to validate and discuss children's FSI trajectories. Results: Each approach identified three distinct trajectories of child's FSI from 1 to 5 years of age: (1) ‘low and fast increasing’, (2) ‘moderate and increasing’ and (3) ‘high and increasing’. The trajectory memberships were consistent across the three approaches, and were for the pairwise scenario (1) 15.1%, (2) 68.3% and (3) 16.6%; the partial or modified pairwise (1) 15.9%, (2) 64.1% and (3) 20.0%; and the listwise (1) 14.9%, (2) 64.9% and (3) 20.2% of children. Conclusions: Given the comparability of the findings across the analytical approaches and the samples' characteristics between baseline and across different data collection waves, it is recommended that the pairwise approach be used in future analyses to optimize the sample size and statistical power when examining the relationship between FSI in the first years of life and health outcome such as dental caries. © 2022 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.
Suicidality among older Australian adults
- Authors: Klein, Britt , Shandley, Kerrie , McLaren, Suzanne , Clinnick, Lisa , Nguyen, Huy
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 10, no. (2023), p.
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- Description: Background: Vulnerability to suicidality is a concern among older adults, particularly as this proportion of the population is growing. Determining what factors contribute to suicidality will help to create a framework for understanding and assessing suicidal risk among older adults and developing effective treatments. This study examined suicidality among older Australian adults. Methods: This study forms part of a larger study to trial a survey to collect cross-sectional data on the mental and physical health of older Australian adults across time. One hundred and fourteen Australian residents aged 65 years and over completed an anonymous survey online or by returning a paper-and-pencil version of the survey by post. The survey took approximately 25 min to complete and comprised of (1) sociodemographic questions (e.g., age, gender, education), (2) validated questionnaires measuring depression, general anxiety, psychological distress, insomnia, substance dependence, problem gambling, and stress, and (3) mental and physical health and wellbeing items (e.g., religiosity, assistance with daily tasks, and mental health service usage in the last 12-months). The dependent variable, suicidality, was measured by asking participants whether they had ever seriously thought about committing suicide. Results: Associations with suicidality were analyzed using Chi-squares and independent samples t-tests. The results found suicidality to be significantly associated with lower levels of satisfaction with the frequency of seeing and/or communicating with friends, and inadequate levels of community engagement. Conclusion: The results of this survey reinforce the importance of social connectedness as a central and significant protective factor against suicidality among older adults. Copyright © 2023 Klein, Shandley, McLaren, Clinnick and Nguyen.
The impact of progressive overload on the proportion and frequency of positive cardio-respiratory fitness responders
- Authors: Bell, Leo , McNicol, Ashleigh , McNeil, Elizabeth , Nguyen, Huy , Hunter, Jayden , O'Brien, Brendan
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 26, no. 10 (2023), p. 561-563
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- Description: The proportion of individuals whose cardio-respiratory fitness change after endurance training does not exceed the test's measurement error can be 40 %. We determined if progressively increasing treadmill run intensity compared to maintaining the same run intensity, improved the responder proportion to a 6-week 20-minute treadmill training regimen. The intervention response standard deviation method estimated the proportion of responders attributable to progressively increasing run intensity. The mixed-effects model demonstrated V̇O2 peak improved significantly more in the progressive versus constant run intensity group. The proportion of V̇O2 peak responses above the smallest worthwhile change attributable to progressively increasing run intensity was 63.6 %. © 2023 The Author(s)
Trajectories of child free sugars intake and dental caries - a population-based birth cohort study
- Authors: Ha, Diep , Nguyen, Huy , Bell, Lucinda , Devenish-Coleman, Gemma , Golley, Rebecca , Thomson, W. , Manton, David , Leary, Sam , Scott, Jane , Spencer, John , Do, Loc
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Dentistry Vol. 134, no. (2023), p.
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- Description: Objectives: To investigate the association between trajectories of free sugars intake during the first five years of life and dental caries experience at five years. Methods: Data from the SMILE population-based prospective birth cohort study, collected at one, two and five years old, were used. A 3-days dietary diary and food frequency questionnaire were used to estimate free sugars intake (FSI) in grams. The primary outcomes were dental caries prevalence and experience (dmfs). The Group-Based Trajectory Modelling method was used to characterize three FSI trajectories (‘Low and increasing’; ‘Moderate and increasing’; and ‘High and increasing’), which were the main exposures. Multivariable regression models were generated to compute adjusted prevalence ratios (APR) and rate ratios (ARR) for the exposure, controlling for socioeconomic factors. Results: The prevalence of caries was 23.3%, with a mean dmfs of 1.4, and a median of 3.0 among those who had caries. There were clear gradients of caries prevalence and experience by the FSI trajectories. The ‘High and increasing’ had an APR of 2.13 (95%CI 1.23-3.70) and ARR of 2.77 (95%CI 1.45-5.32) against the ‘Low and increasing’. The ‘Moderate and increasing’ group had intermediate estimates. A quarter of the caries cases could have been prevented if the whole study sample had been in the ‘Low and increasing’ FSI trajectory. Conclusion: A sustained, high trajectory of FSI from a young age was positively associated with child dental caries. Measures to minimise consumption of free sugars must commence early in life. Clinical significance: The study has provided high level evidence to inform clinicians’ decisions in promoting a healthy dietary pattern for young children. © 2023
A low-cost system for monitoring pH, dissolved oxygen and algal density in continuous culture of microalgae
- Authors: Nguyen, Dung , Nguyen, Huy , Dang, Huyen , Nguyen, Viet , Nguyen, Linh
- Date: 2022
- Type: Text , Journal article
- Relation: HardwareX Vol. 12, no. (2022), p.
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- Description: In a continuous and closed system of culturing microalgae, constantly monitoring and controlling pH, dissolved oxygen (DO) and microalgal density in the cultivation environment are paramount, which ultimately influence on the growth rate and quality of the microalgae products. Apart from the pH and DO parameters, the density of microalgae can be used to contemplate what light condition in the culture chamber is or when nutrients should be supplemented, which both also decide productivity of the cultivation. Moreover, the microalgal density is considered as an indicator indicating when the microalgae can be harvested. Therefore, this work proposes a low-cost monitoring equipment that can be employed to observe pH, DO and microalgal density over time in a culture environment. The measurements obtained by the proposed monitoring device can be utilized for not only real-time observations but also controlling other sub-systems in a continuous culture model including stirring, ventilating, nutrient supplying and harvesting, which leads to more efficiency in the microalgal production. More importantly, it is proposed to utilize the off-the-shelf materials to fabricate the equipment with a total cost of about 513 EUR, which makes it practical as well as widespread. The proposed monitoring apparatus was validated in a real-world closed system of cultivating a microalgae strain of Chlorella vulgaris. The obtained results indicate that the measurement accuracies are 0.3%, 3.8% and 8.6% for pH, DO and microalgae density quantities, respectively. © 2022 The Author(s)
Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019 : results from the Global Burden of Disease Study 2019
- Authors: Kyu, Hmwe , Vongpradith, Avina , Sirota, Sarah , Novotney, Amanda , Troeger, Christopher , Doxey, Matthew , Bender, Rose , Ledesma, Jorge , Biehl, Molly , Albertson, Samuel , Frostad, Joseph , Burkart, Katrin , Bennitt, Fiona , Zhao, Jeff , Gardner, William , Hagins, Hailey , Bryazka, Dana , Dominguez, Regina , Abate, Semagn , Abdelmasseh, Michael , Abdoli, Amir , Abdoli, Gholamreza , Abedi, Aidin , Abedi, Vida , Abegaz, Tadesse , Abidi, Hassan , Aboagye, Richard , Nguyen, Huy , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: The Lancet Infectious Diseases Vol. 22, no. 11 (2022), p. 1626-1647
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- Description: Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–482.8, 483.0–483.9, 484.1–484.2, 484.6–484.7, and 487–489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4–B97.6, J09–J15.8, J16–J16.9, J20–J21.9, J91.0, P23.0–P23.4, and U04–U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age–sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age–sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. Findings: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240–275) LRI incident episodes in males and 232 million (217–248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18–1·42) male deaths and 1·20 million (1·07–1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16–1·18) and 1·31 times (95% UI 1·23–1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4–131·1]) and deaths (100·0% [83·4–115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (–70·7% [–77·2 to –61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7–61·8] in males and 56·4% [40·7–65·1] in females), and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6–35·5] for males and PAF 25·8% [16·3–35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4–25·2) in those aged 15–49 years, 30·5% (24·1–36·9) in those aged 50–69 years, and 21·9% (16·8–27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5–27·9) in those aged 15–49 years and 18·2% (12·5–24·5) in those aged 50–69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2–15·8) of LRI deaths. Interpretation: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting well eing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman and Huy Nguyen” is provided in this record**
Group-based trajectories of maternal intake of sugar-sweetened beverage and offspring oral health from a prospective birth cohort study
- Authors: Ha, Diep , Nguyen, Huy , Dao, An , Golley, Rebecca , Thomson, W. , Manton, David , Leary, Sam , Scott, Jane , Spencer, Andrew , Do, Loc
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Dentistry Vol. 122, no. (2022), p.
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- Description: Objectives: To investigate the trajectory of maternal intake of sugar-sweetened beverages (SSB) during the first five years of their child's life and its effect on the child's dental caries at five years-of-age. Methods: This is an ongoing prospective population-based birth cohort study in Adelaide, Australia. Mothers completed questionnaires on their SSB intake, socioeconomic factors and health behaviors at the birth of their child and at the ages of one, two and five years. Child dental caries measured as decayed, missing, or filled tooth surfaces was collected by oral examination. Maternal SSB intake was used to estimate the trajectory of SSB intake. The trajectories then became the main exposure of the study. Dental caries at age five years were the primary outcomes. Adjusted mean- and prevalence-ratios were estimated for dental caries, controlling for confounders. Results: 879 children had dental examinations at five years-of-age. Group-based trajectory modeling identified three trajectories of maternal SSB intake: ‘Stable low’ (40.8%), ‘Moderate but increasing’ (13.6%), and ‘High early’ trajectory (45.6%). Multivariable regression analysis found children of mothers in the ‘High early’ and ‘Moderate but increasing’ groups to have greater experience of dental caries (MR: 1.37 (95%CI 1.01–1.67), and 1.24 (95%CI 0.96–1.60) than those in the ‘Stable low’ trajectory, respectively. Conclusion: Maternal consumption of SSB during pregnancy and in the early postnatal period influenced their offspring's oral health. It is important to create a low-sugar environment from early childhood. The results suggest that health promotion activities need to be delivered to expecting women or soon after childbirth. © 2022
The COVID-19 pandemic in Australia : public health responses, opportunities and challenges
- Authors: Nguyen, Huy , Lan Nguyen, Hoa , Dao, An Thi , Van Nguyen, Tien , The Nguyen, Phuong , Le, Phuong , Vu, Kien , Tran, Anh , Dao, Phuong. , Nguyen, Cham , Debattista, Joseph
- Date: 2022
- Type: Text , Journal article
- Relation: International Journal of Health Planning and Management Vol. 37, no. 1 (2022), p. 5-13
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- Description: In responding to the COVID-19 pandemic, each country is presented with both opportunities and challenges, some unique and some shared with the global community. It is important to not only recognize, but to embrace them as drivers of the public to the current pandemic success. In this commentary, we discuss the opportunities and challenges that may affect ongoing public health programming in Australia within the current context of epidemiology. COVID-19 within Australia has to date been effectively suppressed through the implementation of nationally coordinated, in which the state delivered public policy, guidelines and practice, and successful establishment of a comprehensive testing, contact tracing, patient isolation and contact quarantine regime combined with national and state social distancing, hygiene etiquette and movement restrictions. However, despite its success to date great challenges lay ahead for future public health policy with the threat of a second wave, or more likely, multiple smaller outbreaks across various population centres. Therefore, policies that aim to balance the twin socioeconomic and health impacts are crucial. The experience of Australia in managing its COVID-19 response can provide a case study for other countries to reshape or adapt their policies and actions in the context of emerging global health crises. © 2021 John Wiley & Sons Ltd.
The global burden of cancer attributable to risk factors, 2010–19 : a systematic analysis for the Global Burden of Disease Study 2019
- Authors: Tran, Khanh , Lang, Justin , Compton, Kelly , Xu, Rixing , Acheson, Alistair , Henrikson, Hannah , Kocarnik, Jonathan , Penberthy, Louise , Aali, Amirali , Abbas, Qamar , Abbasi, Behzad , Abbasi-Kangevari, Mohsen , Abbasi-Kangevari, Zeinab , Abbastabar, Hedayat , Abdelmasseh, Michael , Abd-Elsalam, Sherief , Abdelwahab, Ahmed , Abdoli, Gholamreza , Abdulkadir, Hanan , Abedi, Aidin , Abegaz, Kedir , Abidi, Aidin , Aboagye, Richard , Abolhassani, Hassan , Absalan, Abdorrahim , Abtew, Yonas , Ali, Hiwa , Abu-Gharbieh, Eman , Nguyen, Huy , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article
- Relation: The Lancet Vol. 400, no. 10352 (2022), p. 563-591
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- Description: Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). Interpretation: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliates “Muhammad Aziz Rahman and Huy Nguyen” are provided in this record**
The relationship between team dynamics with healthcare coordination and clinical work satisfaction among Commune Health Workers: A Bayesian model averaging study
- Authors: Ngo, Tuan , Nguyen, Huy , Pham, Thanh , Nguyen, Tien , Vu, Kien , Pham, Minh , Phung, Dung , Thi Tran, Anh , Nguyen, Phuong , Le, Phuong , Thi Dao, An , Ngo, Hiep , Hoang, Minh
- Date: 2022
- Type: Text , Journal article
- Relation: International Journal of Health Planning and Management Vol. 37, no. 5 (2022), p. 2684-2696
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- Description: Objective To determine the relationship between team dynamics with healthcare coordination and clinical job satisfaction of the community health workers (CHWs). Methods A cross‐sectional study was conducted among 133 health workers (including doctors, nurses, or midwives) at 21 Commune Health Cent in Quoc Oai District, Vietnam, from July 2015 to May 2017. A self‐administered questionnaire consisting of 5‐Likert items regarding team dynamics and healthcare coordination clinical work satisfaction was utilised. Descriptive statistics and correlation matrix were applied for seven factors of team dynamic, clinical work satisfaction, and patient care coordination queried by primary care providers. Bayesian model averaging (BMA) was used to identify the predictors of the level of team dynamics and healthcare coordination. Results The mean score of overall team dynamics among the study participants was 4.08. Clinical work satisfaction and patient care coordination scores among resident physicians were higher than those of attending clinicians however, the differences were not statistically significant. The results of BMA analysis indicated that team dynamics significantly associated with clinical work satisfaction, and it explains 9% of the total variance in clinical work satisfaction. Team dynamics level was also positively associated with patient care coordination. Patient care coordination was not a significant mediator between team dynamics and clinical work satisfaction. Conclusion Team dynamics is a potential contributor to improving patient care coordination and clinical job satisfaction of CHWs. As no significant correlation between patient care coordination and clinical job satisfaction was observed, to improve team performance, providing conditions that facilitate team building and teamwork should be conducted for CHWs in CHCs. Highlights Team dynamics, healthcare coordination and clinical work satistsfaction among health professionals are critical to quality of healthcare. In lower‐middle income countries like Vietnam, little has been known about these contributors at community‐based healthcare system. Identifying that team dynamics significantly associated with both patient care coordination and clinical work satisfaction among community health workers, but this association being not mediated by patient care coordination informs healthcare planning at community level. As team dynamics is a contributor to both patient care coordination and clinical job satisfaction, improving team dynamics should be considered as one of priorities for better community healthcare in low or middle resource setting.
Translation, validation and psychometric properties of Effort-Reward Imbalance questionnaire among nurses in Vietnam
- Authors: Nguyen, Phuong , Nguyen, Huy , Le, Phuong , Phung, Huyen , Dao, An , Hayashi, Kuniyoshi , Gilmour, Stuart
- Date: 2022
- Type: Text , Journal article
- Relation: Preventive Medicine Reports Vol. 25, no. (2022), p.
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- Description: We translated the Effort-Reward imbalance questionnaire, an instrument for measuring work stress, into the Vietnamese language and investigated its psychometric properties among nurses in Vietnam. In a hospital-based cross-sectional study design, we sampled and interviewed 207 nurses working full-time (response rate 83%). We evaluated the internal consistency using standardized Cronbach's alpha coefficients and structural validity using confirmatory factor analysis. Discriminative validity was assessed by comparing the measured scores between age groups, gender, education levels, income groups, and job positions. In addition, we confirmed the criterion validity by investigating its association with self-reported health using simple and multiple logistic regression models. Most of the participants were female (73.3%), young (average 28.5 years old), and had education levels of college or higher (53.5%). We observed sufficient internal consistency in effort, reward, and over-commitment scales (Cronbach's alpha 0.80, 0.76, and 0.68, respectively). Confirmatory factor analysis of the three-factor hierarchical model showed an acceptable fit and fair construct validity with most moderate or stronger (>0.3) factor loading coefficients. Poor self-rated health was more likely in respondents in both Effort-Reward ratio's middle tertile (adjusted Odd-Ratio = 2.80, p-value = 0.031) and highest tertile (adjusted Odd-Ratio = 2.64, p-value = 0.05), adjusting for age, gender, and education levels. The Effort-reward imbalance scale has adequate reliability and validity for assessing work stress among nurses in Vietnam. Its significant association with poor self-rated health warrants further investigation. The validated instrument can help measure the effort-reward imbalance to manage better work-related emotional strains and mental health issues among nurses and ensure human resources' stability in healthcare in Vietnam. © 2021
Trends in, projections of, and inequalities in non-communicable disease management indicators in Vietnam 2010–2030 and progress toward universal health coverage : a Bayesian analysis at national and sub-national levels
- Authors: Nguyen, Phuong , Gilmour, Stuart , Le, Phuong , Nguyen, Hoa , Dao, Thi , Tran, Bao , Hoang, Minh , Nguyen, Huy
- Date: 2022
- Type: Text , Journal article
- Relation: eClinicalMedicine Vol. 51, no. (2022), p.
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- Description: Background: Movement towards Universal Health Coverage (UHC) can improve health services, risk factor management, and inequality in non-communicable diseases (NCD); conversely, prioritizing and monitoring NCD management can support pathways to UHC in resource-limited settings. We aimed to estimate trends in NCD management indicators in Vietnam from 2010, and projections to 2030 at national and sub-national levels; compute the probability of reaching UHC targets; and measure inequalities in NCD management indicators at demographic, geographic, and socio-economic levels. Methods: We included data of 37,595 households from four nationally representative surveys from 2010. We selected and estimated the coverage of NCD health service and risk management indicators nationally and by six sub-national groups. Using Bayesian models, we provided trends and projections and calculated the probability of reaching UHC targets of 80% coverage by 2030. We estimated multiple inequality indices including the relative index of inequality, slope index of inequality, and concentration index of inequality, and provided an assessment of improvement in inequalities over the study period. Findings: Nationally, all indicators showed a low probability of achieving 2030 targets except sufficient use of fruit and vegetables (SUFV) and non-use of tobacco (NUT). We observed declining trends in national coverage of non-harmful use of alcohol (NHUA), sufficient physical activity (SPA), non-overweight (NOW), and treatment of diabetes (TOD). Except for SPA, no indicator showed the likelihood of achieving 2030 targets at any regional level. Our model suggested a non-achievement of 2030 targets for all indicators in any wealth quintile and educational level, except for SUFV and NUT. There were diversities in tendency and magnitude of inequalities with widening gaps between genders (SPA, TOD), ethnic groups (SUFV), urban-rural areas (TOH), wealth quintiles, and educational levels (TOD, NUT, NHUA). Interpretation: Our study suggested slow progress in NCD management at the national level and among key sub-populations in Vietnam, together with existing and increasing inequalities between genders, ethnicities, geographic areas, and socioeconomic groups. We emphasised the necessity of continuously improving the healthcare system and facilities, distributing resources between geographic areas, and simultaneously integrating economic, education, and gender intervention and programs. Funding: None. © 2022 The Author(s)
Viral load monitoring for people living with HIV in the era of test and treat: progress made and challenges ahead – a systematic review
- Authors: Pham, Minh , Nguyen, Huy , Anderson, David , Crowe, Suzanne , Luchters, Stanley
- Date: 2022
- Type: Text , Journal article
- Relation: BMC public health Vol. 22, no. 1 (2022), p. 1-1203
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- Description: Abstract Background In 2016, we conducted a systematic review to assess the feasibility of treatment monitoring for people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in low and middle-income countries (LMICs), in line with the 90-90-90 treatment target. By 2020, global estimates suggest the 90-90-90 target, particularly the last 90, remains unattainable in many LMICs. This study aims to review the progress and identify needs for public health interventions to improve viral load monitoring and viral suppression for PLHIV in LMICs. Methods A literature search was conducted using an update of the initial search strategy developed for the 2016 review. Electronic databases (Medline and PubMed) were searched to identify relevant literature published in English between Dec 2015 and August 2021. The primary outcome was initial viral load (VL) monitoring (the proportion of PLHIV on ART and eligible for VL monitoring who received a VL test). Secondary outcomes included follow-up VL monitoring (the proportion of PLHIV who received a follow-up VL after an initial elevated VL test), confirmation of treatment failure (the proportion of PLHIV who had two consecutive elevated VL results) and switching treatment regimen rates (the proportion of PLHIV who switched treatment regimen after confirmation of treatment failure). Results The search strategy identified 1984 non-duplicate records, of which 34 studies were included in the review. Marked variations in initial VL monitoring coverage were reported across study settings/countries (range: 12–93% median: 74% IQR: 46–82%) and study populations (adults (range: 25–96%, median: 67% IQR: 50–84%), children, adolescents/young people (range: 2–94%, median: 72% IQR: 47–85%), and pregnant women (range: 32–82%, median: 57% IQR: 43–71%)). Community-based models reported higher VL monitoring (median: 85%, IQR: 82-88%) compared to decentralised care at primary health facility (median: 64%, IRQ: 48-82%). Suboptimal uptake of follow-up VL monitoring and low regimen switching rates were observed. Conclusions Substantial gaps in VL coverage across study settings and study populations were evident, with limited data availability outside of sub-Saharan Africa. Further research is needed to fill the data gaps. Development and implementation of innovative, community-based interventions are required to improve VL monitoring and address the “failure cascade” in PLHIV on ART who fail to achieve viral suppression.
Adherence to highly active antiretroviral therapy among people living with HIV and associated high-risk behaviours and clinical characteristics: A cross-sectional survey in Vietnam
- Authors: Le, Phuong , Nguyen, Phuong , Nguyen, Huy , Bui, Duc , Vo, Son
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of STD and AIDS Vol. 32, no. 10 (2021), p. 911-918
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- Description: Although Vietnam has promoted the utilisation of highly active antiretroviral therapy (HAART) towards HIV elimination targets, adherence to treatment has remained under-investigated. We aimed to describe high-risk behaviours and clinical characteristics by adherence status and to identify the factors associated with non-adherence. We included 426 people living with HIV (PLWH) currently or previously involved in HAART. Most participants were men (75.4%), young (33.6 years), with low income and low education levels. Non-adherent PLWH (11.5%) were more likely to have a larger number of sex partners (p-value = 0.053), sex without condom use (p-value = 0.007) and not receive result at hospital or voluntary test centre (p-value = 0.001). Multiple logistic regression analysis showed that demographic (education levels), sexual risk behaviours (multiple sex partners and sex without using condom) and clinical characteristics (time and facility at first time received HIV-positive result) were associated with HAART non-adherence. There are differences in associated factors between women (education levels and place of HIV testing) and men (multiple sex partners). Gender-specific programs, changing risky behaviours and reducing harms among PLWH may benefit adherence. We highlight the need to improve the quantity and quality of HIV/AIDS services in Vietnam, especially in pre- and post-test counselling, to achieve better HAART adherence, working towards ending AIDS in 2030. © The Author(s) 2021. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Huy Nguyen” is provided in this record**
Changes in, and predictors of, quality of life among patients with unstable angina after percutaneous coronary intervention
- Authors: Nguyen, Huy , Khuong, Long , Nguyen, Anh , Nguyen, Cham
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Evaluation in Clinical Practice Vol. 27, no. 2 (2021), p. 325-332
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- Description: Rationale, aims and objectives: Changes in, and predictors of, quality of life (QoL) among unstable angina patients are informative for both clinical and public health practice. However, there is little research on this topic, especially in health care settings with limited resources. This study aims to detect changes in QoL and its associated factors among patients with unstable angina after percutaneous coronary intervention. Methods: A longitudinal design was conducted with two repeated rounds of measurements, 1 and 3 months after intervention, using the generic SF-36 questionnaire, in 120 patients from Vietnam National Heart Institute. A linear mixed-effects model was used to assess changes in patient QoL over time while adjusting for other covariates. Results: Only two out of eight QoL subscales (social functioning and emotional well-being) declined after 1 month, but these tended to rise again after 3 months, while scores of all other QoL subscales increased. Adjusting for covariates, QoL increased slightly after 1 month of intervention (β = 0.65, 95%CI = −0.86 to 2.16) but improved by almost six QoL points after 3 months (β = 5.99, 95%CI = 4.48 to 7.50). Four confounders significantly associated with a decline in QoL were older age, being retired, living in rural areas, and having abnormal troponin level. Conclusion: QoL of the patients with unstable angina improves significantly 3 months after intervention, rather than after 1 month. More attention should be given to patients, who are old, retired, live in rural areas and have abnormal troponin level. © 2020 John Wiley & Sons, Ltd. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Huy Nguyen" is provided in this record**