My Hoang Le

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.

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.

The role of nutrition in managing preterm infants, particularly those classified as very low birth weight (VLBW), is pivotal. Optimal nutrition is vital, as early growth deficits and inadequate neonatal nourishment have been linked to significant long-term developmental issues. In the neonatal intensive care units (NICU), tailored nutritional interventions are necessary to meet the unique dietary needs of these infants. Despite advances in neonatal nutrition, gaps remain in understanding the ideal composition and duration of parenteral nutrition, the process of transitioning to enteral feeding, and the need for breast milk augmentation. This review explores current insights and methodologies in the nutritional management of VLBW infants during the critical transition phase. It addresses existing challenges, recent progress, and future directions in enhancing nutritional care for these at-risk infants, aiming to improve outcomes.