BackgroundStigma and discrimination may adversely affect the benefits of methadone maintenance treatment (MMT) for drug users, especially in disadvantaged settings. This study assessed stigma and discrimination against MMT patients in the mountainous and rural areas in Vietnam and explored their associated factors to inform implementation strategies.MethodsWe interviewed 241 MMT patients in two clinics: one in Tuyen Quang Province’s inner city and the other in Son Duong District, to assess stigma and discrimination that patients perceived and experienced. Socioeconomic status, health behaviors, health status, and history of drug abuse were examined. Multivariate linear and logistic regression models were used to explore factors associated with stigma and discrimination.ResultsThe majority of respondents reported experiencing stigma and discrimination including blame/judgment (95.1%), shame (95.1%), disclosure (71.4%), and the fear of human immunodeficiency virus (HIV) transmission by others (74.1%). Unemployed patients were more likely to experience discrimination (Coef = −1.18, 95% CI = −1.87; −0.89). Those who were taking an antiretroviral were more likely to disclose their health status (Coef = 2.27, 95% CI = 0.6; 3.94). In addition, a higher likelihood of being blamed/judged and shamed was associated with those who suffered from anxiety/depression (Coef = 1.59, 95% CI = 0.24; 2.93 and Coef = 1.07, 95% CI = 0.36; 1.79, respectively).ConclusionsMMT patients in these mountainous areas perceived high levels of stigma and discrimination which were associated with mental health disorders, unemployment, and HIV infection. These findings highlighted the importance of reducing drug use and HIV-related stigma against high-risk populations. Besides, psychosocial and familial supports, as well as job referrals, also play crucial roles in terms of promoting quality of life among MMT patients.

BackgroundAs smartphone becomes increasingly prevalent and affordable, more youths today can own a smartphone device and download applications in various application stores. Smartphone applications have been proven to be useful for youths in various aspects. However, there has been a paucity of data looking into the preferences of Vietnamese youths and adolescents with regards to health-related applications and their receptiveness towards smartphone apps. Therefore, this study aimed to determine the receptiveness and preferences of health-related smartphone applications (mHealth apps) among online Vietnamese youths and adolescents.MethodsAn online cross-sectional study was conducted between the periods of August till October 2015 in Vietnam. Respondent-driven sampling technique (RDS) was utilized to recruit participants. Participants were asked questions about their history of downloading and using health-related smartphone applications and their receptiveness when using these applications. Moreover, socio-demographic characteristics and health status were also self-reported. Multivariate logistic regression was employed to determine associated factors.ResultsAmong 1028 participants, 57.4% owned a smartphone and only 14.1% of smartphone users have used a health-related smartphone application, and most of these individuals downloaded the applications for disease prevention (66.3%). 66.4% of the participants who owned these applications reported that health applications were useful and 92.8% reported being satisfied with the functionalities of the applications which they owned. Among smartphone users, people who were employed (OR = 15.46; 95%CI = 4.93–48.47) were more likely to download mHealth apps. Meanwhile, youths with higher EQ-5D index had a lower likelihood of downloading healthcare-related smartphone applications (OR = 0.17; 95%CI = 0.04–0.81).ConclusionsThis study highlighted a low rate of mHealth apps utilization among online Vietnamese youths and adolescents but a high acceptance of individuals who already used these apps. Developing mHealth apps or interventions towards the disease prevention and quality of life improvement could be feasible to proliferate the benefits of such applications in youths and adolescents in Vietnam. Further research should be conducted to optimize the contents and interfaces of mHealth apps that meet the needs of these populations.

The benefits of green infrastructure have been verified at the site-level by many empirical studies. However, there is limited understanding of how local governments prepare and implement green infrastructure planning in practice. This study employs the content analysis method to examine the quality of local comprehensive plans regarding sustainable green infrastructure in 60 municipalities of the United States. The study uses regression analysis to explain the variance of plan quality. Study results indicate that key green infrastructure principles were not fully incorporated in the existing sampled plans, with average score of 19.6 out of 50. While plan quality scores were slightly higher in counties than in cities, both areas could significantly improve plan quality with detailed policies, action strategies, and implementation tactics for green infrastructure planning and management. Regression analysis further identified that planning capacities, as well as socio-economic characteristics of study area may impact overall plan quality. The findings of this study demonstrate the importance of incorporating detailed green infrastructure principles whenever local planners adopt or amend regional plans in order to improve plan quality and to support implementation. Sustainability 2018, 10, 4143 2 of 21 together" (p. 97). Sharing similar views about the role of corridors, Benedict and McMahon [6] added examples of hubs such as natural areas of vegetation, open space, or an unknown ecological value.With the rapid expansion of urbanized areas, leading to increased landscape fragmentation, hubs and corridors have an enhanced role in city or urban areas due to their support to ecosystem services related to landscape connectivity even if rarely evaluated in green infrastructure planning [7,8]. In the city, where natural landscapes have been replaced by man-made structures, hubs and corridors are now more important than ever [5]. To support efforts to restore natural environments to city and urban areas, one of the region's primary tools is implementing effective green infrastructure planning. Green infrastructure often refers to a "strategically planned network of natural and semi-natural areas that is designed to provide a wide range of ecosystem services" [6,9]. Although the concept can be implied differently at the national (green network), regional (planning), or site (low impact development practices) level, the share goal is to design, construct, and manage nature by harmonizing environmental resources with city landscape [10]. In the US, green infrastructure is more focused on various approaches to manage and restore natural water resources at the various level [11]. As one of natural based solutions to move cities toward sustainability, green infrastructure can help improve the urban stormwater management by enhancing the recreation and tourism opportunities as well as aesthetic externalities [12]. More importantly, green infrastructure also plays a crucial role in saving energy, reducing urban heat island effect...

This study found a low proportion using mHealth-related mobile phone apps, but a high level of receptiveness and satisfaction among Vietnamese youth. Acceptance level and preferences toward mHealth apps as well as specifically preferred functionalities discovered in this study are essential not only in conceptualizing and developing appropriate mobile phone interventions targeting youth and adolescents, but also in the application of technically advanced solutions in disease prevention and health management.

BackgroundThe expansion of methadone maintenance treatment in mountainous areas in still limited and little is known about its health impacts on drug users. This study aimed to examine health-related quality of life (HRQOL) and health care access among patients engaging in methadone maintenance treatment (MMT) in Tuyen Quang, a mountainous province in Vietnam.MethodsWe conducted a cross-sectional survey with 241 patients conveniently recruited in two MMT clinics (Son Duong and Tuyen Quang). EuroQol-5 Dimensions – 5 levels (EQ-5D-5 L) and Visual analogue scale (VAS) were employed to measure HRQOL. Multivariate logistic and tobit regressions were used to determine the factors associated with HRQOL and health care utilization.ResultsThe overall mean score of the EQ-5D index and EQ-VAS were 0.88 (SD = 0.20) and 81.8% (SD = 15.27%), respectively. Only 8.7% utilized inpatient services, and 14.9% used outpatient services. Being more highly educated, suffering acute diseases, and using health service within the last 12 months were associated with a decreased EQ-5D index. Individuals who were multiple substance abusers and those who recently had inpatient care were more likely to have a lower VAS. Older respondents, those taking their medications at the more impoverished clinic, substance abusers, and individuals who were struggling with anxiety/depression or their usual daily activities were more likely to use both inpatient and outpatient care.ConclusionsIn summary, we observed good HRQOL, but high prevalence of anxiety/depression and low rates of service utilization among MMT patients in Tuyen Quang province. To improve the outcomes of MMT services in mountainous areas, it is necessary to introduce personalized and integrative services models with counseling and interventions on multiple substance use.