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  1. Chew CH, Hu PY
    Singapore Med J, 1974 Dec;15(4):241-5.
    PMID: 4549136
    Mass BCG Vaccination is an effective and an inexpensive method of tuberculosis control. In Singapore, a nation wide BCG Vaccination programme was implemented in 1957, and from 1957 to 1972, i.e. a 16 year period, over 1 million vaccinations had been performed: 680,098 for infants, 512,797 for school students, 49,417 for contacts of tuberculosis patients and 7,775 for other special groups. The coverage of newborn infants has been over 90% from 1967 to 1972. In 1972, it was estimated that 90% of primary school children and 75% of secondary school students have been covered with BCG vaccinations. Although no controlled studies have been done in Singapore, it is observed from our analysis that the BCG programme has contributed in no small measure to the decline in tuberculosis incidence and mortality rates. Thus for 1972, the tuberculosis incidence rates per 100,000 were 5 for the BCG vaccinated group and 37 for the non-vaccinated group of primary school students, and 34 and 127 for the corresponding groups of secondary school students. In 1956, the death rate per 100,000 of respiratory tuberculosis was 4 and that of non-respiratory tuberculosis was 23 for children aged 4 and below, and the corresponding rates were 0.5 and 6.7 for those aged 5 to 9, and 0.8 and 3.7 for the group aged 10 to 14. In 1971 there were no tuberculosis deaths in children under 10 years of age, and the death rates for the age group 10-14 were 0.3 per 100,000 for either form of 241 tuberculosis.
    Matched MeSH terms: Preventive Health Services*
  2. Miranda J, Miller S, Alfieri N, Lalonde A, Ivan-Ortiz E, Hanson C, et al.
    Int J Gynaecol Obstet, 2024 Jun;165(3):849-859.
    PMID: 38651311 DOI: 10.1002/ijgo.15553
    OBJECTIVE: To demonstrate that successful health systems strengthening (HSS) projects have addressed disparities and inequities in maternal and perinatal care in low-income countries.

    METHODS: A comprehensive literature review covered the period between 1980 and 2022, focusing on successful HSS interventions within health systems' seven core components that improved maternal and perinatal care.

    RESULTS: The findings highlight the importance of integrating quality interventions into robust health systems, as this has been shown to reduce maternal and newborn mortality. However, several challenges, including service delivery gaps, poor data use, and funding deficits, continue to hinder the delivery of quality care. To improve maternal and newborn health outcomes, a comprehensive HSS strategy is essential, which should include infrastructure enhancement, workforce skill development, access to essential medicines, and active community engagement.

    CONCLUSION: Effective health systems, leadership, and community engagement are crucial for a comprehensive HSS approach to catalyze progress toward universal health coverage and global improvements in maternal and newborn health.

    Matched MeSH terms: Maternal Health Services/organization & administration
  3. Ramdzan SN, Khoo EM, Cunningham S, Hussein N, Ramli R, Senawi SA, et al.
    J Glob Health, 2024 May 17;14:03027.
    PMID: 38751315 DOI: 10.7189/jogh.14.03027
    Matched MeSH terms: School Health Services/organization & administration
  4. Shahar S, Lau H, Puteh SEW, Amara S, Razak NA
    BMC Public Health, 2019 Jun 13;19(Suppl 4):552.
    PMID: 31196021 DOI: 10.1186/s12889-019-6852-8
    The current issue of BMC Public Health presents work by the Consortium of Low Income Population Research (CB40R), highlighting a comprehensive aspect of health, i.e., physical health, mental health, health behaviour and health financing; and also nutrition involving all stages of lifespan of the socioeconomic deprived group in Malaysia.Consortium of B40 Research (CB40R) reposited and harmonised shared, non-identifiable data from epidemiological studies involving low income population (B40) in Malaysia. CB40R also performed joint or mega-analyses using combined, harmonised data sets that yield collated results with enhanced statistical power, more variabilities (study population, geographical regions, ethnicities and sociocultural groups) to better understand the needs, characteristics and issues of B40 groups in Malaysia. It also aimed to develope a system/framework of minimum/standard variables to be collected in research involving B40 in future. For this special issues, members of the consortium have been invited to contribute an original article involving analysis of the health aspects, access to health and nutritional issues of the B40 samples.All the papers in this special issue have successfully highlighted the health and nutritional issues (i.e., non-communicable disease (NCD), inflammatory bowel disease (IBD), knowledge towards sexually transmitted disease (STD), low birth weight, Motoric Cognitive Risk (MCR) syndrome, urinary incontinence), mental health, oral health and inequalities among the low-income group in Malaysia, including the rural population and also the urban poor. The low-income population in Malaysia is also at risk of both under- and over nutrition, of which specific cost effective strategies are indeed needed to improve their quality of life.The low income population in Malaysia is facing various health challenges, particularly related to NCD and poor mental health, nutritional and physical function. There is a need for a sustainable intervention model to tackle the issues. It is also important to highlight that reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health.
    Matched MeSH terms: Health Services Accessibility/trends*
  5. Wan Ismail WR, Abdul Rahman R, Rahman NAA, Atil A, Nawi AM
    J Prev Med Public Health, 2019 Jul;52(4):205-213.
    PMID: 31390683 DOI: 10.3961/jpmph.19.020
    OBJECTIVES: Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer.

    METHODS: A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review.

    RESULTS: Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19).

    CONCLUSIONS: Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.

    Matched MeSH terms: Maternal Health Services/standards
  6. Aziz NA, Pindus DM, Mullis R, Walter FM, Mant J
    BMJ Open, 2016 Jan 06;6(1):e009244.
    PMID: 26739728 DOI: 10.1136/bmjopen-2015-009244
    INTRODUCTION: Despite the rising prevalence of stroke, no comprehensive model of postacute stroke care exists. Research on stroke has focused on acute care and early supported discharge, with less attention dedicated to longer term support in the community. Likewise, relatively little research has focused on long-term support for informal carers. This review aims to synthesise and appraise extant qualitative evidence on: (1) long-term healthcare needs of stroke survivors and informal carers, and (2) their experiences of primary care and community health services. The review will inform the development of a primary care model for stroke survivors and informal carers.

    METHODS AND ANALYSIS: We will systematically search 4 databases: MEDLINE, EMBASE, PsycINFO and CINAHL for published qualitative evidence on the needs and experiences of stroke survivors and informal carers of postacute care delivered by primary care and community health services. Additional searches of reference lists and citation indices will be conducted. The quality of articles will be assessed by 2 independent reviewers using a Critical Appraisal Skills Programme (CASP) checklist. Disagreements will be resolved through discussion or third party adjudication. Meta-ethnography will be used to synthesise the literature based on first-order, second-order and third-order constructs. We will construct a theoretical model of stroke survivors' and informal carers' experiences of primary care and community health services.

    ETHICS AND DISSEMINATION: The results of the systematic review will be disseminated via publication in a peer-reviewed journal and presented at a relevant conference. The study does not require ethical approval as no patient identifiable data will be used.

    Matched MeSH terms: Community Health Services*
  7. Chilenski SM, Ang PM, Greenberg MT, Feinberg ME, Spoth R
    Prev Sci, 2014 Apr;15(2):125-137.
    PMID: 23404665 DOI: 10.1007/s11121-012-0347-5
    The current study examined the impact of the PROSPER delivery system for evidence-based prevention programs on multiple indicators of social capital in a rural and semi-rural community sample. Utilizing a randomized blocked design, 317 individuals in 28 communities across two states were interviewed at three time points over the course of 2.5 years. Bridging, linking, and the public life skills forms of social capital were assessed via community members' and leaders' reports on the perceptions of school functioning and the Cooperative Extension System, collaboration among organizations, communication and collaboration around youth problems, and other measures. Longitudinal mixed model results indicate significant improvements in some aspects of bridging and linking social capital in PROSPER intervention communities. Given the strength of the longitudinal and randomized research design, results advance prevention science by suggesting that community collaborative prevention initiatives can significantly impact community social capital in a rural and semi-rural sample. Future research should further investigate changes in social capital in different contexts and how changes in social capital relate to other intervention effects.
    Matched MeSH terms: Preventive Health Services/organization & administration*
  8. Loh PS, Chaw SH, Shariffuddin II, Ng CC, Yim CC, Hashim NHM
    Anesth Analg, 2021 Jan;132(1):15-24.
    PMID: 33002931 DOI: 10.1213/ANE.0000000000005264
    BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic affected and overwhelmed many health care systems around the world at an unprecedented speed and magnitude with devastating effects. In developing nations, smaller hospitals were unprepared to face this outbreak nor had strategies in place to do so at the beginning. Here, we describe the preparation in an anesthetic department using simulation-based training over 2 weeks, as the number of cases rose rapidly.

    METHODS: Three areas of priority were identified as follows: staff safety, patient movement, and possible clinical scenarios based on simulation principles in health care education. Staff was rostered and rotated through stations for rapid-cycle deliberate practice to learn donning and doffing of personal protective equipment (PPE) and powered air-purifying respirator (PAPR). For difficult airway management, Peyton's 4 steps for skills training and Harden's Three Circle model formed the structure in teaching the core skills. Several clinical scenarios used system probing to elicit inadequacies followed by formal debriefing to facilitate reflection. Finally, evaluation was both immediate and delayed with an online survey after 1 month to examine 4 levels of reaction, learning, behavior, and impact based on the Kirkpatrick Model. Frequency and thematic analysis were then conducted on the quantitative and qualitative data, respectively.

    RESULTS: A total of 15 of 16 (93%) consultants, 16 (100%) specialists, and 81 (100%) medical officers in the department completed training within 2 consecutive weeks. Reaction and part of the learning were relayed immediately to trainers during training. In total, 42 (39%) trained staff responded to the survey. All were satisfied and agreed on the relevance of training. A total of 41 respondents (98%; 95% confidence interval [CI], 87-99) answered 16 of 20 questions correctly on identifying aerosol-generating procedures (AGP), indications for PPE, planning and preparation for airway management to achieve adequate learning. About 43% (95% CI, 27-59) and 52% (95% CI, 36-68) recalled donning and doffing steps correctly. A total of 92 responses from 33 respondents were analyzed in the thematic analysis. All respondents reported at least 1 behavioral change in intended outcomes for hand hygiene practice (20%), appropriate use of PPE (27%), and airway management (10%). The emerging outcomes were vigilance, physical distancing, planning, and team communication. Finally, the impact of training led to the establishment of institutional guidelines followed by all personnel.

    CONCLUSIONS: Simulation-based training was a useful preparation tool for small institutions with limited time, resources, and manpower in developing nations. These recommendations represent the training experience to address issues of "when" and "how" to initiate urgent "medical education" during an outbreak.

    Matched MeSH terms: Health Services Needs and Demand*
  9. Kasim MS, Abraham S
    PMID: 7163857
    Even though Malaysia is a relatively prosperous country amongst the developing nations, it is still be set by problems of a rapidly increasing population. The economic cake is also unevenly distributed and there are pockets of poverty in the slums surrounding the towns as well as in the rural areas. Added to that is the problem of ignorance and superstition especially amongst its adult population. It is due to these problems that the Child-to-Child programme has found special application in Malaysia. The Child-to-Child has been introduced through either the government agencies or the voluntary organizations. Through the Ministry of Education, the concept has found its ways through the schools and the state department of education. The Ministry of Information and Broadcasting has also introduced the concept of Child-to-Child in the media. The voluntary organizations have also introduced the concept of Child-to-Child in their projects. The Sang Kancil project has to some extent used the idea in the running of its activities. The Health and Nutrition Education House have found that by applying the concept and using older children to help in running its activities, its over all objective which is the improvement of the health of the children in the slums could be reached more easily.
    Matched MeSH terms: Child Health Services*
  10. Abdullah JM, Hussin AM, Tharakan J, Abdullah MR, Saad R, Kamari Z, et al.
    PMID: 17121309
    The number of cases of neurological disease is expected to rise in the next 10 years, making this the second leading cause of morbidity and mortality after heart disease in Malaysia. The lack of human resources in the neurological field currently serving the Malaysian population may cause a deficiency in specialized care, especially in rural areas where neurological and neurosurgical care may be lacking. Thus, a resolve was made to increase the numbers of specialists by the Universiti Sains Malaysia (USM) with the help of the Ministry of Health of Malaysia. A study was made to evaluate the number of referral centers needed in strategic parts of Malaysia. Our calculation was based on service demands and operative procedures following the guidelines of the Association of British Neurologists (ABN) where 15 minutes of service time was equivalent to 1 unit. Based on 2 million population covered in the state of Kelantan by this University Hospital, 4.27 neurologists are needed to meet service demands with a consultant to population ratio (CPR) of 1:468,384, compared to 7.46 neurosurgeons, with a CPR of 1:268,097. According to the current service demands, one neurologist has to work more than 407 hours per year and one neurosurgeon 1,219 hours per year in our hospital. Hospitals with a larger catchment area would need to have more neurologists and neurosurgeons for optimal care in their area. Thus, more neurologists and neurosurgeons are needed to be produced, since the existing numbers are too small for quality care in Malaysia.
    Matched MeSH terms: Health Services Needs and Demand*
  11. Chongsuvivatwong V, Mo-Suwan L, Mahahing P
    PMID: 2075485
    A survey was carried out in a Malay-speaking Muslim community in southern Thailand to obtain baseline data for planning of long term multidisciplinary research and development. By using a 30-cluster sampling technique, 210 households of 1,308 subjects were studied in the post-Ramadan period. It was found that the community was in a social transition. The crude birth rate was 4% and 37.6% of the households had at least one migrant. About half of these migrants had been to Malaysia and mainly worked in rubber plantations. Ninety-five per cent of the households had electricity whereas only 23.8% had a latrine. Boiled or rain water was regularly drunk in only 13.3 per cent of the households. Home-grown agricultural products were not sufficient to provide adequate food. Twenty-six per cent of the adults were unemployed and 24.6% were illiterate. Of the pregnancies 26.7% had no antenatal care and complete tetanus toxoid was given to only 27.8%. Traditional birth attendants conducted 81.1% of the deliveries and only 28.9 and 24.4% of the umbilical cords were correctly cut and correctly dressed, respectively. Breast feeding was still a common (87.8%) practice. However, complete immunization was given to only 10.8%, and 37.8% of the infants had at least one diarrheal episode in the previous month. It was concluded that high birth rate, high migration, low education, low income and bad health of infants are major problems. These problems were interlinked and needed a special multidisciplinary approach. In addition to common obstacles for routine health delivery, migration may create international complications, particularly related to maternal and child care.
    Matched MeSH terms: Health Services/utilization
  12. Pathmanathan I
    PMID: 1241162
    In a study of infant feeding practices in 95 infants aged three months and six months in the rural, predominantly Malay district of Kubang Pasu, which is recently undergoing rapid economic development consequent on the introduction of improved agricultural techniques in rice farming, it was found that approximately 75% of infants in both age groups were wholly or partially breast fed, modified powered milk being the milk food of most of the others. Semisolids were introduced early in the form of commercial prepacked cereals. It is suggested that medical officers of health recognising local socioeconomic and cultural changes that might affect health behavior can initiate simple studies of this type to identify local needs in health education. In circumstances such as this where a still popular beneficial traditional practice like breast feeding might be at risk of losing popularity in the face of socioeconomic development in the community it is suggested that the most useful educational effort regarding infant nutrition would be to preserve breast feeding.
    Matched MeSH terms: Maternal Health Services*
  13. Ahmad A, Zulaily N, Abdul Manan NS, Shahril MR, Syed Saadun Tarek Wafa SW, Mohd Amin R, et al.
    BMC Public Health, 2017 01 05;17(1):9.
    PMID: 28056904 DOI: 10.1186/s12889-016-3911-2
    BACKGROUND: Body weight is highly associated with overall health status. Being severely thin or obese may impose the risk of many health problems. Early detection of body mass index (BMI) status may help to reduce the associated comorbidities. Although many studies in the literature have investigated the BMI of school adolescents in Malaysia, the data on status of body weight among school adolescents in suburban states like Terengganu is limited. This study aimed to describe the body weight status of the whole population of school adolescents in all seven districts in Terengganu, Malaysia.

    METHODS: Using a cross-sectional study design, body weight and height were measured, and BMI was calculated and classified using WHO BMI-for-age Z-score. Data was obtained using the National Fitness Standard (SEGAK) assessment, which was uploaded in a specific Health Monitoring System (HEMS).

    RESULTS: From a total of 62,567 school adolescents, 50.7% were boys and 49.3% were girls. Girls had significantly higher BMI than boys in age groups of 13 to 15 and 16 to 17 years old. Among boys and girls, there were significant differences in mean BMI of school adolescents between rural and urban school locations in all age groups (p 

    Matched MeSH terms: School Health Services; Adolescent Health Services
  14. Azman N, Leong Bin Abdullah MFI, Musa KI, Hassan N, Mohd Shariff N
    J Psychosoc Oncol, 2024;42(5):688-708.
    PMID: 38449103 DOI: 10.1080/07347332.2024.2325498
    PURPOSE: While the unmet healthcare needs are still being improved upon, the wellbeing of cancer patients has increasingly become a prime concern in Malaysia. The objective of this study is to ascertain the trend of unmet supportive care needs, post-traumatic growth (P T G), coping strategies, and social supports among patients with breast cancer over the three time points of treatment: T1 at early diagnosis, T2 for three months after diagnosis, and T3 for six months after diagnosis.

    METHODS: A total of 240 cancer patients participated in this prospective cohort study, with follow-up visits from October 2019 until July 2021. Data were collected using several instruments: Brief COP E, the Source of Social Support Scale (SSSS), the Post-Traumatic Growth Inventory - Short Form (P T GI-SF), and a Malay version of the 34-Item Shortform Supportive Care Need Survey (SCNS-SF34).

    RESULTS: The results indicated a significant change from T1 to T3 for all domains of the unmet needs (p-value < 0.001), except for the sexual domain. A lower SCNS-SF34 score resulted from more unfavorable social support. The P T GI-SF results indicated a trend toward meeting the unmet needs, and a higher SCNS-SF-34 score predicted a considerably higher P T GI-SF score.

    CONCLUSIONS: Our study findings suggest that majority of the factors evaluated in terms of unmet needs among cancer patients have undergone considerable changes.

    Matched MeSH terms: Health Services Needs and Demand*
  15. Suwanbamrung C, Mehraj SK, Kercho MW, Stanikzai MH, Ageru TA, Jaroenpool J, et al.
    BMC Public Health, 2024 Nov 28;24(1):3315.
    PMID: 39609747 DOI: 10.1186/s12889-024-20767-4
    INTRODUCTION: By the time the globe started to tackle the COVID-19 pandemic, Southeast Asian countries had faced an increased dengue incidence, which has eventually become an important public health problem. However, effective and sustainable disease control measures in the area are still lacking. Therefore, the current study is aimed to evaluate the development and implementation of high school-based dengue solution model in Southern Thailand.

    METHODS: Integrated community participatory action research (CPAR) was employed using preparation, planning, implementation, and evaluation. Data was collected using quantitative and qualitative methods from high school students. Descriptive statistics such as frequency and percentage, chi-square and fisher's exact test were used to summarize and compare quantitative data before and after intervention. Similarly, qualitative data was collected through interviews and focus group discussion (FGD) and then analyzed through thematic analysis.

    RESULTS: Two hundred and thirty-nine (96.3%, n = 239/248) and 232 (93.5, n = 232/248) participants were included in the interventions before and after, respectively. School-based dengue prevention was developed with input from a variety of stakeholders, including students, community leaders, health educators, district officials, and community health volunteers. As demonstrated by pre- to post-test results, students understanding of dengue and the larval indices surveillance system has increased. Students who received the training were not only inspired but created a sense of community responsibility with a high commitment to teaching and sharing information in their circle to enhance overall community wellbeing. Being female and higher educational attainment was associated with students understanding of dengue and larval indices surveillance.

    CONCLUSION: This participatory action research not only improved students' understanding of dengue but also empowered them to be proactive in various community health initiatives. The positive correlation between educational attainment and students understanding of dengue solution and larval indices surveillance underscores the need for tailored educational interventions that address diverse learning needs within the community. Collaborative efforts to establish dengue health information center based at primary schools and above can better improve reduction of dengue incidence.

    Matched MeSH terms: School Health Services/organization & administration
  16. Woon LS, Maguire PA, Reay RE, Mittinty M, Bastiampillai T, Looi JCL
    Aust Health Rev, 2024 Dec;48(6):617-625.
    PMID: 39433299 DOI: 10.1071/AH24196
    Objective Telepsychiatry consultations grew rapidly with increased total consultations and reduced face-to-face consultations following the pandemic-triggered expansion of Medicare Benefits Schedule (MBS) telehealth items. It was unclear how much telehealth expansion independently impacted overall and face-to-face consultation trends after accounting for lockdown severity. Methods We extracted monthly MBS Item Reports for psychiatric consultations (January 2012-December 2023). The monthly average Stringency Index (SI) for Australia represented lockdown severity from January 2020 to December 2022. A dichotomous variable denoted telehealth expansion (March 2020 onward). We constructed consecutive multiple linear regression models for combined consultations and face-to-face consultations to include seasonality, trend, SI, and telehealth expansion. We compared model performance using information criteria. Results Median monthly total consultations increased from 148,413 (Interquartile range, IQR: 138,219-153,709) pre-expansion (January 2012-February 2020) to 173,016 (IQR: 158,292-182,463) post-expansion (March 2020-December 2023). Contrarily, median monthly face-to-face consultations decreased from 143,726 (IQR: 135,812-150,153) to 99,272 (IQR: 87,513-107,778). Seasonality and trend were present in both time series. The time series regression model with expansion but excluding SI best explained all consultations, while both telehealth expansion and SI were significant in the best-fit model for face-to-face consultations. Conclusion MBS telehealth expansion was associated with total and face-to-face consultations independent of lockdown severity changes. Policy changes allowing wider access to new telehealth services have possibly led to increased uptake of psychiatric care and addressed previously unmet needs.
    Matched MeSH terms: Mental Health Services/statistics & numerical data
  17. Murphy JK, Khan A, Sun Q, Minas H, Hatcher S, Ng CH, et al.
    Int J Equity Health, 2021 07 12;20(1):161.
    PMID: 34253198 DOI: 10.1186/s12939-021-01484-5
    BACKGROUND: The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts and may encounter increased barriers to accessing mental health care. The pandemic and related restrictions have led to changes in care delivery, including a rapid shift to the use of e-mental health and digital technologies. It is therefore essential to consider needs and opportunities for equitable mental health care delivery to the most at-risk populations. This rapid scoping review: 1) identifies populations in the APEC region that are at higher risk of the negative mental health impacts of COVID-19, 2) identifies needs and gaps in access to standard and e-mental health care among these populations, and 3) explores the potential of e-mental health to address these needs.

    METHODS: We conducted a rapid scoping review following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched Medline, Embase and PsychInfo databases and Google Scholar using a search strategy developed in consultation with a biomedical librarian. We included records related to mental health or psychosocial risk factors and COVID-19 among at-risk groups; that referred to one or more APEC member economies or had a global, thus generalizable, scope; English language papers, and papers with full text available.

    RESULTS: A total of 132 records published between December 2019 and August 2020 were included in the final analysis. Several priority at-risk populations, risk factors, challenges and recommendations for standard and e-mental health care were identified. Results demonstrate that e-mental health care can be a viable option for care delivery but that specific accessibility and acceptability considerations must be considered. Options for in-person, hybrid or "low-tech" care must also remain available.

    CONCLUSIONS: The COVID-19 pandemic has highlighted the urgent need for equitable standard and e-mental health care. It has also highlighted the persistent social and structural inequities that contribute to poor mental health. The APEC region is vast and diverse; findings from the region can guide policy and practice in the delivery of equitable mental health care in the region and beyond.

    Matched MeSH terms: Health Services Needs and Demand*
  18. Ahmad NA, Mat Ludin AF, Shahar S, Mohd Noah SA, Mohd Tohit N
    BMJ Open, 2020 Mar 16;10(3):e033870.
    PMID: 32184309 DOI: 10.1136/bmjopen-2019-033870
    INTRODUCTION: The world's older population continues to grow at an unprecedented rate. An ageing population poses a great challenge to our healthcare system that requires new tool to tackle the complexity of health services as well as the increasing expenses. Mobile health applications (mHealth app) is seen to have the potential to address these challenges, alleviating burdens on the healthcare system and enhance the quality of life for older adults. Despite the numerous benefits of mHealth apps, relatively little is known about whether older adults perceive that these apps confer such benefits. Their perspectives towards the use of mobile applications for health-related purposes have also been little studied. Therefore, in this paper, we outline our scoping review protocol to systematically review literature specific to older adults' willingness, perceived barriers and motivators towards the use of mobile applications to monitor and manage their health.

    METHODS AND ANALYSIS: Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. The search strategy will involve electronic databases including PubMed, Excerpta Medica Database, Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Google Scholar and ScienceDirect, in addition to grey literature sources and hand-searching of reference lists. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data will be charted and sorted through an iterative process by the research team. The extracted data will undergo a descriptive analysis and simple quantitative analysis will be conducted using descriptive statistics. Engagement with relevant stakeholders will be carried out to gain more insights into our data from different perspectives.

    ETHICS AND DISSEMINATION: Since the data used are from publicly available sources, this study does not require ethical approval. Results will be disseminated through academic journals, conferences and seminars. We anticipate that our findings will aid technology developers and health professionals working in the area of ageing and rehabilitation.

    Matched MeSH terms: Health Services for the Aged*
  19. Pindus DM, Lim L, Rundell AV, Hobbs V, Aziz NA, Mullis R, et al.
    BMJ Open, 2016 Oct 24;6(10):e012840.
    PMID: 27798023 DOI: 10.1136/bmjopen-2016-012840
    INTRODUCTION: Interventions delivered by primary and/or community care have the potential to reach the majority of stroke survivors and carers and offer ongoing support. However, an integrative account emerging from the reviews of interventions addressing specific long-term outcomes after stroke is lacking. The aims of the proposed scoping review are to provide an overview of: (1) primary care and community healthcare interventions by generalist healthcare professionals to stroke survivors and/or their informal carers to address long-term outcomes after stroke, (2) the scope and characteristics of interventions which were successful in addressing long-term outcomes, and (3) developments in current clinical practice.

    METHODS AND ANALYSIS: Studies that focused on adult community dwelling stroke survivors and informal carers were included. Academic electronic databases will be searched to identify reviews of randomised controlled trials (RCTs) and controlled trials, trials from the past 5 years; reviews of observational studies. Practice exemplars from grey literature will be identified through advanced Google search. Reports, guidelines and other documents of major health organisations, clinical professional bodies, and stroke charities in the UK and internationally will be included. Two reviewers will independently screen titles, abstracts and full texts for inclusion of published literature. One reviewer will screen search results from the grey literature and identify relevant documents for inclusion. Data synthesis will include analysis of the number, type of studies, year and country of publication, a summary of intervention components/service or practice, outcomes addressed, main results (an indicator of effectiveness) and a description of included interventions.

    ETHICS AND DISSEMINATION: The review will help identify components of care and care pathways for primary care services for stroke. By comparing the results with stroke survivors' and carers' needs identified in the literature, the review will highlight potential gaps in research and practice relevant to long-term care after stroke.

    Matched MeSH terms: Community Health Services*
  20. Fong MWK, Lim KS, Fong SL, Chen C, Kwan SY, Lee CC, et al.
    Neurophysiol Clin, 2025 Jan;55(1):103033.
    PMID: 39644808 DOI: 10.1016/j.neucli.2024.103033
    BACKGROUND: Invasive/ intracranial EEG forms an important component of assessment for epilepsy surgery in many patients with Drug-Resistant Epilepsy (DRE). Intracranial EEG has been poorly utilized though Southeast Asia (SEA) and Oceania. This study aimed to document the development of stereo-EEG (SEEG) across the region and highlight regional barriers to utilization and access.

    METHODS: A survey was developed by multicenter consensus. The survey captured institutional characteristics, geographic distributions, intracranial EEG utilization, and barriers to SEEG. Respondents were representative epilepsy centers across the region.

    RESULTS: Four epilepsy centers with established intracranial/ SEEG and two centers from a country without any access to SEEG participated. The responses identified that 1. Access to SEEG remained highly restricted across the region with an estimated one capable epilepsy center per 100 million people; 2. The region includes over half a billion people living in countries with no access to SEEG; 3. Staffing/ financial constraints were universal factors that limited growth of services or development of new services; 4. SEEG numbers have plateaued as a result of these challenges.

    CONCLUSION: The study puts into real numbers the challenges faced by the region in accessing SEEG. SEEG remains highly underutilized and future approaches should focus on regional training and referral pathways.

    Matched MeSH terms: Health Services Accessibility/statistics & numerical data
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