Displaying publications 201 - 220 of 390 in total

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  1. Fulltext Critical incident monitoring in anaesthesia (1)
    Choy YC
    Med J Malaysia, 2006 Dec;61(5):577-85.
    PMID: 17623959
    Critical incident monitoring in anaesthesia is an important tool for quality improvement and maintenance of high safety standards in anaesthetic services. It is now widely accepted as a useful quality improvement technique for reducing morbidity and mortality in anaesthesia and has become part of the many quality assurance programmes of many general hospitals under the Ministry of Health. Despite wide-spread reservations about its value, critical incident monitoring is a classical qualitative research technique which is particularly useful where problems are complex, contextual and influenced by the interaction of physical, psychological and social factors. Thus, it is well suited to be used in probing the complex factors behind human error and system failure. Human error has significant contributions to morbidities and mortalities in anaesthesia. Understanding the relationships between, errors, incidents and accidents is important for prevention and risk management to reduce harm to patients. Cardiac arrests in the operating theatre (OT) and prolonged stay in recovery, constituted the bulk of reported incidents. Cardiac arrests in OT resulted in significant mortality and involved mostly de-compensated patients and those with unstable cardiovascular functions, presenting for emergency operations. Prolonged-stay in the recovery extended period of observation for ill patients. Prolonged stay in recovery was justifiable in some cases, as these patients needed a longer period of post-operative observation until they were stable enough to return to the ward. The advantages of the relatively low cost, and the ability to provide a comprehensive body of detailed qualitative information, which can be used to develop strategies to prevent and manage existing problems and to plan further initiatives for patient safety makes critical incident monitoring a valuable tool in ensuring patient safety. The contribution of critical incident reporting to the issue of patient safety is far from clear and very difficult to study. Efforts to do so have tended to rely on incident reporting, the only practical approach when funding is limited. The heterogeneity of critically ill patients as a group means that huge study populations would be required if other research techniques were to be used. In the era of evidence-based medicine, anaesthetists are looking for alternative evidence-based solutions to problems that we have accepted traditionally when we cannot quantify for good practical reasons. In the quest for patient safety, investment should be made in reliable audit, detection and reporting systems. The growing recognition that human error usually result from a failure of a system rather than an individual should be fostered to allow more lessons to be learnt, an approach that has been successful in other, safety-critical industries. New technology has a great deal to offer and investment is warranted in novel fail-safe drug administration systems. Last but not the least the importance of simple and sensible changes and better education should be remembered.
    Matched MeSH terms: Safety Management/methods*
  2. The Clinimetric Properties of Instruments Measuring Home Hazards for Older People at Risk of Falling: A Systematic Review
    Romli MH, Mackenzie L, Lovarini M, Tan MP, Clemson L
    Eval Health Prof, 2018 03;41(1):82-128.
    PMID: 29415567 DOI: 10.1177/0163278716684166
    Home hazards are associated with falls among older people living in the community. However, evaluating home hazards is a complex process as environmental factors vary according to geography, culture, and architectural design. As a result, many health practitioners commonly use nonstandardized assessment methods that may lead to inaccurate findings. Thus, the aim of this systematic review was to identify standardized instruments for evaluating home hazards related to falls and evaluate the clinimetric properties of these instruments for use by health practitioners. A systematic search was conducted in the Medline, CINAHL, AgeLine, Web of Science databases, and the University of Sydney Library CrossSearch Engine. Study screening, assessment, and quality ratings were conducted independently. Thirty-six studies were identified describing 19 instruments and three assessment techniques. The clinimetric properties varied between instruments. The Home Falls and Accidents Screening Tool, Home Safety Self-Assessment Tool, In-Home Occupational Performance Evaluation, and Westmead Home Safety Assessment were the instruments with high potential for evaluating home hazards associated with falls. Health practitioners can choose the most appropriate instruments for their practice, as a range of standardized instruments with established clinimetric properties are available.
    Matched MeSH terms: Safety/standards
  3. Prevalence of potentially pathogenic Vibrio species in the seafood marketed in Malaysia
    Elhadi N, Radu S, Chen CH, Nishibuchi M
    J Food Prot, 2004 Jul;67(7):1469-75.
    PMID: 15270503
    Seafood samples obtained in seafood markets and supermarkets at 11 sites selected from four states in Malaysia were examined for the presence of nine potentially pathogenic species from the genus Vibrio between July 1998 and June 1999. We examined 768 sample sets that included shrimp, squid, crab, cockles, and mussels. We extensively examined shrimp samples from Selangor State to determine seasonal variation of Vibrio populations. Eight potentially pathogenic Vibrio species were detected, with overall incidence in the samples at 4.6% for V. cholerae, 4.7% for V. parahaemolyticus, 6.0% for V. vulnificus, 11% for V. alginolyticus, 9.9% for V. metschnikovii, 1.3% for V. mimicus, 13% for V. damsela, 7.6% for V. fluvialis, and 52% for a combined population of all of the above. As many as eight Vibrio species were detected in shrimp and only four in squid and peel mussels. The overall percent incidence of any of the eight vibrios was highest (82%) in cockles (Anadara granosa) among the seafoods examined and was highest (100%) in Kuching, Sarawak State, and lowest (25%) in Penang, Pulau Penang State, among the sampling sites. Of 97 strains of V. cholerae isolated, one strain belonged to the O1 serotype and 14 to the O139 serotype. The results indicate that the various seafood markets in Malaysia are contaminated with potentially pathogenic Vibrio species regardless of the season and suggest that there is a need for adequate consumer protection measures.
    Matched MeSH terms: Consumer Product Safety*
  4. Fulltext Microplastics Pollution as an Invisible Potential Threat to Food Safety and Security, Policy Challenges and the Way Forward
    Usman S, Abdull Razis AF, Shaari K, Amal MNA, Saad MZ, Mat Isa N, et al.
    Int J Environ Res Public Health, 2020 Dec 21;17(24).
    PMID: 33371479 DOI: 10.3390/ijerph17249591
    Technological advances, coupled with increasing demands by consumers, have led to a drastic increase in plastic production. After serving their purposes, these plastics reach our water bodies as their destination and become ingested by aquatic organisms. This ubiquitous phenomenon has exposed humans to microplastics mostly through the consumption of sea food. This has led the World Health Organization (WHO) to make an urgent call for the assessment of environmental pollution due to microplastics and its effect on human health. This review summarizes studies between 1999 and 2020 in relation to microplastics in aquatic ecosystems and human food products, their potential toxic effects as elicited in animal studies, and policies on their use and disposal. There is a paucity of information on the toxicity mechanisms of microplastics in animal studies, and despite their documented presence in food products, no policy has been in place so far, to monitor and regulates microplastics in commercial foods meant for human consumption. Although there are policies and regulations with respect to plastics, these are only in a few countries and in most instances are not fully implemented due to socioeconomic reasons, so they do not address the problem across the entire life cycle of plastics from production to disposal. More animal research to elucidate pathways and early biomarkers of microplastic toxicity that can easily be detected in humans is needed. This is to create awareness and influence policies that will address this neglected threat to food safety and security.
    Matched MeSH terms: Food Safety*
  5. Identification of competencies for Malaysian occupational safety and health professionals
    Daud R, Ismail M, Omar Z
    Ind Health, 2010;48(6):824-34.
    PMID: 20616464
    Competencies of occupational safety and health (OSH) professionals have become a concern due to the significance of safety management in the field of safety engineering. The purpose of this article is to identify competencies needed by OSH professionals. These competencies are required by professionals in administrating and enforcing legislations related to OSH in Malaysia. This study used Delphi technique in three rounds of data collection. The benefits of this research approach are the use of experts in gaining opinions without time and geographical restraints. The results show 25 generic competencies with combinations of cognitive, interpersonal and intrapersonal competencies and 33 functional or specific competencies including knowledge and skills needed by OSH professionals. Both generic and functional competencies are also divided into threshold and differentiating competencies that would be used to differentiate average and excellent performance of OSH professionals.
    Matched MeSH terms: Safety Management/standards*; Safety Management/statistics & numerical data
  6. Workplace injuries and risk reduction practices in Malaysia
    Ali R, Shaharudin R, Omar A, Yusoff F
    Int J Occup Environ Health, 2012 Oct-Dec;18(4):299-306.
    PMID: 23433290 DOI: 10.1179/1077352512Z.00000000031
    INTRODUCTION: This study on workplace injuries and risk reduction practices was part of the Malaysia National Health Morbidity Survey III (NHMS III) conducted in 2006.
    METHODS: This cross-sectional population-based survey was conducted to determine the incidence of workplaces injuries and assess the magnitude of some important risk reduction practices among workers. Data were gathered through face-to-face household interviews using a pre-coded questionnaire.
    RESULTS: Of the 22 880 eligible respondents, 88·2% (20 180) responded. The incidence rate for injuries at the workplace was 4·9 per 100 (95% CI: 4·6-5·2). The overall proportion of workers who had received occupational safety and health (OSH) training before or within 1 month of starting work was 33·6%. Among respondents who perceived that personal protective equipment (PPE) was required at their workplace, only 38·9% (95% CI: 37·8-39·4) were provided with it by their employers.
    DISCUSSION: Further studies are urgently needed to identify reasons for and management of the low uptake of risk reduction practices. This issue needs to be addressed to ensure the safety and health of our working population.
    Study name: National Health and Morbidity Survey (NHMS-2006)
    Matched MeSH terms: Safety Management/methods; Safety Management/organization & administration*
  7. The effectiveness of applying different permissible exposure limits in preserving the hearing threshold level: a systematic review
    Sayapathi BS, Su AT, Koh D
    J Occup Health, 2014;56(1):1-11.
    PMID: 24270928
    OBJECTIVES: A systematic review was conducted to identify the effectiveness of different permissible exposure limits in preserving the hearing threshold level. This review compared the limits of the US National Institute of Occupational Safety and Health with those of the US Occupational Safety and Health Administration. The prevalence of occupational noise-induced hearing loss is on an increasing trend globally. This review was performed to reduce the prevalence of noise-induced hearing loss.

    METHODS: We searched 3 major databases, i.e., PubMed, Embase and Lippincott Williams & Wilkins Journals@Ovid, for studies published up until 1May 2013 without language restrictions. All study designs were included in this review. The studies were identified and retrieved by two independent authors.

    RESULTS: Of 118 titles scanned, 14 duplicates were removed, and a total of 13 abstracts from all three databases were identified for full-text retrieval. From the full text, eight articles met the inclusion criteria for this systematic review. These articles showed acceptable quality based on our scoring system. Most of the studies indicated that temporary threshold shifts were much lower when subjects were exposed to a noise level of 85 dBA or lower.

    CONCLUSIONS: There were more threshold shifts in subjects adopting 90 dBA compared with 85 dBA. These temporary threshold shifts may progress to permanent shifts over time. Action curtailing noise exposure among employees would be taken earlier on adoption of 85 dBA as the permissible exposure limit, and hence prevalence of noise-induced hearing loss may be reduced.

    Matched MeSH terms: United States Occupational Safety and Health Administration/standards*
  8. A new cell culture tube in diagnostic virology for virus isolation
    Chua KB, Chua KH, Chua IL, Chen KF
    Malays J Pathol, 2004 Jun;26(1):69-71.
    PMID: 16190110
    Virus isolation and accurate characterization plays a crucial role in the rapid identification of the causative agents of infectious disease outbreaks especially if the causative viruses are novel where no pre-existing diagnostic reagents would be available. A new cell culture tube, named Jui Meng (JM) Cell Culture Tube, was developed to reduce the cost and improve the efficiency and biosafety of work pertaining to virus isolation. The design of the tube is based heavily on the principle of practicability, functionality, biosafety and long-term cost saving for diagnostic laboratory work in virus isolation. It is designed to culture an initial inoculum of one milliliter of culture medium containing 1 x 10(4) to 1 x 10(5) cells/ml.
    Matched MeSH terms: Safety
  9. Fulltext Food safety knowledge, attitude, and practice toward compliance with abattoir laws among the abattoir workers in Malaysia
    Abdullahi A, Hassan A, Kadarman N, Saleh A, Baraya YS, Lua PL
    Int J Gen Med, 2016;9:79-87.
    PMID: 27110137 DOI: 10.2147/IJGM.S98436
    Foodborne diseases are common in the developing countries due to the predominant poor food handling and sanitation practices, particularly as a result of inadequate food safety laws, weak regulatory structures, and inadequate funding as well as a lack of appropriate education for food-handlers. The most frequently involved foods in disease outbreaks are of animal origin. However, in spite of the adequate legislation and laws governing the abattoir operation in Malaysia, compliance with food safety requirements during meat processing and waste disposal is inadequate. Therefore, the present study was designed to assess the food safety knowledge, attitude, and practice toward compliance with abattoir laws among the workers in Terengganu, Malaysia.
    Matched MeSH terms: Food Safety
  10. Health risk assessments of heavy metal exposure via consumption of marine mussels collected from anthropogenic sites
    Yap CK, Cheng WH, Karami A, Ismail A
    Sci Total Environ, 2016 May 15;553:285-96.
    PMID: 26925739 DOI: 10.1016/j.scitotenv.2016.02.092
    A total of 40 marine mussel Perna viridis populations collected (2002-2009) from 20 geographical sites located in two busy shipping lanes namely the Straits of Malacca (10 sites; 16 populations) and the Straits of Johore (8 sites; 21 populations) and three populations (2 sites) on the east coast of Peninsular Malaysia, was determined for Cd, Cu, Fe, Ni, Pb and Zn concentrations. In comparison with the maximum permissible limits (MPLs) set by existing food safety guidelines, all metal concentrations found in all the mussel populations were lower than the prescribed MPLs. In terms of the provisional tolerable weekly intake prescribed by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and oral reference doses (ORDs) by the USEPA, all the studied metals (except for Pb) were unlikely to become the limiting factors or unlikely to pose a risk for the consumption of the mussel populations. The estimated daily intake (EDI) for average level mussel (ALM) and high level mussel (HLM) consumers of mussels was found to be lower than the ORD guidelines for Cd, Cu, Fe, Ni and Zn. Furthermore, the target hazard quotient (THQ) was found to be less than 1 for ALM consumers but higher than 1 for HLM consumers in some sites. Therefore, there were no potential human health risks to the ALM consumers of the mussels. However, for Pb THQ values, the Pb levels in some mussel populations could create a health risk problem. Present results indicate that the consumption amounts of mussels should be limited for minimizing potential health risks of heavy metals to the HLM consumers.
    Matched MeSH terms: Food Safety
  11. Assessment of knowledge, attitude and practice of food allergies among food handlers in the state of Penang, Malaysia
    Shafie AA, Azman AW
    Public Health, 2015 Sep;129(9):1278-84.
    PMID: 25931434 DOI: 10.1016/j.puhe.2015.03.016
    Food handler's knowledge, attitude and practice regarding food allergies are important to prevent debilitating and sometimes fatal reactions. This study aimed to assess their food allergy knowledge, attitude and practice, which could help to maintain the safety and hygiene of food consumed by the public.
    Matched MeSH terms: Food Safety
  12. Fulltext Compliance with monitoring standards for anaesthesia in Malaysian hospitals
    Khoo TH, Cardosa MS, Inbasegaran K
    Med J Malaysia, 1999 Mar;54(1):72-8.
    PMID: 10972008
    The Malaysian Society of Anaesthesiologists published a document entitled "Recommendations for Standards of Monitoring during Anaesthesia and Recovery" in 1993. This paper examines the results of two surveys, carried out in 1995 and 1996 respectively; to determine compliance with published Monitoring Standards in Malaysian public and private hospitals. In the private sector, compliance with the recommended standards during anaesthesia varied greatly. Of the 28 government hospitals surveyed in 1996, compliance with monitoring standards during anaesthesia was almost 100%. Standards in recovery areas were less than ideal. The majority of anaesthesiologists thought that the current recommended standards were adequate.
    Matched MeSH terms: Safety
  13. Fulltext Isolation and identification of common bacteria causing Subclinical Mastitis in dairy goats
    Omar, S., Mat-Kamir, N.F.
    International Food Research Journal, 2018;25(4):1668-1674.
    MyJurnal
    The purpose of the current study was to isolate and identify subclinical mastitis causing bacteria from milk samples of dairy goats. The milk samples from individual dairy goats were collected from several dairy goat farms around Kota Bharu, Kelantan. Major bacterial isolates were Staphylococcus spp. (73.2%). Coagulase negative staphylococci encompassing 68.3% of the isolates, whereas 4.9% was coagulase positive staphylococci. Bacillus spp. constituted 12.2% out of the isolates. Listeria spp. and Neisseria spp. both were represented 7.3%. There is a need to discuss the potential hazards of these bacteria in affecting milk quality, health of goats and food safety to consumers. The findings also emphasize the need to study the exact species of bacteria isolated in order to plan for their prevention as well as to assist veterinarians in prescribing correct antibiotic therapy.
    Matched MeSH terms: Food Safety
  14. Survey-based data on food security, nutrition and agricultural production shocks among rural farming households in northern Uganda
    Mwungu CM, Shikuku KM, Atibo C, Mwongera C
    Data Brief, 2019 Apr;23:103818.
    PMID: 31372462 DOI: 10.1016/j.dib.2019.103818
    Climate change, degradation of natural resources, conflict or civil war, diseases and poverty are among the key threats that impact agriculture, human nutrition, food security and food safety among rural households in developing countries. Sustainability of food systems and livelihoods will thus crucially depend on not only the ability to accommodate or recover from these threats but also to tap into opportunities for strengthening long-term capabilities. One approach to enhancing resilience to enhance food security and nutrition is building an evidence base to better understand the various types of smallholders, threats to agriculture production and the associated risks to food security and nutrition and household food preferences. Unfortunately, such data in many African countries is still unavailable or has not been shared publicly. In this paper, we describe data that were collected in Nwoya district, Northern Uganda in December 2017. These data can be used to assess the relationship between resilience of farm households to climatic risks and their food and nutrition security.
    Matched MeSH terms: Food Safety
  15. Fulltext Antibacterial activity of ethanolic Piper cubeba L. extract against Escherichia coli and its effect on microbiological quality of raw chicken meat during storage
    Fazly Ann, Z., Rukayadi, Y.
    International Food Research Journal, 2019;26(3):933-944.
    MyJurnal
    Piper cubeba L. is traditionally recognised as flavouring ingredient in various types of foods and has been used to marinate meat. Scientifically, it has been reported to possess various valuable nutritional and pharmacological properties including antimicrobial potential. The aim of the present work was to determine the antibacterial activity of ethanolic P. cubeba L. extract against Escherichia coli and its effect on the microbiological quality of raw chicken meat during storage. Disc diffusion assay was done and resulted in 8.40 ± 0.10 mm of inhibition zone. The bacteriostatic and bactericidal effects of the extract were determined at 0.63 ± 0.00 mg/mL and 1.25 ± 0.00 mg/mL of concentration by MIC and MBC methods, respectively. The killing time was recorded at 2 × MIC (1.25 mg/mL) for 4 h. The application of the extract on chicken meat samples showed reduction in TPC and E. coli count with the observed optimum condition at 5.00% concentration stored at -18°C for 14 days based on the consistent reduction. Sensory attributes acceptability evaluation by 9-point hedonic scale showed acceptable score for colour, odour, texture and overall acceptability of the treated raw chicken meat samples. The findings implies that P. cubeba L. can be listed as one of the alternatives to reduce the bacterial load of raw chicken meat prior to cooking which is very important in ensuring food safety as well as reducing the occurrence of foodborne poisoning associated with chicken meat.
    Matched MeSH terms: Food Safety
  16. Facilitating Mindful Safety Practices among First Line Workers in Chinese Petroleum Industry through Safety Management Practices and Safety Motivation
    Shi H, Mohamed Zainal SR
    Int J Occup Saf Ergon, 2021 Mar 11.
    PMID: 33704011 DOI: 10.1080/10803548.2021.1902672
    Petroleum Industry belongs to the high-risk industry and operates under the social technical system. Therefore, safety behavior of employees need to be paid high attention. Thus, six dimensions of safety management practices are identified as independent variables to predict a special component of common safety behavior-mindful safety practices in Chinese Petroleum Industry. HRO (High Reliability Organization) theory is adopted as the underpinning theory. 255 first line workers from a Chinese petroleum company participated in this survey. The results reveal that safety training and safety communication and feedbacks are positively related to safety motivation. Moreover, workers' involvement and safety promotion policy have direct and positive impacts on mindful safety practices. Further, safety motivation is found to play a mediating role in the prediction of mindful safety practices in Chinese Petroleum Industry. These findings give new insights for petroleum companies on how to promote mindful safety practices in the workplace.
    Matched MeSH terms: Safety Management
  17. Fulltext Fitness to practise for doctors and medical students with mental issues in Malaysia
    Muhammad Darwiis Abdullah, Aiman Faiz Ahmad Fuad, Hafiz Ilmie Rahman, Mark Tan Kiak Min
    Journal of Clinical and Health Sciences, 2019;4(1):22-29.
    MyJurnal
    Mental illness is expected to become the second biggest health problem affecting Malaysians by 2020. Doctors and medical students are more prone to mental illness compared to the general population. However, they are often reluctant to and resist seeking help because of stigma and a (strong) sense of shame. This can lead to detrimental consequences for themselves and their patients. That said, a doctor with a mental illness receiving appropriate treatment and who is in a stable condition may still be permitted to practise provided patient safety is not compromised. Determining this is a key responsibility of a healthcare regulator like the Malaysian Medical Council (MMC). Using some prominent cases to illustrate this point, this article reviews the MMC guideline on ‘Managing Impaired Registered Medical Practitioners’. In the absence of similar local guidelines for medical students, we also allude to the UK General Medical Council’s guideline on ‘Supporting Medical Students with Mental Health Conditions’. The article recommends that doctors and medical students with mental illness should seek help; outlines a number of factors to consider in deciding whether a doctor should continue practising; and explores alternative career paths in instances where they should not. The article concludes that appropriate support goes a long way for doctors and medical students who grapple with mental health issues in that there is hope and a way through a seemingly devastating situation.
    Matched MeSH terms: Patient Safety
  18. Fulltext Interactive games to improve knowledge on food poisoning prevention among school children in Cheras
    Mohd Safwan Ibrahim, Noriah Hajib, Mohd Fadhli Mohd Fauzi, Erma Nur Shadila Mahamad Najadi
    Malaysian Journal of Medicine and Health Sciences, 2019;15(104):98-98.
    MyJurnal
    Introduction: Food poisoning may occur as single sporadic cases or massive outbreak in any institution, including boarding schools. Early this year, Cheras District Health Office had implemented set of interactive games on food safety programme at two boarding schools in Cheras which had repeated incidences of food poisoning outbreak. This study aims to evaluate the effectiveness of interactive games on knowledge of food safety among school children in Cheras. Methods: This study is a retrospective study based on secondary data. Two boarding school with total of 135 students were. The students were divided into 4 groups and participates in all 4 modules of interactive games. There were 10 items pre and post questionnaire on food safety knowledge collected during the program with score ranged zero to ten. The data were analysed descriptively and analytically with paired t test. Results: The response rate of this study was 100 %. Majority of the respondents were Malays (68.1%) and male (66.7%). The mean score at pre and post were 6.78 and 7.72 respectively. Paired t test showed that there was a significant increase of 0.94 mean score of knowledge after the programme (p-value < 0.05, CI 95%= -1.212, -0.664). Conclusion: The knowledge scores on food safety of the students increased significantly after the interactive game. However, without control group, the improvement cannot be said solely due to the program itself.
    Matched MeSH terms: Food Safety
  19. Nonlinear effects of increasing nitrogen deposition on rice growth and heavy metal uptake in a red soil ecosystem of southeastern China
    Wang J, Yi X, Cui J, Chang Y, Yao D, Zhou D, et al.
    Sci Total Environ, 2019 Jun 20;670:1060-1067.
    PMID: 31018421 DOI: 10.1016/j.scitotenv.2019.03.245
    With the population growth, urbanization and industrialization, China has become a hotspot of atmospheric deposition nitrogen (ADN), which is a threat to ecosystem and food safety. However, the impacts of increased ADN on rice growth and grain metal content are little studied. Based on previous long-term ADN studies, greenhouse experiment was conducted with four simulated ADN rates of 0, 30, 60 and 90 kg N ha-1 yr-1 (CK, N1, N2 and N3 as δ15N, respectively) to assess rice growth and metal uptake in a red soil ecosystem of southeast China during 2016-2017. Results showed that simulated ADN could promote rice growth and increase yields by 15.68-24.41% (except N2) and accumulations of cadmium (Cd) or copper (Cu) in organs. However, there was no linear relationship between ADN rate and rice growth or Cd or Cu uptake. The 15N-ADN was mainly accumulated in roots (21.31-67.86%) and grains (25.26-49.35%), while Cd and Cu were primarily accumulated in roots (78.86-93.44% and 90.00-96.24%, respectively). 15N-ADN and Cd accumulations in roots were significantly different between the two growing seasons (p 
    Matched MeSH terms: Food Safety
  20. Fulltext An Automated Patient Self-Monitoring System to Reduce Health Care System Burden During the COVID-19 Pandemic in Malaysia: Development and Implementation Study
    Lim HM, Teo CH, Ng CJ, Chiew TK, Ng WL, Abdullah A, et al.
    JMIR Med Inform, 2021 Feb 26;9(2):e23427.
    PMID: 33600345 DOI: 10.2196/23427
    BACKGROUND: During the COVID-19 pandemic, there was an urgent need to develop an automated COVID-19 symptom monitoring system to reduce the burden on the health care system and to provide better self-monitoring at home.

    OBJECTIVE: This paper aimed to describe the development process of the COVID-19 Symptom Monitoring System (CoSMoS), which consists of a self-monitoring, algorithm-based Telegram bot and a teleconsultation system. We describe all the essential steps from the clinical perspective and our technical approach in designing, developing, and integrating the system into clinical practice during the COVID-19 pandemic as well as lessons learned from this development process.

    METHODS: CoSMoS was developed in three phases: (1) requirement formation to identify clinical problems and to draft the clinical algorithm, (2) development testing iteration using the agile software development method, and (3) integration into clinical practice to design an effective clinical workflow using repeated simulations and role-playing.

    RESULTS: We completed the development of CoSMoS in 19 days. In Phase 1 (ie, requirement formation), we identified three main functions: a daily automated reminder system for patients to self-check their symptoms, a safe patient risk assessment to guide patients in clinical decision making, and an active telemonitoring system with real-time phone consultations. The system architecture of CoSMoS involved five components: Telegram instant messaging, a clinician dashboard, system administration (ie, back end), a database, and development and operations infrastructure. The integration of CoSMoS into clinical practice involved the consideration of COVID-19 infectivity and patient safety.

    CONCLUSIONS: This study demonstrated that developing a COVID-19 symptom monitoring system within a short time during a pandemic is feasible using the agile development method. Time factors and communication between the technical and clinical teams were the main challenges in the development process. The development process and lessons learned from this study can guide the future development of digital monitoring systems during the next pandemic, especially in developing countries.

    Matched MeSH terms: Patient Safety
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