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Fulltext Spinocerebellar ataxias in Asia: Prevalence, phenotypes and management

van Prooije T, Ibrahim NM, Azmin S, van de Warrenburg B

Parkinsonism Relat Disord, 2021 11;92:112-118.
PMID: 34711523 DOI: 10.1016/j.parkreldis.2021.10.023

This paper reviews and summarizes three main aspects of spinocerebellar ataxias (SCA) in the Asian population. First, epidemiological studies were comprehensively reviewed. Overall, the most common subtypes include SCA1, SCA2, SCA3, and SCA6, but there are large differences in the relative prevalence of these and other SCA subtypes between Asian countries. Some subtypes such as SCA12 and SCA31 are rather specific to certain Asian populations. Second, we summarized distinctive phenotypic manifestations of SCA patients of Asian origin, for example a frequent co-occurrence of parkinsonism in some SCA subtypes. Lastly, we have conducted an exploratory survey study to map SCA-specific expertise, resources, and management in various Asian countries. This showed large differences in accessibility, genetic testing facilities, and treatment options between lower and higher income Asian countries. Currently, many Asian SCA patients remain without a final genetic diagnosis. Lack of prevalence data on SCA, lack of patient registries, and insufficient access to genetic testing facilities hamper a wider understanding of these diseases in several (particularly lower income) Asian countries.

Matched MeSH terms: Disease Management*
Fulltext Percutaneous nephrostomy versus retrograde ureteral stenting for acute upper obstructive uropathy: a systematic review and meta-analysis

Zul Khairul Azwadi I, Norhayati MN, Abdullah MS

Sci Rep, 2021 Mar 23;11(1):6613.
PMID: 33758312 DOI: 10.1038/s41598-021-86136-y

Acute obstructive uropathy is associated with significant morbidity among patients with any condition that leads to urinary tract obstruction. Immediate urinary diversion is necessary to prevent further damage to the kidneys. In many centres, the two main treatment options include percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS). The purpose of this study if to compare the efficacy and safety of PCN and RUS for the treatment of acute obstructive uropathy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, the World Health Organisation International Clinical Trials Registry Platform and ClinicalTrials.gov. We also searched the reference lists of included studies to identify any additional trials. We included randomised controlled trials and controlled clinical trials comparing the outcomes of clinical improvement (septic parameters), hospitalisation duration, quality of life, urinary-related symptoms, failure rates, post-procedural pain [measured using a visual analogue scale (VAS)] and analgesics use. We conducted statistical analyses using random effects models and expressed the results as risk ratio (RR) and risk difference (RD) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CIs). Seven trials were identified that included 667 patients. Meta-analysis of the data revealed no difference in the two methods in improvement of septic parameters, quality of life, failure rates, post-procedural pain (VAS), or analgesics use. Patients receiving PCN had lower rates of haematuria and dysuria post-operatively and longer hospitalisation duration than those receiving RUS. PCN and RUS are effective for the decompression of an obstructed urinary system, with no significant difference in most outcomes. However, PCN is preferable to RUS because of its reduced impact on the patient's post-operative quality of life due to haematuria and dysuria, although it is associated with slightly longer hospitalisation duration.

Matched MeSH terms: Disease Management
Recent Advances in Rational Diagnosis and Treatment of Normal Pressure Hydrocephalus: A Critical Appraisal on Novel Diagnostic, Therapy Monitoring and Treatment Modalities

Zhang L, Hussain Z, Ren Z

Curr Drug Targets, 2019;20(10):1041-1057.
PMID: 30767741 DOI: 10.2174/1389450120666190214121342

BACKGROUND: Normal pressure hydrocephalus (NPH) is a critical brain disorder in which excess Cerebrospinal Fluid (CSF) is accumulated in the brain's ventricles causing damage or disruption of the brain tissues. Amongst various signs and symptoms, difficulty in walking, slurred speech, impaired decision making and critical thinking, and loss of bladder and bowl control are considered the hallmark features of NPH.
OBJECTIVE: The current review was aimed to present a comprehensive overview and critical appraisal of majorly employed neuroimaging techniques for rational diagnosis and effective monitoring of the effectiveness of the employed therapeutic intervention for NPH. Moreover, a critical overview of recent developments and utilization of pharmacological agents for the treatment of hydrocephalus has also been appraised.
RESULTS: Considering the complications associated with the shunt-based surgical operations, consistent monitoring of shunting via neuroimaging techniques hold greater clinical significance. Despite having extensive applicability of MRI and CT scan, these conventional neuroimaging techniques are associated with misdiagnosis or several health risks to patients. Recent advances in MRI (i.e., Sagittal-MRI, coronal-MRI, Time-SLIP (time-spatial-labeling-inversion-pulse), PC-MRI and diffusion-tensor-imaging (DTI)) have shown promising applicability in the diagnosis of NPH. Having associated with several adverse effects with surgical interventions, non-invasive approaches (pharmacological agents) have earned greater interest of scientists, medical professional, and healthcare providers. Amongst pharmacological agents, diuretics, isosorbide, osmotic agents, carbonic anhydrase inhibitors, glucocorticoids, NSAIDs, digoxin, and gold-198 have been employed for the management of NPH and prevention of secondary sensory/intellectual complications.
CONCLUSION: Employment of rational diagnostic tool and therapeutic modalities avoids misleading diagnosis and sophisticated management of hydrocephalus by efficient reduction of Cerebrospinal Fluid (CSF) production, reduction of fibrotic and inflammatory cascades secondary to meningitis and hemorrhage, and protection of brain from further deterioration.

Matched MeSH terms: Disease Management
Fulltext A Methodology on the Impact of Different Teamwork Skill Levels on the Efficiency of the Software Development Workflow Based on Malaysia Industry

Zairina Ibrahim, Md Gapar Md Johar

Journal of Management & Science, 2018;16(2):1-10.
MyJurnal

The process of software development life cycle (SDLC) is an important element of development phases to develop the application. In fact, there are needs to upgrade the sequence of methodology in software development. Thus, the SDLC is very crucial in order for them to ensure the quality of skills is placed accordingly in the workflow. This research contributes to the development of a new approach in system development workflow with the aim to properly manage system development projects. It started by providing some background data related to the previous mode of operation in the teamwork samples as shared by the stakeholders of the transformation projects and the new proposed Analysis System Development Framework (ASDF) method team members. Then, the key findings related to steps of software development such as (1) input for User Requirement Specification (URS) and (2) System Requirement Specification (SRS), (3) process for module, (4) process for database, (5) process for User Acceptance Testing (UAT) (6) output for Final Acceptance Testing (FAT) and empowerment for the whole level based on ASDF method. This paper contribution significantly to support the perception of high quality of skills in a teamwork, results in better performance of software development.

Matched MeSH terms: Disease Management
Improving Hypertension Outcome Measurement in Low- and Middle-Income Countries

Zack R, Okunade O, Olson E, Salt M, Amodeo C, Anchala R, et al.

Hypertension, 2019 05;73(5):990-997.
PMID: 30929516 DOI: 10.1161/HYPERTENSIONAHA.118.11916

High blood pressure is the leading modifiable risk factor for mortality, accounting for nearly 1 in 5 deaths worldwide and 1 in 11 in low-income countries. Hypertension control remains a challenge, especially in low-resource settings. One approach to improvement is the prioritization of patient-centered care. However, consensus on the outcomes that matter most to patients is lacking. We aimed to define a standard set of patient-centered outcomes for evaluating hypertension management in low- and middle-income countries. The International Consortium for Health Outcomes Measurement convened a Working Group of 18 experts and patients representing 15 countries. We used a modified Delphi process to reach consensus on a set of outcomes, case-mix variables, and a timeline to guide data collection. Literature reviews, patient interviews, a patient validation survey, and an open review by hypertension experts informed the set. The set contains 18 clinical and patient-reported outcomes that reflect patient priorities and evidence-based hypertension management and case-mix variables to allow comparisons between providers. The domains included are hypertension control, cardiovascular complications, health-related quality of life, financial burden of care, medication burden, satisfaction with care, health literacy, and health behaviors. We present a core list of outcomes for evaluating hypertension care. They account for the unique challenges healthcare providers and patients face in low- and middle-income countries, yet are relevant to all settings. We believe that it is a vital step toward international benchmarking in hypertension care and, ultimately, value-based hypertension management.

Matched MeSH terms: Disease Management*
Fulltext Initial evaluation of the training programme for health care professionals on the use of Malaysian clinical practice guidelines for management of dementia

Yusoff S, Koh CT, Mohd Aminuddin MY, Krishnasamy M, Suhaila MZ

East Asian Arch Psychiatry, 2013 Sep;23(3):91-101.
PMID: 24088402

The Malaysian Clinical Practice Guidelines (CPG) for Management of Dementia (second edition) was launched in April 2010 by the Ministry of Health Malaysia. A training programme for the management of dementia, involving all categories of staff working at primary and secondary centres, was implemented to ensure that care delivery for people with dementia was in accordance with the guidelines. The study aimed to look into improving knowledge and understanding of dementia following training, and to evaluate the effectiveness of the training programme using a clinical audit indicator recommended in the guidelines.

Matched MeSH terms: Disease Management*
Fulltext ALLHAT in perspective: implications to clinical practice and clinical trials

Yusoff K

Med J Malaysia, 2005 Jun;60(2):239-45.
PMID: 16114170

ALLHAT study is the biggest randomized clinical trial in hypertension ever conducted. Its objective was to ompare the efficacy of newer (calcium channel blocker amlodipine and angiotensin-converting enzyme inhibitor inopril) to the older (diuretic chlorthalidone) antihypertensive agents in the treatment of patients with hypertension. After enrolling 42,000 patients who were followed for an average of 4.9 years, ALLHAT did not find significant differences in the primary end-points between these antihypertenive agents. ALLHAT however found significant differences in the secondary end-points such as heart failure and strokes between chlorthalidone and amlodipine or lisinopril. Based on these and on economic reasons, the investigators unequivocally recommended diuretics as the first line therapy for hypertension. Since its publication, ALLHAT has been much discussed, debated A and opined. The choice of drugs for study, the study design, the conduct of the study and the conclusions drawn by the investigators had all been criticised or controversial. Yet ALLHAT has been widely quoted, commented upon or referred to and it has been instrumental in initiating the JNC VII Guidelines. Thus a thorough understanding of ALLHAT is necessary for clinical practice and in designing and evaluating clinical trials in the future. Moving Points: in Medicine will capture the essence of ALLHAT, discusses its implications to clinical trials and explores its possible impact on the practice of medicine in this country.

Matched MeSH terms: Disease Management
The estimated cost of surgically managed isolated traumatic head injury secondary to road traffic accidents

You X, Liew BS, Rosman AK, Dcsn, Musa KI, Idris Z

Neurosurg Focus, 2018 05;44(5):E7.
PMID: 29712526 DOI: 10.3171/2018.1.FOCUS17796

OBJECTIVE Traumatic brain injury due to road traffic accidents occurs mainly in the younger age group in which injury-related disability leads to long-term impact on employment and economic and social consequences across the lifespan. This study was designed to assign a monetary cost (in Malaysian ringgits [RM]) to the treatment of patients with surgically treated isolated traumatic head injury as determined up to 1 year after injury. METHODS Relevant resource items used were identified and valued using the direct measurement of costs method, cost accounting methods, standard unit costs method, fees, charges and/or market prices method. These values were then tabulated to generate the total costs for each patient, via a combination of macro-costing and micro-costing methods. Malaysian currency values were converted to US dollars according to the average conversion rate for the period from January to May 2016: RM1 = US$0.2452. RESULTS This costing study analyzed data from 49 patients. The estimated cost for the 1st year of care for all patients was RM1,471,919.80 (US$360,914.735), with a mean (± SD) cost per case of RM30,039.18 ± 22,986.25 or $7365.61 ± $5636.23. The mean cost of care per case was RM11,041.35 ± 10,936.88 or $2707.34 ± $2681.72 for mild head injury, RM32,550.00 ± 20,998.76 or $7981.26 ± $5148.90 for moderate head injury, and RM36,917.86 ± 23,697.34 or $9052.26 ± $5810.59 for severe head injury. Severe head injury (p = 0.001), sustaining 2 or more intracranial pathologies (p = 0.01), having a poor Glasgow Outcome Scale (GOS) score (GOS score 1-3) (p = 0.02), requiring a tracheostomy (p < 0.001), and contracting pneumonia (p < 0.001) were significantly associated with higher cost. Logistic regression analysis revealed that cost of care increased by RM591.60 or $145.06 per year increment of age (β = RM591.60, p = 0.05). CONCLUSIONS The mean cost of treatment for traumatic head injury is high compared to the per capita income of RM37,900 in 2016. The cost values generated in this study provide baseline cost estimates that the authors hope will be used as a guide to determine where adequate funding should be allocated to provide timely and appropriate delivery of care.

Matched MeSH terms: Disease Management*
Fulltext Prosthodontic considerations in the management of oligodontia in growing patients

Yew, Hsu Zenn

Malaysian Dental Journal, 2011;32(1):21-27.
MyJurnal

Congenitally missing teeth creates significant challenges to the clinicians in both diagnosis and management. The need for interdisciplinary involvement is essential for optimum dental care. The purpose of this clinical report is to describe an interdisciplinary management of a 15-year-old adolescent presented with non-syndromic oligodontia. The principle of management is presented with special emphasis on prosthodontic aspects. Various restorative treatment modalities specified for oligodontia patients are outlined.

Matched MeSH terms: Disease Management
Fulltext A Pictorial Review of Diabetic foot Manifestations

Yang C, Tandon A

Med J Malaysia, 2013 Jun;68(3):279-89.
PMID: 23749027

The diabetic foot with its many associated complications and presentations can provide a challenge in diagnosis and subsequent treatment. MRI, being increasingly available commonly, is now the main investigative modality. In particular, it is helpful in differentiating between neuroarthropathy and osteomyelitis and in cases where the latter is superimposed on the former. By being well versed in the interpretation of the images, the radiologist can make crucial contribution to the care and management of these patients.

Matched MeSH terms: Disease Management
Fulltext Pan-Asian adapted Clinical Practice Guidelines for the management of patients with metastatic non-small-cell lung cancer: a CSCO-ESMO initiative endorsed by JSMO, KSMO, MOS, SSO and TOS

Wu YL, Planchard D, Lu S, Sun H, Yamamoto N, Kim DW, et al.

Ann Oncol, 2019 Feb 01;30(2):171-210.
PMID: 30596843 DOI: 10.1093/annonc/mdy554

The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of metastatic non-small-cell lung cancer (NSCLC) was published in 2016. At the ESMO Asia Meeting in November 2017 it was decided by both ESMO and the Chinese Society of Clinical Oncology (CSCO) to convene a special guidelines meeting immediately after the Chinese Thoracic Oncology Group Annual Meeting 2018, in Guangzhou, China. The aim was to adapt the ESMO 2016 guidelines to take into account the ethnic differences associated with the treatment of metastatic NSCLC cancer in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with metastatic NSCLC representing the oncological societies of China (CSCO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence, and was independent of both the current treatment practices and the drug availability and reimbursement situations in the six participating Asian countries. During the review process, the updated ESMO 2018 Clinical Practice Guidelines for metastatic NSCLC were released and were also considered, during the final stages of the development of the Pan-Asian adapted Clinical Practice Guidelines.

Matched MeSH terms: Disease Management
The management of leukaemia

WELLS R

Med J Malaya, 1957 Dec;12(2):406-15.
PMID: 13515871
Matched MeSH terms: Disease Management*
Fulltext Amyand’s Hernia: A Diagnostic Dilemma

Vairavan, N., Rohaizak, M., Hairol, O.

International Medical Journal Malaysia, 2006;5(1):1-4.
MyJurnal

Appendicitis within an Amyand's hernia is rare; when it occurs it is often misdiagnosed as a strangulated inguinal hernia. Management of these cases needs to be individualized according to the presentation. In uncomplicated cases, we recommend concurrent appendectomy and darning repair of the hernia. We present such a case and review the related literature.

Matched MeSH terms: Disease Management
Fulltext An audit of bronchial asthma control at a primary public health care facility

Usha Devi B, Hairul Izwan AR, Munjeet KPS, Rosidah CP

Malaysian Journal of Public Health Medicine, 2011;11(2):22-26.
MyJurnal

A study was conducted at Greentown Health Clinic, Ipoh to assess and classify asthma by levels of control based on the Global Initiative for Asthma (GINA). The secondary objective was to identify those patients whose control was suboptimal. A total of 102 patients were included in this study based on random sampling between 25th April 2008 and 6th June 2008. Standard Asthma Control Questionnaires were used to classify asthma and levels of control. Baseline Peak Expiratory Flow Rate (PEFR) measurements and PEFR at audit visits were also recorded. All data were analysed using SPSS version 13. The study showed that only 39.2 % of the patients were classified as having controlled asthma, 34.3 % had asthma that was partly controlled and 26.5 % of the patients had uncontrolled asthma. Among those patients who had inadequate asthma control, more than half of them had nocturnal attacks and exacerbations. These findings demonstrate the need by the attending doctor to improve assessment of the patient’s control of asthma by actively questioning the patients and subsequently improving management to achieve optimal control of asthma.
Study site: Klinik Kesihatan Greentown, Ipoh, Perak, Malaysia

Matched MeSH terms: Disease Management
Fulltext Impact of Quercetin Encapsulation with Added Phytosterols on Bilayer Membrane and Photothermal-Alteration of Novel Mixed Soy Lecithin-Based Liposome

Toopkanloo SP, Tan TB, Abas F, Alharthi FA, Nehdi IA, Tan CP

Nanomaterials (Basel), 2020 Dec 05;10(12).
PMID: 33291386 DOI: 10.3390/nano10122432

This study used highly lipophilic agents with an aim to increase the oxidant inhibitory activity and enhance photothermal stability of a novel mixed soy lecithin (ML)-based liposome by changing the composition of formulation within the membrane. Specifically, the development and optimization of the liposome intended for improving Trolox equivalent antioxidant capacity (TEAC) value and %TEAC loss was carried out by incorporating a natural antioxidant, quercetin (QU). In this context, a focus was set on QU encapsulation in ML-based liposomes and the concentration-dependent solubility of QU was investigated and calculated as encapsulation efficiency (EE). To explore the combined effects of the incorporation of plant sterols on the integrity and entrapment capacity of mixed phospholipid vesicles, conjugation of two types of phytosterols (PSs), namely β-sitosterol (βS) and stigmasterol (ST), to mixed membranes at different ratios was also performed. The EE measurement revealed that QU could be efficiently encapsulated in the stable ML-based liposome using 0.15 and 0.1 g/100 mL of βS and ST, respectively. The aforementioned liposome complex exhibited a considerable TEAC (197.23%) and enhanced TEAC loss (30.81%) when exposed to ultraviolet (UV) light (280-320 nm) over a 6 h duration. It appeared that the presence and type of PSs affect the membrane-integration characteristics as well as photodamage transformation of the ML-based liposome. The association of QU with either βS or ST in the formulation was justified by their synergistic effects on the enhancement of the EE of liposomes. Parallel to this, it was demonstrated that synergistic PS effects could be in effect in the maintenance of membrane order of the ML-based liposome. The findings presented in this study provided useful information for the development and production of stable QU-loaded ML-based liposomes for food and nutraceutical applications and could serve as a potential mixed lipids-based delivery system in the disease management using antioxidant therapy.

Matched MeSH terms: Disease Management
Exploring the current and future role of the pharmacists in osteoporosis screening and management in Malaysia

Toh LS, Lai PSM, Othman S, Shah A, Dang CPL, Low BY, et al.

Int J Clin Pharm, 2018 Apr;40(2):450-457.
PMID: 29380234 DOI: 10.1007/s11096-018-0597-9

Background: Several studies have found that pharmacists can assist in screening and prevention of osteoporosis by referring patients for bone mineral density scans and counselling on lifestyle changes. In Malaysia, screening osteoporosis in all elderly women is not mandatory due to its cost. One approach to address this gap is to develop a pharmacist-led osteoporosis screening and prevention program. However, there is a paucity of data on the perspectives of Malaysian pharmacists in this area.
Objective: To explore the perspective of stakeholders (policy makers, doctors, pharmacists, nurses and patients) towards the role of pharmacists in osteoporosis screening and management.
Setting: A primary care clinic located within a teaching hospital in Kuala Lumpur, Malaysia.
Method: Patients (n = 20), nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) were individually interviewed using a semi-structured topic guide. Purposive sampling was used. Interviews were transcribed verbatim and analysed using thematic analysis. Main outcome measure Perspective of stakeholders on the current and future role of pharmacists.
Results: All participants perceived pharmacists to be suppliers of medication, although there was some recognition of roles in providing medication advice. Nonetheless, these stakeholders were eager for pharmacists to expand their non-dispensing roles towards counselling, creating awareness and screening of osteoporosis. Interviewed pharmacists referred to their current role as 'robotic dispensers' and unanimously agreed to spread out to osteoporosis management role.
Conclusion: Under stakeholders there is a willingness to expand the role of pharmacists in Malaysia to non-dispensing roles, particularly in osteoporosis screening and management.
Study site: Primary care clinic, teaching hospital, Kuala Lumpur, Malaysia

Matched MeSH terms: Disease Management*
Insights, attitudes and perceptions about asthma and its treatment: findings from a multinational survey of patients from 8 Asia-Pacific countries and Hong Kong

Thompson PJ, Salvi S, Lin J, Cho YJ, Eng P, Abdul Manap R, et al.

Respirology, 2013 Aug;18(6):957-67.
PMID: 23730953 DOI: 10.1111/resp.12137

BACKGROUND AND OBJECTIVE: The Asthma Insight and Management (AIM) survey was conducted in North America, Europe, the Asia-Pacific region and Latin America to characterize patients' insights, attitudes and perceptions about their asthma and its treatment. We report findings from the Asia-Pacific survey.
METHODS: Asthma patients (≥12 years) from Australia, China, Hong Kong, India, Malaysia, Singapore, South Korea, Taiwan and Thailand were surveyed. Patients answered 53 questions exploring general health, diagnosis/history, symptoms, exacerbations, patient burden, disease management, medications/treatments and patient's attitudes. The Global Initiative for Asthma guidelines were used to assess asthma control. The survey was conducted by random digit telephone dialling (Australia, China and Hong Kong) or by random face-to-face interviews (India, Malaysia, Singapore, South Korea, Taiwan and Thailand).
RESULTS: There were 80 761 households screened. Data from 3630 patients were collected. Wide disparity existed between objective measures of control and patient perception. Reported exacerbations during the previous year ranged from 19% (Hong Kong) to 67% (India). Reported unscheduled urgent/emergency visits to a doctor's office/hospital/clinic in the previous year ranged from 15% (Hong Kong) to 46% (Taiwan). Patients who reported having controlled asthma in the previous month ranged from 27% (South Korea) to 84% (Taiwan). Substantial functional and emotional limitations due to asthma were identified by 13% (South Korea) to 78% (India) of patients.
CONCLUSIONS: Asthma has a profound impact on patients' well-being despite the availability of effective treatments and evidence-based management guidelines. Substantial differences across the surveyed countries exist, suggesting unmet, country-specific cultural and educational needs. A large proportion of asthma patients overestimate their level of control.
Study site: random digit telephone dialling or by random face-to-face interviews at pre-selected locations.

Matched MeSH terms: Disease Management*
Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne

Thiboutot DM, Dréno B, Abanmi A, Alexis AF, Araviiskaia E, Barona Cabal MI, et al.

J. Am. Acad. Dermatol., 2018 02;78(2 Suppl 1):S1-S23.e1.
PMID: 29127053 DOI: 10.1016/j.jaad.2017.09.078

Scientific advances are continually improving the knowledge of acne and contributing to the refinement of treatment options; it is important for clinicians to regularly update their practice patterns to reflect current standards. The Global Alliance to Improve Outcomes in Acne is an international group of dermatologists with an interest in acne research and education that has been meeting regularly since 2001. As a group, we have continuously evaluated the literature on acne. This supplement focuses on providing relevant clinical guidance to health care practitioners managing patients with acne, with an emphasis on areas where the evidence base may be sparse or need interpretation for daily practice.

Matched MeSH terms: Disease Management*
Fulltext Airport passengers' adoption behaviour towards self-check-in Kiosk Services: the roles of perceived ease of use, perceived usefulness and need for human interaction

Taufik N, Hanafiah MH

Heliyon, 2019 Dec;5(12):e02960.
PMID: 31890945 DOI: 10.1016/j.heliyon.2019.e02960

Purpose: The purpose of this paper is to examine the factors influencing passenger adoption and behaviour of self-service technology (SST) in airports. This study adopted the Theory Acceptance Model (TAM) and extended the model by including the need for human interaction (NI) construct in the study framework.
Design/methodology/approach: The research framework is based on the theoretical concepts of SST usage from the inter-disciplinary field. Four hundred two questionnaires were collected from passengers who used the self-check-in kiosks in Kuala Lumpur International Airport (KLIA and KLIA2). The collected data were analysed using the structural equation modelling (SEM) technique.
Findings: Different factors determine passengers' willingness and adoption of SSTs. Perceived ease of use and perceived usefulness significantly affect passenger adoption and behaviour of SSTs in airports. However, the passenger was much comfortable with the SST as the moderating effect of need for human interaction shows a negative result.
Practical implications: The findings contribute to an understanding of how and why passengers use SSTs, which is critical from a customer relationship management (CRM) perspective. Better strategies can be developed to manage and coordinate SSTs delivery in the airport by understanding the passengers' experience from the self-check-in kiosks.
Originality/value: This paper goes beyond the basic SSTs usage and intentions study by highlighting the nonimportance of human interaction in SSTs usage specifically by airport passengers.

Matched MeSH terms: Disease Management
Fulltext Impact of a standardized protocol for the Management of Prolonged Neonatal Jaundice in a regional setting: an interventional quasi-experimental study

Tan HS, Balasubramaniam IS, Hss AS, Yeong ML, Chew CC, Singh RP, et al.

BMC Pediatr, 2019 05 29;19(1):174.
PMID: 31142302 DOI: 10.1186/s12887-019-1550-3

BACKGROUND: Prolonged neonatal jaundice (PNNJ) is often caused by breast milk jaundice, but it could also point to other serious conditions (biliary atresia, congenital hypothyroidism). When babies with PNNJ receive a routine set of laboratory investigations to detect serious but uncommon conditions, there is always a tendency to over-investigate a large number of well, breastfed babies. A local unpublished survey in Perak state of Malaysia revealed that the diagnostic criteria and initial management of PNNJ were not standardized. This study aims to evaluate and improve the current management of PNNJ in the administrative region of Perak.
METHODS: A 3-phase quasi-experimental community study was conducted from April 2012 to June 2013. Phase l was a cross-sectional study to review the current practice of PNNJ management. Phase ll was an interventional phase involving the implementation of a new protocol. Phase lll was a 6 months post-interventional audit. A registry of PNNJ was implemented to record the incidence rate. A self-reporting surveillance system was put in place to receive any reports of biliary atresia, urinary tract infection, or congenital hypothyroidism cases.
RESULTS: In Phase I, 12 hospitals responded, and 199 case notes were reviewed. In Phase II, a new protocol was developed and implemented in all government health facilities in Perak. In Phase III, the 6-month post-intervention audit showed that there were significant improvements when comparing mean scores of pre- and post-intervention: history taking scores (p

Matched MeSH terms: Disease Management*

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