METHODS: A systematic search was conducted using the relevant Web of Science, Scopus, EBSCO, PubMed, and PsycINFO; 22 studies published between January 2000 and March 2023 were identified.
RESULTS: These included studies understanding the psychosocial factors of breastfeeding by introducing the ETPB framework, incorporating psychosocial factors such as affective attitude, instrumental attitude, injunctive norms, descriptive norms, perceived behavioral control, breastfeeding self-efficacy, moral norms, breastfeeding knowledge, and breastfeeding self-identity. Based on these factors, intervention strategies for breastfeeding enhancement were categorized into professional breastfeeding education, interpersonal social support, and personalized breastfeeding services.
CONCLUSIONS: The 22 breastfeeding studies related to the ETPB model demonstrate its effectiveness in explaining the psychosocial factors influencing breastfeeding intention and duration. The model's application in intervention studies suggests that more diverse and proactive approaches are required to empower mothers. Future research should address societal context and cultural influences and expand interventions beyond essential information provision.
METHODS: A multicentre cross-sectional survey was conducted with 596 participants (response rate of 97.2%) in the mountainous Lishui region of China by using a multi-stage, stratified, cluster-sampling procedure. The survey included questions on sociodemographic characteristics, the Adult Health Self-Management Skills (Ability) Rating scale, family APGAR scale and General Self-Efficacy (GSE) scale. Data were analysed using descriptive statistics, Spearman's correlation, and multiple regression analysis with mediation and moderated mediation models.
RESULTS: The average score for HSMA, family function, and GSE were 149.6 ± 18.1 (out of 190), 8.2 ± 2.2 (out of 10), and 24.0 ± 6.0 (out of 40), respectively, which indicate moderate HSMA and family function levels and low GSE among older adults in Lishui. Significant correlations were observed between family function and GSE (rs = 0.150, P
METHODS: A total of 86 patients were divided into the control and experimental groups. The control group underwent a traditional CFEMBI, and the experimental group underwent a CFEMBI based on the midnight-noon ebb-flow theory. Outcomes were assessed at the 4th week, 8th week, and 12th week during the intervention.
RESULTS: After the 12th week, there was a significant difference in scores on the Hamilton Depression Rating Scale (HAM-D) between the control and experimental groups (Z = -6.375, P value
OBJECTIVE: The aim of this study is to systematically review and synthesize evidence on the risk factors, prevalence, and detection methods for intestinal protozoal infections in Malaysia, offering insights that are applicable to other tropical and low-income regions.
METHODS: Studies on intestinal protozoal infections among Malaysian patients published after January 2010 up to November 2024 will be eligible for inclusion. The eligibility criteria include studies investigating infections caused by E. histolytica, G. lamblia, and C. parvum using validated diagnostic methods such as microscopy, molecular techniques, or immunoassays. Case reports, reviews, and studies without original data will be excluded. Comprehensive database searches will be conducted in PubMed/MEDLINE, Scopus, ProQuest, Web of Science, Google Scholar, and the Cochrane Library. The reference lists of selected papers are also checked. A standardized data extraction form will be used to record study characteristics, outcomes, and associated variables. Risk of bias will be assessed using the Joanna Briggs Institute tools and Newcastle-Ottawa Scale approach. Data synthesis will utilize a random effects model to estimate pooled prevalence and identify risk factors associated with these infections. Subgroup analyses will examine variations by geographic region and diagnostic method. Statistical heterogeneity will be assessed using I2 statistic and meta-regression. Publication bias will be assessed using Egger and Begg funnel plot test. The results are reported in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.
RESULTS: This systematic review was funded in June 2024. Database searches were started in July 2024, and we identified 1652 papers as of December 2024 for screening. Completion of study screening is anticipated by May 2025, with data extraction and analysis expected to conclude by December 2025.
CONCLUSIONS: Our study will address critical knowledge gaps in the epidemiology and risk factors of intestinal protozoal infections in Malaysia. Study limitations include potential bias in study selection, heterogeneity in diagnostic methods, and differences in the reporting quality of the included studies. Our findings will provide valuable insights into the prevalence of these infections, the associated risk factors, and the diagnostic techniques employed, which should strengthen public health measures, improve diagnostic procedures, and guide future research to reduce the prevalence of intestinal protozoal infections in Malaysia.
TRIAL REGISTRATION: PROSPERO (International Prospective Registry of Systematic Reviews) registration CRD42023456199; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023456199.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66350.
METHODOLOGY/PRINCIPAL FINDINGS: Household costs were estimated from patient-level surveys collected from four hospitals between 2013 and 2016. Direct costs including medical and associated travel costs, and indirect costs due to lost productivity were included. One hundred and fifty-two malaria cases were enrolled: P. knowlesi (n=108), P. vivax (n=22), P. falciparum (n=16), and P. malariae (n=6). Costs were inflated to 2023 Malaysian Ringgits and reported in United States dollars (US$). Across all cases, the mean total costs were US$131 (SD=102), with productivity losses accounting for 58% of costs (US$76; SD=70). P. vivax had the highest mean total household cost at US$199 (SD=174), followed by P. knowlesi and P. falciparum at US$119 (SD=81 and SD=83, respectively), and P. malariae (US$99; SD=42). Most patients (80%) experienced direct health costs above 10% of monthly income, with 58 (38%) patients experiencing health spending over 25% of monthly income, consistent with catastrophic health expenditure.
CONCLUSIONS/SIGNIFICANCE: Despite Malaysia's free health-system care for malaria, patients and families face other related medical, travel, and indirect costs. Household out-of-pocket costs were driven by productivity losses; primarily attributed to infections in working-aged males in rural agricultural-based occupations. Costs for P. vivax were higher than those of P. knowlesi and P. falciparum. This may be attributable to a younger age profile and the longer treatment required to clear the liver-stage parasites of P. vivax.
METHODS: This study investigated differences in the intracerebral distribution of current density comparing the standard d'Elia right unilateral positioning (temporoparietal [TP]) with two recently developed RUL placements, focal electrically administered seizure therapy (FEAST) and frontoparietal (FP) stimulation. The strength of the electrical fields (E-fields) was compared in brain regions of interest (ROIs) implicated in both clinical and cognitive outcomes. Computational modeling was conducted in the head models of five participants with major depression who had received RUL ECT.
RESULTS: Results showed that the FEAST and FP placements were associated with significantly less bilateral stimulation effects in regions hypothesized to be associated with memory, whereas the FP and TP placements produced significantly greater bilateral stimulation effects in some regions hypothesized to be associated with efficacy. FEAST, using a smaller anterior electrode, produced significantly greater E-fields in some ROIs associated with memory and efficacy, although those differences were much smaller in magnitude.
CONCLUSIONS: These findings suggest that both FEAST and FP may result in a superior clinical profile relative to TP. Future clinical studies are required to confirm the differences in clinical outcomes associated with the novel RUL placements.
DESIGN: A qualitative approach was taken.
METHODS: Semi-structured interviews were conducted with 50 bachelor and vocational-educated nurses working in care for older adults. Interviews were conducted between December 2019 and May 2020. Data were analysed and interpreted through inductive content analysis.
RESULTS: Five themes embody the meaning of the nursing professional identity of nurses who work in care for older adults. The five themes are: born to care: a lifelong motivation to nursing; nursing through the noise: dedication in a demanding profession; the silent backbone: caught in the crossfire of interdisciplinary teams; learning under pressure: the demand for expanded nursing expertise and against the current: the barriers to advocacy in nursing.
CONCLUSION: The professional nursing identity of nurses working in care for older adults is multi-faceted. A personal dedication to patient care, where patients 'human' aspect is heavily valued, commits nurses to their profession and underscores their dedication to upholding the quality standard in nursing practice.
IMPLICATIONS FOR THE PROFESSION: The older adults' nursing identity highlights that nursing deserves acknowledgement as a professional occupation. Nurses should speak to the public about their professional roles to improve the public view of older adult nursing.
IMPACT: A clear understanding of the older adult nursing professional identity clarifies specific roles, experiences and expectations. This can help attract and retain nurses whose views of older adult nursing align with the nursing professional identity. This could help resolve nurse turnover and reduce shortages in older adult care.
REPORTING METHOD: We adhered to Consolidated Criteria For Reporting Qualitative Research guidelines.
PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
METHODS: The Upper Gastrointestinal (GI) Focus Group of the Asian Pacific Association of Gastroenterology-Emerging Leaders Committee developed an international survey, which was distributed to 98 clinicians in the Asia-Pacific region, compromising an online questionnaire focusing on the management of H. pylori infection.
RESULTS: Participants responded from Japan (15, 15.3%), Hong Kong (15, 15.3%), Thailand (33, 33.7%), Vietnam (23, 23.5%), Malaysia (4, 4.1%), Singapore (3, 3.1%), and others (5, 5.1%). The most common first-line eradication regimen was clarithromycin (CAM) triple therapy, including proton pump inhibitor (PPI), amoxicillin (AMPC), and CAM (64.3%) for 14 days (70.4%). The most common second-line eradication regimen was levofloxacin (LVX) triple therapy, including PPI, AMPC, and LVX (22.4%) for 14 days (67.3%). Eradication therapy was deemed necessary for all asymptomatic adults and minors (aged ≤ 17 years) currently infected with H. pylori by 81.6% and 64.3% of respondents, respectively, with 82.7% considering upper GI endoscopy for GC screening useful in the secondary prevention of GC.
CONCLUSION: There appears to be a growing consensus among clinicians, acknowledging the necessity of eradication therapy. We anticipate that this study will establish a new benchmark in preventive medicine aimed at eradicating GC in the Asia-Pacific region.
OBJECTIVE: The aim of this study is to prioritize the content and user interface appropriate for developing a web health application, known as the MAwar app, to promote breast and cervical cancer screening.
METHODS: A cross-sectional study for stakeholder engagement was conducted to develop a web-based application known as the MAwar app as part of a larger study entitled "The Effectiveness of an Interactive Web Application to Motivate and Raise Awareness on Early Detection of Breast and Cervical Cancers (The MAwar study)". The stakeholder engagement process was conducted in a public health district that oversees 12 public primary care clinics with existing cervical and breast cancer screening programs. We purposively selected the stakeholders for their relevant roles in breast and cervical cancer screening (health care staff, patients, and public representatives), as well as expertise in software and user interface design (technology experts). The Quality Function Deployment method was used to reflect the priorities of diverse stakeholders (health care, technology experts, patients, and public representatives) in its design. The Quality Function Deployment method facilitated the translation of stakeholder perspectives into app features. Stakeholders rated features on a scale from 1 (least important) to 5 (most important), ensuring the app's design resonated with user needs. The correlations between the "WHATs" (user requirements) and the "HOWs" (technical requirements) were scored using a 3-point ordinal scale, with 1 indicating weak correlation, 5 indicating medium correlation, and 9 indicating the strongest correlation.
RESULTS: A total of 13 stakeholders participated in the study, including women who had either underwent or never had health screening, a health administrator, a primary care physician, medical officers, nurses, and software designers. Stakeholder evaluations highlighted cost-free access (mean 4.64, SD 0.81), comprehensive cancer information (mean 4.55, SD 0.69), detailed screening benefits (mean 4.45, SD 0.68), detailed screening facilities (mean 4.45, SD 0.68) and personalized risk calculator for breast and cervical cancers (mean 4.45, SD 0.68) as essential priorities of the app. The highest-ranked features include detailed information on screening procedures (weighted score [WS]=367.84), information on treatment options (WS=345.80), benefits of screening (WS=333.75), information about breast and cervical cancers (WS=332.15), and frequently asked questions about the concerns around screening (WS=312.00).
CONCLUSIONS: The MAwar app, conceived through a collaborative, stakeholder-driven process, represents a significant step in leveraging digital health solutions to tackle cancer screening disparities. By prioritizing accessibility, information quality, and clarity on benefits, the app promises to encourage early cancer detection and management for targeted communities.
METHODS: A two-round Delphi process was conducted, surveying an international expert panel in the field of stroke care and cerebrovascular medicine, including patient representatives, healthcare professionals, researchers, policymakers, and medical directors. Experts scored the importance and required effort to close 13 gaps throughout the stroke care continuum and proposed potential solutions. Data were analyzed using descriptive statistics and qualitative analysis methods.
RESULTS: In the first and second Delphi rounds, 35 and 30 experts participated, respectively. Expert consensus was reached on the high importance of closing 11 out of 13 gaps. Two out of 13 gaps were considered moderately important to close, with expert consensus for one of these two gaps. Expert consensus indicated that only one gap, related to the prevention of complications after stroke, requires moderate effort to close, whereas the others were considered to require high effort to close. Key focus areas for potential solutions included: "Care infrastructure," "Geographic disparities," "Interdisciplinary collaboration," and "Advocacy and funding."
CONCLUSIONS: While closing gaps in stroke care primarily requires high effort and substantial resources, targeted interventions in the identified key focus areas may provide feasible and clinically meaningful improvements.