[The American war in Southeast Asia featured the most widespread use of chemical warfare since World War I. Earlier, the British had resorted to chemicals in their colonies, Italy did so in Ethiopia, and Japan in China in the 1930s and 1940s. These were lethal chemicals where the Americans thought theirs were not. Iraq in the 1980s made the largest-scale known use of lethal chemical weapons in its Iran war and against its Kurdish minority. But two elements distinguished the U.S. effort in Vietnam. First, massive quantities of these chemicals were used, as the below article makes clear. The amounts cited are equivalent to roughly 60,000 tons of chemical agent. By comparison, in the 1972 Christmas Bombing of North Vietnam, which some hold to be the decisive air campaign of the war, and including both B-52 bombers and tactical aircraft, the Nixon administration loosed some 36,000 tons of munitions over Hanoi and its environs.

This paper demonstrates how learning the structure of a Bayesian network, often used to predict and represent causal pathways, can be used to inform policy decision-making.

We show that Bayesian networks are a rigorous and interpretable representation of interconnected factors that affect the complex environment in which policy decisions are made. Furthermore, Bayesian structure learning differentiates between proximal or immediate factors and upstream or root causes, offering a comprehensive set of potential causal pathways leading to specific outcomes.

We show how these causal pathways can provide critical insights into the impact of a policy intervention on an outcome. Central to our approach is the integration of causal discovery within a Bayesian framework, which considers the relative likelihood of possible causal pathways rather than only the most probable pathway.

We argue this is an essential part of causal discovery in policy making because the complexity of the decision landscape inevitably means that there are many near equally probable causal pathways. While this methodology is broadly applicable across various policy domains, we demonstrate its value within the context of educational policy in Australia. Here, we identify pathways influencing educational outcomes, such as student attendance, and examine the effects of social disadvantage on these pathways. We demonstrate the methodology’s performance using synthetic data and its usefulness by applying it to real-world data. Our findings in the real example highlight the usefulness of Bayesian networks as a policy decision tool and show how data science techniques can be used for practical policy development.

The introduction of the 2012 Labour Code is considered ‘groundbreaking’ in industrial relations in Vietnam. However, knowledge about the effects of this law is still minimal. This study provides the first evidence of the impacts of the law on worker outcomes, disaggregated by location and migration status. The Vietnam Labour Force Survey is used as the primary dataset. Both difference-in-differences and fixed-effect models are applied in the investigation. The estimated results show a relationship between the introduction of the law and the labour supply of contracted workers in urban areas, especially long-term migrant workers. Furthermore, income for these long-term migrant contract workers was affected significantly by the introduction of the law. A link between the law and health insurance participation was also found among non-migrant contracted workers in urban areas. We also perform estimations using a short panel sample and find notable results. The study likewise reveals disadvantages of rural workers compared to urban workers in terms of earnings, and of short-term migrants compared to other workers, in terms of labour supply.

The COVID-19 pandemic and ensuing restrictions/lockdowns have caused significant physical and psychological consequences for people with cognitive impairment who are heavily dependent on their care-givers. However, little is known about the impact on care-givers, the factors that exacerbate their situation and what supports they need. The aims of this paper are threefold: (a) to examine the impact of COVID-19 physical restrictions on both formal and informal care-givers of people with cognitive impairment; (b) to identify attributing factors influencing this impact; and (c) to recognise their support needs. Further, this paper informs future research, policy and practice. Guided by the Joanna Briggs Institute framework, a systematic review was conducted using a mixed-methods convergent integrated approach. Eight databases were searched using keywords related to COVID-19 restriction, dementia care-givers, impacts and care settings, followed by a manual search. The study was limited to primary research published in English between January 2020 and December 2021. Of the 840 records identified, 30 met the inclusion criteria. Service withdrawal and social distancing has effectively led to the reprivatisation of care to the family, particularly women. Care-givers experienced negative impacts including reduced psychological wellbeing and physical health, increased care burden and financial difficulties. A number of clinical attributes and socio-demographic factors influenced the COVID-19 impact on care-givers. Consequently, counselling services, assistance with care and financial support were identified as support needs. Implementation of new support and the strengthening of existing services are recommended to enhance resilience, build capacity to support care-givers in any given situation and mitigate the effects of future outbreaks.

This study examines the relationships between e-government service quality, perceived value, satisfaction, and loyalty toward e-government services. Survey data were collected from 340 randomly selected e-government service users in Vietnam. The results reveal that (1) e-government service quality consists of five dimensions: ease of interaction, fulfillment, citizen care, security and privacy, and trustworthiness; (2) among the five dimensions of e-government service quality, only trustworthiness and fulfillment are significantly related to perceived value; however, trustworthiness has a stronger association with perceived value than does fulfillment; and (3) both perceived value and satisfaction are positively associated with loyalty. The results indicate that the e-government can create value for the citizens by improving service quality, which may help satisfy citizens’ needs and build their loyalty.

Objectives: Studies have revealed that a relatively high incidence of severe infection and mortality in COVID-19 patients is attributed to healthcare-associated infections (HAIs). We implemented a study in 2 field hospitals dedicated to COVID-19 treatment in Da Nang, Vietnam (July–August 2020), and Ho Chi Minh City, Vietnam (August–October 2021), to identify pathogens, risk factors, and outcomes associated with HAIs. Methods: We applied a prospective study tool to estimate HAI incidence among 1,454 patients. HAIs are diagnosed and ascertained using surveillance criteria established by the US Centers for Disease Control and Prevention. All patients hospitalized for COVID-19 for at least 2 days were enrolled in this assessment of HAI risks, pathogens, and outcomes. Results: Among 1,454 sampled patients, 391 patients had 423 HAIs (27.1%). The highest proportion occurred in ICUs, with 422 HAI patients (34.1%). Pneumonia (n = 331, 78.3%) and bloodstream infections (n = 55, 13.1%) were the most common HAIs. Multidrug-resistant (MDR) bacteria, such as Klebsiella pneumonia (27.9%) and Acinetobacter baumannii (25.3%), were the most commonly isolated organisms. Ventilators and central venous catheters were independently associated with HAIs. Regarding the mortality rates, 55% of deaths occurred in intensive care units. Patients with HAIs (70.3%) were twice as likely to die compared to patients without HAIs (38.8%). HAIs leading to septic shock caused almost triple mortality (n = 58, 90.6%) compared with non-HAI patients (n = 412, 38.8%). HAIs prolonged hospital stay: 24.7 days for patients with HAIs and 19.1 days for patients without HAIs (P < .001). Conclusions: Patients with COVID-19–related critical illnesses are at high risk of HAIs from multidrug-resistant (MDR) bacteria. HAIs prolong hospitalization, whereas HAIs with septic shock almost tripled mortality. Guidelines and procedures to prevent and control HAIs caused by MDR bacteria as well as training and monitoring on aseptic-compliant techniques during invasive clinical procedures are needed.

Objectives: At the onset of COVID-19, whenever SARS-CoV-2 was detected at Children’s Hospital 1 (CH1), the related department or building was closed for extensive tracing, testing, and medical isolation. This process disrupted hospital activities, reduced the efficiency of patient care, and used medical resources. To address this problem, CH1 implemented a system of grouping inpatients to color-coded areas from June to December 2021. Methods: In this retrospective study, we describe the system of grouping inpatients to color-coded areas based on SARS-CoV-2 test result at a 1,600-bed, national pediatric hospital in Ho Chi Minh City. Results: Inpatients were first separated into those with or without respiratory symptoms, and secondly to different color-coded areas based on SARS-CoV-2 test result and hospitalization length: red zone (days 1–3), orange zone (days 3–7), and green zone (day 7 onward). Prior to admission, all patients were tested with a SARS-CoV-2 rapid diagnostic test. If negative, the patient was admitted to the red zone. On days 3 and 7 of hospitalization, the patient was tested using a pooled RT-PCR method. Patients negative on day 3 were relocated to the orange zone; patients negative on day 7 were relocated to the green zone. A patient with a positive test result at any time point was transferred to a COVID-19 zone. One caregiver was allowed to stay with 1 patient with similar testing regimen. A mobile transportation team was set up to deliver food and other necessities; thus, movement was restricted and interaction was prevented among zones. After this system was implemented, COVID-19 cases were detected early, with most positive cases in the red zone (19.6%) and the orange zone (2.8%), with only 1 case in the green zone (0.7%). Conclusions: The system of grouping patients to color-coded areas helped prevent SARS-CoV-2 transmission within the hospital, allowing undisrupted operation.

Objectives: In early 2021, when the COVID-19 vaccine was scarce in Vietnam, healthcare workers (HCWs) were prioritized for vaccination due to high risk of occupational exposure. However, there is some COVID-19 vaccine hesitancy within HCW communities. Assessing COVID-19 severity among vaccinated and nonvaccinated HCWs would contribute essential information to assure people of vaccine effectiveness and reduce vaccine hesitancy. Methods: We conducted a descriptive cross-sectional study at the National Hospital for Tropical Diseases in Hanoi, Vietnam, from May to June 2021. Clinical and epidemiological data from HCWs with positive polymerase chain reaction (PCR) results were collected. The severity of symptoms were classified according to Vietnam Ministry of Health guideline (Decision no. 3416 issued  July 14, 2021) into 5 categories: asymptomatic, mild, moderate, severe, and critical conditions Results: Overall, 25 HCWs qualified for this study (14 women and 11 men), with a median age of 31 years. Among them, 3 HCWs were infected due to community exposure, and the rest were infected due to occupational exposure. Also, 3 HCWs received the Astra Zeneca vaccine before being infected with SARS-CoV-2 (one fully vaccinated with 2 doses and the other 2 had had the first dose). Categorized by the severity of infection, 28% were asymptomatic, 44% had mild symptoms, 20% had moderate symptoms, and 8% experienced severe symptoms. All 3 vaccinated HCWs showed only mild symptoms. Cough and sore throat were the main symptoms recorded (60%), followed by fever (56%). Blood test results did not show significant differences between the severe and mild COVID-19 groups. Conclusions: COVID-19 vaccination reduced the severity of COVID-19 in this small sample of HCWs. Full COVID-19 vaccination is strongly recommended for HCWs to reduce the spread of COVID-19 and to limit the number of cases with severe disease.