MATERIALS AND METHODS: A cross-sectional, global, online survey on PE was conducted using a questionnaire developed by an international cohort of experts. Results were analyzed using R version 4.1.2. Additionally, expert recommendations were formulated using a modified Delphi method.
RESULTS: The survey was completed by 264 participants from 41 countries. The majority of respondents were below the age of 45 years and were urologists focusing on andrology and sexual health. PE diagnosis was primarily based (by 61.5%) on an intravaginal ejaculatory latency time of less than one minute. Lifelong PE was the most common category reported (47.7%), and most respondents (84.2%) observed ante-portas PE in less than 25% of cases. Distinguishing PE from erectile dysfunction was challenging for many respondents (60.7%). Diabetes mellitus was the most common comorbidity (17.1%). Pharmacological therapy was the most common treatment method (34.3%), with dapoxetine being the most preferred medication (37.9%). Surgical methods were infrequently used. Emerging treatments like hyaluronic acid gel glans augmentation were favored by only 11.7%. Patient satisfaction was the primary criterion for successful PE treatment (55.9%), and cost was a significant concern for many (35.5%).
CONCLUSIONS: This global survey highlights significant diversity in the diagnostic and treatment strategies for PE. Standard diagnostic criteria are generally accepted, off-label medication is widely used in therapy, and the role of surgery is still controversial. A multi-modal therapy approach, tailored to the patient's specific needs, is favored. Further research into the neurobiology of PE and the development of effective and safe options is crucial for improving the management of PE.
DESIGN: A cross-sectional study design and top-down costing approach, analysing Malaysian diagnosis-related group (DRG) data for AMR patients admitted to MoH hospitals from 2017 to 2020.
SETTING AND PARTICIPANTS: A total of 1190 cases were identified using International Statistical Classification of Diseases-10 version 2010 codes for AMR pathogens.
OUTCOME MEASURES: The study aims to estimate direct healthcare costs for treating AMR patients. Costs per admission were calculated based on each patient's length of stay (LOS). A binary logistic regression model identified cost determinants, with significant factors (p<0.05) further analysed using a multivariate multiple logistic regression. ORs with 95% CIs were determined, and treatment costs were categorised as above or below the annual national base rate.
RESULTS: Findings showed that costs are influenced by the volume of cases identified through DRG codes and LOS, which averaged between 21.7 and 36.4 days. Median admission costs for AMR patients ranged from RM12 476.28 (IQR RM 15 655.93) to RM19 295.11 (IQR RM20 200.28). Both LOS and total costs increased annually, from RM3 711 046.10 in 2017 to RM9 700 249.08 in 2019. Patients over 56 years old and those with severity levels II and III were more likely exceeding the national base rate.
CONCLUSIONS: These findings, explaining 9.3% of the variance in the regression model, can inform policies to reduce the economic burden of AMR and improve patient outcomes, highlighting the need for a comprehensive strategy to address this global health threat.
METHODS AND RESULTS: Drawing on the GBD 2021 data, this study conducted a comprehensive analysis of the burden of stroke in the Chinese population, encompassing prevalence, incidence, mortality, years of life lost (YLL), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Subsequently, we examined the temporal trends of these indicators and employed a Joinpoint regression analysis coupled with an age-period-cohort (APC) model to precisely dissect mortality and incidence patterns. Furthermore, we delved into the attributable burden of stroke. The results indicated that the prevalence of stroke in China reached 26 million in 2021, representing a 104.26 % increase since 1990. Compared to 1990, the number of DALYs attributable to stroke increased by 45.25 %. Joinpoint analysis revealed a declining trend in incidence rates, while mortality rates showed a significant reduction. The APC model fitting outcomes suggested that prevalence rates were higher in recent generations than in the past, with an increase observed within the same age cohort. Notably, in 2019, the primary burden of cardiovascular diseases (CVDs) stemmed from metabolic risks, particularly hypertension, followed by air pollution particulate matter as an environmental risk factor.
CONCLUSIONS: Given China's vast population base and rapid aging process, the burden of stroke has emerged as a significant public health concern.
OBJECTIVE: This review aims to assess the applicability, outcomes, and recent advancement of digital health modalities in antenatal care.
METHOD: We conducted a scoping review by searching four electronic databases (Scopus, Web of Science, PubMed, EBSCOhost), performing manual searches of Google Scholar, and examining the references of relevant studies. Eligible studies included original research published in English between 2010 and 2024 involving the use of digital health technologies for antenatal care, complying with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review guidelines.
RESULTS: One hundred twenty-six eligible articles were identified, with the majority (61.11%) conducted in high-income countries, including the United States, United Kingdom, and Australia. Digital health studies have increased over time, driven by telehealth adoption in affluent nations. Interventions predominantly focused on patient-provider consultations, remote monitoring, and health education, complementing in-person visits or as a substitute when necessary. High levels of acceptance and satisfaction were reported among users. These interventions primarily targeted general maternal care (28.57%), gestational diabetes mellitus (15.07%), and mental health (13.49%) while also addressing gestational weight management, hypertensive disorders, high-risk pregnancies and maternal education. The findings demonstrated positive outcomes in managing clinical conditions, enhancing knowledge, promoting birth preparedness, and improving antenatal care access and utilisation. Additionally, the findings revealed the cost-effectiveness of these approaches in alleviating financial burdens for patients and healthcare systems.
CONCLUSION: Digital health is emerging as a pivotal tool in maternal and child care, fostering positive outcomes and high acceptance among patients and healthcare providers. Its integration into antenatal care ensures the maintenance of standard care quality, with no adverse effects reported despite limited discussions on safety and privacy concerns. As these technologies continue to evolve, they are set to redefine antenatal care by offering more accessible, efficient, and patient-centred solutions, ultimately shaping the future of maternal healthcare delivery.
MATERIALS AND METHODS: A cross-sectional study was conducted from March 2023 to February 2024 with a sample of 180 FSW mothers/institutional caregivers and their school-going children between ages 7 to 17. A semi-structured questionnaire was used to collect data on KAP. The children's oral health was assessed using the DMFT/dmft index for caries and the gingival index (GI) for gingival health, while plaque and calculus levels were measured using the plaque index (PI) and calculus index (CI), respectively.
RESULTS: Among the FSW mothers/ institutional caregivers, 79% had good knowledge of oral health, 77.2% displayed a positive attitude, and 62.8% were informed about proper oral health practices. FSW mothers/ institutional caregivers who had higher educational attainment were three times more likely to practice good oral hygiene compared to those with lower-educated caregivers (OR = 3.27, β = 1.11, p
METHODS: Monthly OPD attendance from 1,053 public primary care health clinics in Malaysia, from January 1, 2019, to June 30, 2021, was analysed. The study duration was divided into four distinct periods: pre-pandemic, pandemic with the first lockdown implementation, pandemic after the first lockdown was lifted, and pandemic with the second lockdown implementation. An interrupted time series analysis was conducted to assess the impact of different interventions at national, regional, urban-rural, and district levels. Data were then aggregated at the district level and the utilisation changes were visualised in a choropleth map. Additionally, simple linear regression (SLR) was performed to explore the association between utilisation changes and urbanisation rates of the district, for each period.
RESULTS: Nationally, OPD utilisation dropped by nearly 13% at the onset of the first lockdown and continued to decline by almost 24% monthly thereafter. In terms of urban-rural differences, urban areas in the Central and Eastern Regions showed greater fluctuations in OPD utilisation during different periods. Results from the SLR revealed that higher urbanisation rates were associated with more pronounced changes in utilisation, although the direction of these changes varied across time periods.
CONCLUSION: The OPD utilisation was affected during the COVID-19 and sporadic urban-rural differences were observed in some areas of the country. This study offers important insights into the geographic and urban-rural patterns of healthcare utilisation during the pandemic, which are crucial in improving healthcare equity in Malaysia.
METHODS: In Malaysia, we developed a multi-level primary school asthma programme incorporating educational sessions for children with asthma and their parents, raising awareness within the whole school community and training school staff to provide first-aid asthma management. The programme was adapted for delivery during the COVID-19 pandemic, and a mixed-method feasibility study was conducted in October 2020.
RESULTS: We identified 34 children with asthma, who comprised 3.7% of the school population. Only 14/34 (41.2%) children with asthma and 4/14 (28.5%) of their parents attended the remote sessions. The in-person session for school staff was attended by 55/62 (88.7%), among whom 86.0% rated the session as good/excellent.
CONCLUSION: The school-based intervention was feasible and received good feedback, despite the COVID-19 pandemic forcing remote delivery. Stakeholder engagement is essential in the development and feasibility of a school-based asthma programme.
METHODS: The ReReki module was developed using the analysis, design, development, implementation and evaluation model, based on the theory of planned behaviour. Content validation involved six adolescent health experts, using Russell's model validity approach and a content validity questionnaire. Games were then designed to complement the Sexual and Reproductive Health (SRH) materials. The gamified ReReki module was pre-tested with 20 adolescent boys from a selected school, and the language was refined by a linguistic expert.
RESULTS: The module included five main topics, 29 subtopics and six games. The overall content validity score based on the survey method was 81.8%, while that based on Russell's model was 79.3%, indicating a high level of validity for the ReReki module. One new topic and two subtopics were added, while two subtopics scoring below 70% were flagged for further review. The adolescent boys expressed their acceptance of the gamified SRH content.
CONCLUSION: All five main topics, along with the 29 subtopics in the ReReki module, are suitable and ready for use by adolescent boys in the Malaysian context.
METHODS: This two-arm quasi-experimental study was conducted in two primary healthcare facilities selected using simple random sampling with opaque envelopes. A total of 524 participants were enrolled using purposive sampling. Data were statistically analysed using the Statistical Package for the Social Sciences version 28 with repeated-measures logistic regression analysis, the Z test for Poisson rates and the Wilcoxon signed-rank test.
RESULTS: The parental SMS reminders significantly improved the immunisation coverage, as reported by 69 (26.3%) (P=0.001, 95% confidence interval [CI] = 12.2-40.5), 117 (44.7%) (P=0.001, 95% CI=32.6-56.9) and 116 (44.3%) participants (P=0.001, 95% CI=34.2-54.4) for the 6th-, 10th- and 14th-week schedules, respectively. Compared to mothers' involvement, fathers' involvement did not significantly affect the immunisation coverage (B=0.158, P=0.311, 95% CI=-0.148-0.464). With regard to the immunisation timeliness, the parental SMS reminders yielded a significant effect for the 6th-, 10th- and 14th-week schedules (P=0.001, 95% CI=25.9-46.7; P=0.001, 95% CI=24.2-43.0; and P=0.001, 95% CI=21.1-36.9, respectively). Compared to mothers' involvement, fathers' involvement significantly influenced the immunisation timeliness (B=0.298, P=0.038, 95% CI=0.016-0.579). Lastly, the parental SMS reminders significantly reduced the barriers to immunisation, with a P-value of 0.001.
CONCLUSION: Parental SMS reminders can significantly improve immunisation outcomes in Nigeria.