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Fulltext "Suiting Up" to Enhance Empathy Toward Aging: A Randomized Controlled Study

Lee SWH, Teh PL

Front Public Health, 2020;8:376.
PMID: 32984232 DOI: 10.3389/fpubh.2020.00376

Background: Healthcare professionals who have a positive attitude and who are more empathetic toward older adults are in a better position to deliver quality healthcare. This study examines the impact of using an aging simulation suit on undergraduate pharmacy students' empathy levels.
Methods: One hundred and twenty first-year students enrolled in the Bachelor of Pharmacy course were randomized to either a medication review polypharmacy workshop (control) or an immersive aging simulation suit and medication review polypharmacy workshop (intervention). Intervention participants donned the aging suit and performed a series of tasks, including walking up a flight of stairs and filling up a form to simulate the physical limitations experienced by an older adult. The workshop was delivered at week 10 of semester. Both groups also completed a medication review polypharmacy workshop at week 12 of semester. The primary outcome was a measurement of change on the Jefferson Empathy Scale-Healthcare Professional Questionnaire among both groups at week 12 of semester. Secondary outcomes include the longitudinal impact of intervention after 3 months of the workshop and perceptions on learning.
Results: The use of a simulation suit did not increase participants' self-rated empathy compared to control. However, the suit enhanced the ability of participants to understand the physical limitations and visual issues associated with aging. Participants also felt that it enhanced their health advocacy, as it taught them the importance of listening, patience and respect for older adults.
Conclusion: The use of an immersive aging suit can be a useful adjunctive tool to help enhance students' understanding of the physical limitations and visual limitations of aging. Further research is needed to understand how these limitations affect other healthcare students. Trial Registration: ClinicalTrials.gov identifier: NCT04133727.
Study site: Monash University Malaysia
Fulltext A Comprehensive Review on the Optical Micro-Electromechanical Sensors for the Biomedical Application

Upadhyaya AM, Hasan MK, Abdel-Khalek S, Hassan R, Srivastava MC, Sharan P, et al.

Front Public Health, 2021;9:759032.
PMID: 34926383 DOI: 10.3389/fpubh.2021.759032

This study presented an overview of current developments in optical micro-electromechanical systems in biomedical applications. Optical micro-electromechanical system (MEMS) is a particular class of MEMS technology. It combines micro-optics, mechanical elements, and electronics, called the micro-opto electromechanical system (MOEMS). Optical MEMS comprises sensing and influencing optical signals on micron-level by incorporating mechanical, electrical, and optical systems. Optical MEMS devices are widely used in inertial navigation, accelerometers, gyroscope application, and many industrial and biomedical applications. Due to its miniaturised size, insensitivity to electromagnetic interference, affordability, and lightweight characteristic, it can be easily integrated into the human body with a suitable design. This study presented a comprehensive review of 140 research articles published on photonic MEMS in biomedical applications that used the qualitative method to find the recent advancement, challenges, and issues. The paper also identified the critical success factors applied to design the optimum photonic MEMS devices in biomedical applications. With the systematic literature review approach, the results showed that the key design factors could significantly impact design, application, and future scope of work. The literature of this paper suggested that due to the flexibility, accuracy, design factors efficiency of the Fibre Bragg Grating (FBG) sensors, the demand has been increasing for various photonic devices. Except for FBG sensing devices, other sensing systems such as optical ring resonator, Mach-Zehnder interferometer (MZI), and photonic crystals are used, which still show experimental stages in the application of biosensing. Due to the requirement of sophisticated fabrication facilities and integrated systems, it is a tough choice to consider the other photonic system. Miniaturisation of complete FBG device for biomedical applications is the future scope of work. Even though there is a lot of experimental work considered with an FBG sensing system, commercialisation of the final FBG device for a specific application has not been seen noticeable progress in the past.
Fulltext A Cross-Sectional Assessment of Urinary Tract Infections Among Geriatric Patients: Prevalence, Medication Regimen Complexity, and Factors Associated With Treatment Outcomes

Akhtar A, Ahmad Hassali MA, Zainal H, Ali I, Khan AH

Front Public Health, 2021;9:657199.
PMID: 34733812 DOI: 10.3389/fpubh.2021.657199

Background: Urinary tract infections (UTIs) are the second most prevalent infection among the elderly population. Hence, the current study aimed to evaluate the prevalence of UTIs among older adults, medication regimen complexity, and the factors associated with the treatment outcomes of elderly patients infected with UTIs. Methods: A retrospective cross-sectional study was conducted at the Department of Urology, Hospital Pulau Pinang, Malaysia. The patients ≥65 years of age were included in the present study with a confirmed diagnosis of UTIs from 2014 to 2018 (5 years). Results: A total of 460 patients met the inclusion criteria and were included in the present study. Cystitis (37.6%) was the most prevalent UTI among the study population followed by asymptomatic bacteriuria (ASB) (31.9%), pyelonephritis (13.9%), urosepsis (10.2%), and prostatitis (6.4%). Unasyn (ampicillin and sulbactam) was used to treat the UTIs followed by Bactrim (trimethoprim/sulfamethoxazole), and ciprofloxacin. The factors associated with the treatment outcomes of UTIs were gender (odd ratio [OR] = 1.628; p = 0.018), polypharmacy (OR = 0.647; p = 0.033), and presence of other comorbidities (OR = 2.004; p = 0.002) among the study population. Conclusion: Cystitis is the most common UTI observed in older adults. Gender, the burden of polypharmacy, and the presence of comorbidities are the factors that directly affect the treatment outcomes of UTIs among the study population.
Fulltext A Future Forecasting for FMCG Firm Performance in Covid-19: An Investigation of Consumer and Business Survival

Sun Y, Li Y, Wang Y, Jiang D, Liu X

Front Public Health, 2021;9:723084.
PMID: 34604162 DOI: 10.3389/fpubh.2021.723084

The Covid-19 outbreak has spread over the world, limiting population and trade, causing job losses, and forcing businesses to close. The study's goal is to look at Covid-19's pandemic and consumer survival as a mediator for the future of running a business when FMCG companies are doing well. The researchers employed a basic random sampling strategy to do a layered transverse evaluation of samples. EFA, CFA, and SEM are used to choose data collection techniques for participants at Covid-19. According to the data, Malaysia has resulted in job losses, business growth, and customer satisfaction retention, as well as an increase in unemployment, company closures, and a drop in overall GDP. The impact of the Covid-19 epidemic on survival, production, and GDP has been demonstrated. Incorporating technology into all aspects of a company's working practices reveals the necessity and capacity of the organization to adapt to new scenarios.
Fulltext A Multi-Domain Intervention Protocol for the Potential Reversal of Cognitive Frailty: "WE-RISE" Randomized Controlled Trial

Murukesu RR, Singh DKA, Shahar S, Subramaniam P

Front Public Health, 2020;8:471.
PMID: 33014971 DOI: 10.3389/fpubh.2020.00471

Following the rapid increase of the aging population, health promotion and prevention of physical disability and dementia in older persons are essential for healthy aging. For example, there may be a potential to prevent or reverse cognitive frailty, the co-existence of both physical frailty and cognitive impairment in older persons. However, evidence-based interventions targeting the prevention or potential reversibility of cognitive frailty among community dwelling older adults are scarce. In this paper, we described the rationale, development and delivery of a multi-domain intervention comprising multi-component physical exercise prescription, cognitive training, dietary counseling and promotion of psychosocial support, called the WE-RISE trial. The aim of WE-RISE intervention is to potentially reverse cognitive frailty. This is a two-armed, single blinded, randomized controlled trial conducted over a duration of 6 months, at senior citizen activity centers within the Klang Valley, Malaysia. Ambulating, community dwelling older adults aged 60 years and above with cognitive frailty are randomized into two groups; (1) intervention group: which receives an instructor based "WE-RISE" intervention for the first 3 months, and then a home-based "WE-RISE at Home" intervention for the following 3 months; (2) control group: usual care with no modifications to their daily routine. Primary outcome is cognitive frailty status and secondary outcome include physical function, cognitive performance, nutritional status, psychosocial status and quality of life which are obtained during baseline screening and subsequent follow ups at 3rd and 6th month. Description of the intervention is done using the template for intervention description and replication (TIDieR) checklist. This trial protocol has received approval from Research Ethics Committee of Universiti Kebangsaan Malaysia (UKM PPI/111/8/JEP-2018-558) and the Department of Social Welfare Malaysia (MyResearch Reference: JKMM 100/12/5/2: 2018/405). Trial registration number: ACTRN12619001055190.
Fulltext A Non-severe Coronavirus Disease 2019 Patient With Persistently High Interleukin-6 Level

Hambali NL, Mohd Noh M, Paramasivam S, Chua TH, Hayati F, Payus AO, et al.

Front Public Health, 2020;8:584552.
PMID: 33304877 DOI: 10.3389/fpubh.2020.584552

Interleukin 6 (IL-6) is one of the markers of immune system activation indicating existent infection and inflammation. We present here a case of a 55-year-old male COVID-19 patient with an unusual high level of interleukin 6 (IL-6). Further investigation revealed he had hepatocellular carcinoma (HCC) with underlying hepatitis B. He did not present with respiratory symptoms although a baseline chest x-ray showed changes, and the patient was categorized as Class 3A of COVID-19. Routine investigations proceeded with high-resolution computed tomography and IL-6 to monitor for progression to severe COVID-19. Notably, there was a high IL-6 level but other parameters did not show he was in severe COVID-19. In this report, we conclude that elevated IL-6 level in a COVID-19 patient is not necessarily associated with severe COVID-19.
Fulltext A Predictive and Preventive Model for Onset of Alzheimer's Disease

Singhania U, Tripathy B, Hasan MK, Anumbe NC, Alboaneen D, Ahmed FRA, et al.

Front Public Health, 2021;9:751536.
PMID: 34708019 DOI: 10.3389/fpubh.2021.751536

Alzheimer's Disease (AD) is a neurodegenerative irreversible brain disorder that gradually wipes out the memory, thinking skills and eventually the ability to carry out day-to-day tasks. The amount of AD patients is rapidly increasing due to several lifestyle changes that affect biological functions. Detection of AD at its early stages helps in the treatment of patients. In this paper, a predictive and preventive model that uses biomarkers such as the amyloid-beta protein is proposed to detect, predict, and prevent AD onset. A Convolution Neural Network (CNN) based model is developed to predict AD at its early stages. The results obtained proved that the proposed model outperforms the traditional Machine Learning (ML) algorithms such as Logistic Regression, Support Vector Machine, Decision Tree Classifier, and K Nearest Neighbor algorithms.
Fulltext A Qualitative Study Exploring Community Pharmacists' Experiences and Views About Weight Management Interventions and Services in Klang Valley, Malaysia

Verma RK, Chong WW, Taha NA, Paraidathathu T

Front Public Health, 2021;9:720928.
PMID: 34540789 DOI: 10.3389/fpubh.2021.720928

Objective: To qualitatively explore the perspectives of community pharmacists in Malaysia on their roles in weight management, and the barriers and facilitators in the expansion of these roles. Methods: A purposive sampling method was used to recruit community pharmacists in Klang Valley, Malaysia. Semi-structured individual interviews were conducted with community pharmacists, with an interview guide, from May 2018 to January 2019. The interviews were conducted in person (face-to-face). All interviews were audio-recorded with consent and transcribed verbatim. The interview transcripts were analyzed thematically, whereby emerging themes were coded and grouped into categories. Results: Twenty-four community pharmacists were recruited, with years of experience in pharmacy practice ranging from 2 to 40 years. Participants described their perceptions on the different weight management interventions where they emphasized the importance of a comprehensive lifestyle intervention and viewed that it should be the first-line intervention. Participants regarded their weight management service as easily accessible or approachable since community pharmacies are often the first point of call for patients seeking advice for their conditions before consulting doctors. Barriers identified by community pharmacists were mainly organizational in nature, which included lack of private consultation rooms, lack of time, and lack of qualified staff. Participants also described the need for training in weight management. Conclusion: Community pharmacists in Malaysia believed that they can positively contribute to the area of weight management. They cited multiple roles that they could play in weight management interventions and services. The roles cited include provision of education and advice, including on lifestyle modifications, drug therapy, weight loss products and supplements, and monitoring and providing referrals to other healthcare professionals. However, barriers would need to be addressed, including through pharmacist training, to strengthen and improve community pharmacists' roles and contributions in weight management service.
Fulltext A Qualitative Study on Formal and Informal Carers' Perceptions of Dementia Care Provision and Management in Malaysia

Goodson M, McLellan E, Rosli R, Tan MP, Kamaruzzaman S, Robinson L, et al.

Front Public Health, 2021;9:637484.
PMID: 34368037 DOI: 10.3389/fpubh.2021.637484

Background: The number of people living with dementia worldwide is increasing, particularly in low- and middle-income countries (LMICs) where little is known about existing post-diagnostic care and support. This study aimed to better understand healthcare provision for people living with dementia in Malaysia, and to identify priorities for providing timely, quality, and accessible care and support to all. Methods: This is a qualitative interview study on care providers and facilitators (health and community care professionals, paid carers, traditional medicine practitioners, faith healers, community leaders, non-governmental organisations). A topic guide, piloted in Malaysia and peer reviewed by all LMIC partners, elicited the understanding of dementia and dementia care and barriers and facilitators to care for people living with dementia and carers, and perceptions of key priorities for developing efficient, feasible, and sustainable dementia care pathways. Verbatim transcription of audio-recorded interviews was followed by iterative, thematic data analysis. Results: Twenty interviews were conducted (11 healthcare professionals, 4 traditional medicine practitioners, and 5 social support providers). The findings indicate that dementia care and support services exist in Malaysia, but that they are not fully utilised because of variations in infrastructure and facilities across the country. Despite a locally recognised pathway of care being available in an urban area, people with dementia still present to the healthcare system with advanced disease. The interviewees linked this to a public perception that symptoms of dementia, in particular, are normal sequelae of ageing. Earlier detection of dementia is commonly opportunistic when patients present to GPs, government clinic staff, and general physicians with other ailments. Dementia may only be identified by practitioners who have some specialist interest or expertise in it. Workforce factors that hindered early identification and management of dementia included lack of specialists, overburdened clinics, and limited knowledge of dementia and training in guideline use. Post-diagnostic social care was reported to be largely the domain of families, but additional community-based support was reported to be available in some areas. Raising awareness for both the public and medical professionals, prevention, and more support from the government are seen as key priorities to improve dementia management. Conclusions: This qualitative study provides novel insight into the availability, delivery, and use of post-diagnostic care and support in Malaysia from the perspective of care providers. The respondents in this study perceived that while there was a provision for dementia care in the hospital and community settings, the different care sectors are largely unaware of the services each provides. Future work should explore how care provision across different service sectors and providers can be supported to better facilitate patient access and referral between primary, secondary, and social care. The importance of supporting families to understand dementia and its progression, and strategies to help them care for relatives was emphasised. There is also a need for broad workforce training and development, at both the postgraduate and undergraduate levels, as well as improved general awareness in the community to encourage earlier help-seeking for symptoms of dementia. This will enable the use of preventive strategies and access to specialist services to optimise care and quality of life for people living with dementia in Malaysia.
Fulltext A Systematic Review of Medical Equipment Reliability Assessment in Improving the Quality of Healthcare Services

Zamzam AH, Abdul Wahab AK, Azizan MM, Satapathy SC, Lai KW, Hasikin K

Front Public Health, 2021;9:753951.
PMID: 34646808 DOI: 10.3389/fpubh.2021.753951

Medical equipment highly contributes to the effectiveness of healthcare services quality. Generally, healthcare institutions experience malfunctioning and unavailability of medical equipment that affects the healthcare services delivery to the public. The problems are frequently due to a deficiency in managing and maintaining the medical equipment condition by the responsible party. The assessment of the medical equipment condition is an important activity during the maintenance and management of the equipment life cycle to increase availability, performance, and safety. The study aimed to perform a systematic review in extracting and categorising the input parameters applied in assessing the medical equipment condition. A systematic searching was undertaken in several databases, including Web of Science, Scopus, PubMed, Science Direct, IEEE Xplore, Emerald, Springer, Medline, and Dimensions, from 2000 to 2020. The searching processes were conducted in January 2020. A total of 16 articles were included in this study by adopting Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The review managed to classify eight categories of medical equipment reliability attributes, namely equipment features, function, maintenance requirement, performance, risk and safety, availability and readiness, utilisation, and cost. Applying the eight attributes extracted from computerised asset maintenance management system will assist the clinical engineers in assessing the reliability of medical equipment utilised in healthcare institution. The reliability assessment done in these eight attributes will aid clinical engineers in executing a strategic maintenance action, which can increase the equipment's availability, upkeep the performance, optimise the resources, and eventually contributes in providing effective healthcare service to the community. Finally, the recommendations for future works are presented at the end of this study.
Fulltext A longitudinal analysis of injury characteristics among elite and amateur tennis players at different tournaments from electronic newspaper reports

Musa RM, Hassan I, Abdullah MR, Latiff Azmi MN, Abdul Majeed APP, Abu Osman NA

Front Public Health, 2022;10:835119.
PMID: 36033746 DOI: 10.3389/fpubh.2022.835119

The non-complexity of tennis, coupled with its health benefits, renders it appealing and encourages varying competitions at different levels of age, gender, and expertise. However, the rapid increase in the participation rates witnesses a surge in injury occurrences, prompting the need for in-depth analysis to facilitate immediate intervention. We employed a media content analysis technique in which tennis-associated articles published in the last 5 years were examined. A total of 207 news reports were gathered and screened for analysis. Subsequently, 71 articles were excluded from the study due to content duplications or summary updates of existing news articles, while 23 news articles were also excluded from the study due to inappropriateness. Finally, 113 news reports directly related to injury in tennis were coded and analyzed. We examined various types of injuries reported from the screened articles with respect to their status (fresh, recurrent, and recovery) across expertise levels i.e., elite, or amateur. Similarly, the incidence of injury occurrences based on the types of tournaments the players engage in was also investigated. A chi-square analysis was employed to achieve the objectives of the study. Occurrences of tennis-associated injuries are disseminated across expertise levels [ χ ( 18 ) 2 = 16.542; p = 0.555], with knee, hip, elbow, and shoulder injuries being highly prevalent in both elite and amateur players. Nevertheless, it was noted that elite players suffered a staggering 72.60% of injury-related problems, while amateur players sustained 27.40% of injuries. Moreover, the status of injury spreads based on types of tournaments [ χ ( 4 ) 2 = 3.374; p = 0.497], with higher occurrences of fresh and recurrent injuries, while low recovery rates were observed. The findings further demonstrated that injuries are sustained regardless of tournament types [ χ ( 36 ) 2 = 39.393; p = 0.321]. However, most of the injuries occurred at international tournaments (85%). Whereas, only 5.30% of the injuries occurred at national/regional tournaments while 9.70% were unidentified. It could be deduced from the findings of this investigation that elite players are more prone to injuries compared with amateur players. Furthermore, the most common tennis-related injuries affect the lower, trunk, and upper regions of the body, respectively. A large number of the reported tennis injuries are fresh and recurrent, with a few recoveries. The international tennis tournaments are highly attributed to injury occurrences as opposed to the national/regional tournaments. The application of the media-based data mining technique is non-trivial in projecting injury-related problems that could be used to facilitate the development of an injury index peculiar to the tennis sport for prompt intervention.
Fulltext A narrative action on the battle against hunger using mushroom, peanut, and soybean-based wastes

Mohd Zaini NA, Azizan NAZ, Abd Rahim MH, Jamaludin AA, Raposo A, Raseetha S, et al.

Front Public Health, 2023;11:1175509.
PMID: 37250070 DOI: 10.3389/fpubh.2023.1175509

Numerous generations have been affected by hunger, which still affects hundreds of millions of people worldwide. The hunger crisis is worsening although many efforts have been made to minimize it. Besides that, food waste is one of the critical problems faced by most countries worldwide. It has disrupted the food chain system due to inefficient waste management, while negatively impacting the environment. The majority of the waste is from the food production process, resulting in a net zero production for food manufacturers while also harnessing its potential. Most food production wastes are high in nutritional and functional values, yet most of them end up as low-cost animal feed and plant fertilizers. This review identified key emerging wastes from the production line of mushroom, peanut, and soybean (MPS). These wastes (MPS) provide a new source for food conversion due to their high nutritional content, which contributes to a circular economy in the post-pandemic era and ensures food security. In order to achieve carbon neutrality and effective waste management for the production of alternative foods, biotechnological processes such as digestive, fermentative, and enzymatic conversions are essential. The article provides a narrative action on the critical potential application and challenges of MPS as future foods in the battle against hunger.
Fulltext A systematic review and meta-analysis of the effects of temperature on the development and survival of the Aedes mosquito

Nik Abdull Halim NMH, Che Dom N, Dapari R, Salim H, Precha N

Front Public Health, 2022;10:1074028.
PMID: 36600940 DOI: 10.3389/fpubh.2022.1074028

INTRODUCTION: The Aedes mosquito species, which are the vectors for the transmission of the dengue virus (DENV) to humans, are becoming increasingly susceptible to the formidable effects of influential factors, especially temperature. However, there are still very few studies that have systematically reviewed the existing literature. Hence, in the present study, a systematic literature review and meta-analysis was conducted into the effects of temperature on dengue vectors.
METHOD: Several research methodologies were incorporated into the current study, and a review was carried out using PRISMA as a guide. The publications for this study were chosen from two prominent databases, Scopus and Web of Science. All of the studies were assessed, reviewed, and evaluated independently by two reviewers. The meta-analysis tool, Review Manager (RevMan Copenhagen Version 5.4.1), was used to record the extracted data for the meta-analysis. Moran's I 2 and a funnel plot were utilized to measure heterogeneity, and publication bias was investigated. A 95% confidence interval (CI) and overall risk difference (RD) were estimated using a random-effects model.
RESULT AND DISCUSSION: As a consequence of the search efforts, a total of 46 articles were selected for inclusion in the systematic review and meta-analysis. This review was divided into five major themes, based on a thematic analysis: (i) hatching rate, (ii) development time, (iii) longevity, (iv) survival rate, and (v) wing morphology. In addition, the development time, survival rate, and wing morphology revealed significantly higher risk differences between the maximum and minimum temperatures (RD: 0.26, 95% CI: 0.16, 0.36; p = < 0.00001; RD: 0.10, 95% CI: 0.05, 0.14; p < 0.0001; and RD: 0.07, 95% CI: 0.02, 0.12; p = 0.006, respectively). This study makes several substantial contributions to the body of knowledge and to practical applications. Finally, a number of recommendations are made at the conclusion of this research for the future reference of researchers.
Fulltext Acceptance of a COVID-19 Vaccine in Southeast Asia: A Cross-Sectional Study in Indonesia

Harapan H, Wagner AL, Yufika A, Winardi W, Anwar S, Gan AK, et al.

Front Public Health, 2020;8:381.
PMID: 32760691 DOI: 10.3389/fpubh.2020.00381

Introduction: Several vaccine candidates are being clinically tested in response to the 2019 coronavirus disease (COVID-19) pandemic. This study was conducted to assess the acceptance of a 50 or 95% effective COVID-19 vaccine, when it becomes available in southeast Asia, among the general population in Indonesia. Methods: A cross-sectional online survey was conducted between March 25 and April 6, 2020. Participants were asked if they would accept a free vaccine which was 95 or 50% effective. Using a logistic regression model, we assessed the associations between sociodemographic characteristics, exposure to COVID-19 information, or perceived risk of infection with acceptance of a hypothetical COVID-19 vaccine. Results: Among 1,359 respondents, 93.3% of respondents (1,268/1,359) would like to be vaccinated for a 95% effective vaccine, but this acceptance decreased to 67.0% (911/1,359) for a vaccine with 50% effectiveness. For a 95% effective vaccine, being a healthcare worker and having a higher perceived risk of COVID-19 infection were associated with higher acceptance, adjusted odds ratio (aOR): 2.01; 95%CI: 1.01, 4.00 and aOR: 2.21; 95%CI: 1.07, 4.59, respectively; compared to civil servants, being retired was associated with less acceptance (aOR: 0.15; 95%CI: 0.04, 0.63). For a 50% effective vaccine, being a healthcare worker was also associated with greater acceptance, aOR: 1.57; 95%CI: 1.12, 2.20. Conclusion: Acceptance of a COVID-19 vaccine was highly influenced by the baseline effectiveness of the vaccine. Preparing the general population to accept a vaccine with relatively low effectiveness may be difficult.
Fulltext Acceptance of medical drone technology and its determinant factors among public and healthcare personnel in a Malaysian urban environment: knowledge, attitude, and perception

Za'im Sahul Hameed M, Nordin R, Ismail A, Zulkifley MA, Sham ASH, Sabudin RZAR, et al.

Front Public Health, 2023;11:1199234.
PMID: 38045974 DOI: 10.3389/fpubh.2023.1199234

INTRODUCTION: Unmanned aerial vehicles (UAVs) are used for commercial, medical, public safety, and scientific research purposes in various countries.
METHODS: This study aimed to explore the acceptance of medical delivery drones among medical practitioners as well as the public community in Malaysia using a knowledge, attitude, and perception (KAP) model and statistical analysis to decrease uncertainty. Bivariate and multivariate analyses of the results were performed in SPSS.
RESULTS: A total of 639 respondents took part in the survey, of which 557 complete responses were finally analyzed. The results showed that the overall acceptance rate for medical delivery drones was positive. The acceptance rate was significantly correlated with knowledge, attitude, and perception scores but not with sociodemographic factors.
DISCUSSION: Raising awareness and educating the medical as well as public communities regarding the potential role and benefits of drones are therefore important in garnering support for drone usage for medical purposes.
Fulltext Adapted digital health literacy and health information seeking behavior among lower income groups in Malaysia during the COVID-19 pandemic

Marzo RR, Chen HWJ, Abid K, Chauhan S, Kaggwa MM, Essar MY, et al.

Front Public Health, 2022;10:998272.
PMID: 36187682 DOI: 10.3389/fpubh.2022.998272

BACKGROUND: Misinformation has had a negative impact upon the global COVID-19 vaccination program. High-income and middle-income earners typically have better access to technology and health facilities than those in lower-income groups. This creates a rich-poor divide in Digital Health Literacy (DHL), where low-income earners have low DHL resulting in higher COVID-19 vaccine hesitancy. Therefore, this cross-sectional study was undertaken to assess the impact of health information seeking behavior on digital health literacy related to COVID-19 among low-income earners in Selangor, Malaysia.
METHODS: A quantitative cross-sectional study was conducted conveniently among 381 individuals from the low-income group in Selangor, Malaysia. The remote data collection (RDC) method was used to gather data. Validated interviewer-rated questionnaires were used to collect data via phone call. Respondents included in the study were 18 years and older. A normality of numerical variables were assessed using Shapiro-Wilk test. Univariate analysis of all variables was performed, and results were presented as means, mean ranks, frequencies, and percentages. Mann-Whitney U test or Kruskal Wallis H test was applied for the comparison of DHL and health information seeking behavior with characteristics of the participants. Multivariate linear regression models were applied using DHL as dependent variable and health information seeking behavior as independent factors, adjusting for age, gender, marital status, educational status, employment status, and household income.
RESULTS: The mean age of the study participants was 38.16 ± 14.40 years ranging from 18 to 84 years. The vast majority (94.6%) of participants stated that information seeking regarding COVID-19 was easy or very easy. Around 7 percent of the respondents cited reading information about COVID-19 on the internet as very difficult. The higher mean rank of DHL search, content, reliability, relevance, and privacy was found among participants who were widowed, had primary education, or unemployed. An inverse relationship was found between overall DHL and confidence in the accuracy of the information on the internet regarding COVID-19 (β = -2.01, 95% CI = -2.22 to -1.79).
CONCLUSION: It is important to provide support to lower-income demographics to assist access to high-quality health information, including less educated, unemployed, and widowed populations. This can improve overall DHL.
Fulltext Adopting social health insurance in Nepal: A mixed study

Paneru DP, Adhikari C, Poudel S, Adhikari LM, Neupane D, Bajracharya J, et al.

Front Public Health, 2022;10:978732.
PMID: 36589957 DOI: 10.3389/fpubh.2022.978732

OBJECTIVE: The Social Health Insurance Program (SHIP) shares a major portion of social security, and is also key to Universal Health Coverage (UHC) and health equity. The Government of Nepal launched SHIP in the Fiscal Year 2015/16 for the first phase in three districts, on the principle of financial risk protection through prepayment and risk pooling in health care. Furthermore, the adoption of the program depends on the stakeholders' behaviors, mainly, the beneficiaries and the providers. Therefore, we aimed to explore and assess their perception and experiences regarding various factors acting on SHIP enrollment and adherence.
METHODS: A cross-sectional, facility-based, concurrent mixed-methods study was carried out in seven health facilities in the Kailali, Baglung, and Ilam districts of Nepal. A total of 822 beneficiaries, sampled using probability proportional to size (PPS), attending health care institutions, were interviewed using a structured questionnaire for quantitative data. A total of seven focus group discussions (FGDs) and 12 in-depth interviews (IDIs), taken purposefully, were conducted with beneficiaries and service providers, using guidelines, respectively. Quantitative data were entered into Epi-data and analyzed with SPSS, MS-Excel, and Epitools, an online statistical calculator. Manual thematic analysis with predefined themes was carried out for qualitative data. Percentage, frequency, mean, and median were used to describe the variables, and the Chi-square test and binary logistic regression were used to infer the findings. We then combined the qualitative data from beneficiaries' and providers' perceptions, and experiences to explore different aspects of health insurance programs as well as to justify the quantitative findings.
RESULTS AND PROSPECTS: Of a total of 822 respondents (insured-404, uninsured-418), 370 (45%) were men. Families' median income was USD $65.96 (8.30-290.43). The perception of insurance premiums did not differ between the insured and uninsured groups (p = 0.53). Similarly, service utilization (OR = 220.4; 95% CI, 123.3-393.9) and accessibility (OR = 74.4; 95% CI, 42.5-130.6) were found to have high odds among the insured as compared to the uninsured respondents. Qualitative findings showed that the coverage and service quality were poor. Enrollment was gaining momentum despite nearly a one-tenth (9.1%) dropout rate. Moreover, different aspects, including provider-beneficiary communication, benefit packages, barriers, and ways to go, are discussed. Additionally, we also argue for some alternative health insurance schemes and strategies that may have possible implications in our contexts.
CONCLUSION: Although enrollment is encouraging, adherence is weak, with a considerable dropout rate and poor renewal. Patient management strategies and insurance education are recommended urgently. Furthermore, some alternate schemes and strategies may be considered.
Fulltext Ageing Population's Impact on Economic Growth in Malaysia From 1981 to 2019: Evidence From an Autoregressive Distributed Lag Approach

Mohd SNA, Ishak AA, Selvaratnam DP

Front Public Health, 2021;9:731554.
PMID: 35004564 DOI: 10.3389/fpubh.2021.731554

This study investigates the impact of the ageing population on the economic growth for short- and long-run estimations in Malaysia, by using time series data from 1981 to 2019. This study adopts the autoregressive distributed lag (ARDL) method with the Bound test approach for the long-run estimation and the vector error correction model for the short-run estimation. Several econometric diagnostic tests were applied for validation and the appropriate model specification basis. The estimated result of this work indicates that the age dependency ratio proxy for the ageing population variable has a significant negative impact on economic growth in Malaysia. A 1% increase in old age dependency will decline gross domestic product's (GDP's) growth by an average of 6.6043% at the 5% level of significance. Hence, an increase in the ageing population will impede economic growth. Although controlled variables (e.g., physical capital, labour participation, and human capital) have a significant positive impact on economic growth in Malaysia, there is evidence of a long- and short-run relationship between economic growth and the ageing population variable, and also the control variable.
Fulltext An Empirical Model to Predict the Diabetic Positive Using Stacked Ensemble Approach

R S, M S, Hasan MK, Saeed RA, Alsuhibany SA, Abdel-Khalek S

Front Public Health, 2021;9:792124.
PMID: 35127623 DOI: 10.3389/fpubh.2021.792124

Today, disease detection automation is widespread in healthcare systems. The diabetic disease is a significant problem that has spread widely all over the world. It is a genetic disease that causes trouble for human life throughout the lifespan. Every year the number of people with diabetes rises by millions, and this affects children too. The disease identification involves manual checking so far, and automation is a current trend in the medical field. Existing methods use a single algorithm for the prediction of diabetes. For complex problems, a single model is not enough because it may not be suitable for the input data or the parameters used in the approach. To solve complex problems, multiple algorithms are used. These multiple algorithms follow a homogeneous model or heterogeneous model. The homogeneous model means the same algorithm, but the model has been used multiple times. In the heterogeneous model, different algorithms are used. This paper adopts a heterogeneous ensemble model called the stacked ensemble model to predict whether a person has diabetes positively or negatively. This stacked ensemble model is advantageous in the prediction. Compared to other existing models such as logistic regression Naïve Bayes (72), (74.4), and LDA (81%), the proposed stacked ensemble model has achieved 93.1% accuracy in predicting blood sugar disease.
Fulltext An Exploratory Qualitative Study With Older Malaysian Stroke Survivors, Caregivers, and Healthcare Practitioners About Falls and Rehabilitation for Falls After Stroke

Ahmad Ainuddin H, Romli MH, Hamid TA, Sf Salim M, Mackenzie L

Front Public Health, 2021;9:611814.
PMID: 33987161 DOI: 10.3389/fpubh.2021.611814

Background: Studies on rehabilitation for falls after a stroke remain limited despite its impact being profound. This scenario justifies a deeper understanding of why falls in stroke rehabilitation received less attention. Current investigations on the perception of falls and stroke also proved inadequate. Therefore, this study aims to explore the perceptions and experiences of older Malaysian stroke survivors, spousal caregivers, and healthcare practitioners on falls in stroke rehabilitation. Method: A qualitative study of three focus groups with 18 individuals from one community-based stroke rehabilitation center was conducted. The discussions were audio-recorded, video-recorded, transcribed, summarized, and analyzed using thematic analysis. Results: Three themes emerged from the analysis: (i) perceived factors and consequences of falls after stroke, (ii) physical-based interventions predominate in rehabilitation for falls after stroke, and (iii) the role of home hazards in fall prevention is taken for granted. Although, awareness of falls is high, they are regarded as a peripheral issue in stroke. Rehabilitation interventions such as improved functionality are believed to be adequate and can indirectly prevent falls. Other interventions for fall prevention such as home hazards management are relatively less known. Conclusion: There is a need for more attention regarding home environment risk assessment and intervention among healthcare professionals, and more education for clients and caregivers is required. Although, other stroke interventions may also benefit stroke survivors, falls prevention should be a central component in stroke rehabilitation. As this study focused on a specific population, the findings should be validated with larger populations, and in diverse settings.

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