Ly Cong Tran

Background: Mental health issues, including stress, anxiety, and depressive symptoms, are increasingly prevalent among high school students. Despite this growing concern, the related factors to these problems remain insufficiently explored, particularly within the Vietnamese context. Methods: This cross-sectional study aimed to identify factors associated with stress, anxiety, and depressive symptoms among 789 Vietnamese high school students. Univariable and multivariable logistic regression analyses were conducted to examine these associations. Results: The current study revealed significant associations between various factors and stress, anxiety, and depressive symptoms among high school students. Regarding stress, female students reported higher odds of stress symptoms than males, and those attending gifted schools experienced higher odds compared to their peers in non-gifted schools. Furthermore, students who reported feeling less happy or unhappy or moderately happy had higher odds of stress than those who described themselves as happy or very happy. In terms of anxiety, elevated odds of anxiety were observed among female students compared to male counterparts, those aged 18–20 compared to 16-year-olds, and students with less, unhappy, or moderately happy feelings compared to those with happy and very happy feelings. Regarding depressive symptoms, higher odds of depressive symptoms were found among female students, individuals not living with either parent, those with a family history of mental disorders, students with less, unhappy, or moderately happy feelings, and those who perceived their academic environment as negative or very negative. Conclusion: Being female, having lower perceived happiness, and experiencing negative academic or familial circumstances were significantly associated with higher odds of stress, anxiety, and depressive symptoms. These findings highlight the need for targeted mental health interventions, particularly those that address gender-specific needs, enhance students’ well-being, and improve academic and family support systems. These findings support the need for school-based mental health screening and supportive interventions, while recognizing that DASS-21 outcomes reflect symptom burden rather than clinical diagnoses.

Background: While pediatric obesity prevalence is rising, the association between ICD-coded obesity, healthcare resource utilization, and inpatient outcomes in middle-income countries remains poorly quantified. This study examined inpatient diagnostic patterns, resource utilization, and in-hospital mortality among hospitalized pediatric patients with ICD-coded obesity in Thailand’s Universal Coverage scheme during a 9-year period. Methods: We analyzed nationwide inpatient administrative data from January 2015 to December 2023 for children aged 1 month to p < 0.001) and higher hospitalization cost (adjusted cost ratio, 1.42; 95% CI, 1.32–1.53; p < 0.001). The association with in-hospital mortality was observed in the unadjusted model but was attenuated after adjustment and was not statistically significant (adjusted odds ratio, 1.14; 95% CI, 0.89–1.45; p = 0.303). Conclusions: In Thailand’s national universal coverage scheme, ICD-coded obesity was associated with greater inpatient resource utilization, especially longer length of stay and higher hospitalization costs. These findings support the need for weight-aware inpatient management and adjusted funding models for hospitals treating this higher-resource-utilization subgroup.

Background: Asthma is a chronic inflammatory airway disease with increasing prevalence, yet pediatric control rates remain low. Caregivers' knowledge, attitudes, and practices are crucial for effective asthma management. However, validated knowledge, attitudes, and practices scales using advanced statistical methods are limited in the Mekong Delta. Objectives: To develop and validate a knowledge, attitudes, and practices scale for caregivers of asthmatic children. Materials and methods: A cross-sectional study enrolled 260 primary caregivers of children aged 4-16 years with asthma at Can Tho City Children's Hospital from December 2024 to December 2025. Caregivers completed a standardized questionnaire covering sociodemographic characteristics and a 29-item KAP questionnaire. For scale development and validation, the sample was split into two equal subsamples using the Solomon method. Each domain of the knowledge, attitudes, and practices scale was first examined separately by exploratory factor analysis in subset 1, and the retained factor structure was then tested by confirmatory factor analysis in subset 2. Results: The mean age of caregivers of children with asthma was 38.32 ± 8.194 years. Exploratory factor analysis and confirmatory factor analysis eliminated 10 items, retaining 19 items with satisfactory psychometric properties. The Knowledge, Attitudes, and Practices domains achieved high composite reliability (CR = 0.875-0.940) and good convergent validity (AVE = 0.503-0.759). HTMT indices were <0.85, demonstrating good discriminant validity. All confirmatory factor analysis models showed good data fit. Conclusion: The 19-item knowledge, attitudes, and practices questionnaire demonstrated satisfactory validity and reliability, serving as a simple, concise, and highly feasible tool for rapid outpatient assessment. This instrument represents a practical and reliable tool for assessing caregiver knowledge, attitudes, and practices in both clinical and research settings.

Objective: To examine biological, maternal, and socio-cognitive determinants of under-five mortality in Vietnam using nationally representative data. Methods: This retrospective study analyzed data from the Vietnam Multiple Indicator Cluster Survey 2020–2021, including 4,475 children under five. Bayesian Model Averaging reduced redundancy among correlated predictors and addressed model uncertainty before multivariable logistic regression identified independent predictors. Results: Multiple birth was the strongest risk factor (adjusted odds ratio [aOR] 8.37, 95% CI 4.35–15.87; P<0.001). Receiving prenatal care from a doctor was strongly protective and was associated with a 64% lower odds of death (aOR 0.36, 95% CI 0.25–0.52; P<0.001). Birth interval of at least 4 years, maternal age ≥35 years, and maternal digital connectivity were also associated with better survival. Conclusion: These findings highlight biological vulnerability and modifiable social determinants of child survival in Vietnam, supporting targeted interventions for high-risk births and equitable access to quality maternal and newborn care.

Childhood obesity has increased markedly in Thailand, yet nationwide data on clinical outcomes, and the impact of the COVID-19 pandemic remain limited, par

Background: Internet addiction has emerged as a widespread concern, particularly among adolescents. Despite this growing issue, there is a scarcity of empirical data regarding the socio-demographic factors of internet addiction among high school students in Vietnam. Therefore, this study aimed to investigate the extent of internet addiction and its associated factors among Vietnamese high school adolescents. Methods: This analytical cross-sectional study was conducted from February to March 2025 among Vietnamese high school students. Internet addiction was assessed using the Internet Addiction Test – Short Version (IAT-SV), alongside data on demographics, academic performance, and psychosocial factors. Statistical analyses, including independent t-tests, one-way ANOVA, Post-Hoc Test, and multiple linear regression, were applied to explore differences between these variables and internet addiction. Results: A total of 789 students participated in the study, with a mean IAT-SV score of 28.79 (SD = 9.41). Female students (M = 29.84) and older students (M = 30.24) exhibited significantly higher internet addiction scores. Similar trends were observed among students with a family history of psychological disorders (M = 32.48) or smoking addiction (M = 31.22). Higher internet addiction scores were also found among students from families with difficult or very difficult economic conditions (M = 32.37), those reporting lower levels of happiness (M = 33.16), and those who perceived their academic environment negatively (M = 33.59). In contrast, lower scores were observed among male and younger students, those without such family histories, from families with moderate economic status, who reported being happy or very happy, and who viewed their academic environment positively. The regression model was statistically significant and accounted for 7.4% of the variance in internet addiction scores. Conclusion: Several factors are associated with internet addiction. Notably, fostering a supportive academic environment and enhancing students’ overall well-being and happiness may contribute to reducing the prevalence of internet addiction. Further research is warranted to explore effective strategies for addressing internet addiction among adolescents.

University students, particularly in their first year of medical training, face psychological and academic challenges that may impair well-being, hinder pe

Poorly controlled pediatric asthma increases morbidity, reduces quality of life, and raises healthcare use. Caregiver education on asthma and medication use is essential for control. In Vietnam, pediatric asthma services are centralized at tertiary centers, limiting access for many families. Telemedicine may help bridge these gaps. To evaluate the effectiveness of telemedicine education on asthma control in children with uncontrolled asthma and its impact on caregiver knowledge, attitudes, and children's MDI technique. We conducted a pragmatic randomized clinical trial among children aged 4-16 years with uncontrolled asthma. Participants were randomized 1:1, stratified by age and sex, to receive either a structured educational video call or a brief scheduling call. Changes in C-ACT/ACT scores, caregiver knowledge, caregiver attitudes, and children's MDI technique were compared between groups. A multivariable generalized linear model was used to identify factors associated with improvement in asthma control. Baseline characteristics were comparable between groups. At a median follow-up of 5 weeks (IQR 4-8), C-ACT scores were higher in the intervention than control group (median 25.0 vs 19.5, P < 0.001), with mean change exceeding the minimal clinically important difference. Caregiver knowledge and attitudes and children's MDI technique also improved more in the intervention group (P < 0.001 for all). In multivariable models, telemedicine education was independently associated with greater improvement in asthma control (β = 4.24, 95% CI: 2.64-5.85, P < 0.001). Telemedicine-based education improved asthma control and caregiver-related outcomes and may serve as an effective supportive strategy where access to pediatric asthma services is limited.

Pediatric anemia remains a significant public health challenge in Northeast Thailand, where hemoglobinopathies and nutritional deficiencies coexist. Early identification of children at risk of anemia is crucial to prevent developmental and health consequences. This study assessed the prevalence of children under five being at risk of anemia using Masimo Rad-67® with Rainbow DCI-mini Sensor, while evaluating the association between caregivers’ knowledge, attitudes, and practices on complementary feeding and childhood anemia. A clustered randomized cross-sectional study was conducted involving 2,000 child-caregiver pairs (aged 6 months to 5 years) in Northeast Thailand from September 2022 to March 2023. Non-invasive hemoglobin measurement was used, with anemia risk defined as spectrophotometry hemoglobin (SpHb) < 13.0 g/dL. Data collection included demographic characteristics, natal history, and feeding practices. Additionally, a survey was conducted to assess associated factors of anemia and caregivers’ attitudes, knowledge, and practices regarding complementary feeding. The study found a 36.9% prevalence of at-risk anemia. Key predictors included age under 24 months (adjusted OR 2.1, 95%CI 1.7–2.6), maternal thalassemia trait (adjusted OR 1.8, 95%CI 1.4–2.3), and wasting (adjusted OR 1.6, 95%CI 1.2–2.1). Iron supplementation was a protective factor. Despite 48.2% of children receiving iron supplementation per government policy, only 24.6% met the daily iron intake according to the Thai dietary reference intake. Gap in caregiver knowledge persisted, with 68.1% of caregivers having received education on iron deficiency anemia, and only 32% able to name iron-rich foods. Public health strategies should combine nutritional education targeting iron-rich complementary feeding, implementation of a thalassemia-integrated screening protocol, and proactive community surveillance programs to improve iron intake. Thai clinical trial registration: TCTR20221024002.