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Applying data mining in healthcare: an info-structure for delivering 'data-driven' strategic services

Abidi SS

Stud Health Technol Inform, 1999;68:453-6.
PMID: 10724926

Presently, there is a growing demand from the healthcare community to leverage upon and transform the vast quantities of healthcare data into value-added, 'decision-quality' knowledge, vis-à-vis, strategic knowledge services oriented towards healthcare management and planning. To meet this end, we present a Strategic Knowledge Services Info-structure that leverages on existing healthcare knowledge/data bases to derive decision-quality knowledge-knowledge that is extracted from healthcare data through services akin to knowledge discovery in databases and data mining.

Matched MeSH terms: Policy Making
Guidelines and policies on collection of biological specimens in the Philippines. Philippine Congress, International Convention on Biodiversity

Madulid DA

J Ethnopharmacol, 1996 Apr;51(1-3):205-8.
PMID: 9213618

In October, 1993, 16 months after the United Nations approved the International Convention on Biodiversity held in Rio de Janeiro, June, 1992, the Philippine Congress ratified and adopted the Convention. This is a manifestation of the full support of the Philippines for the principles and policies adopted by the UN body on the conservation of biodiversity, sustainable development of biological resources and equitable sharing of benefits between users and owners of biodiversity resources. The Philippine scientific community has long recognized the need for and importance of a national guideline and policy with regard to the collection of plants and animals in the Philippines for scientific or commercial purposes. A series of consultative meetings were held by representatives of government agencies, non-government organizations, private organizations, academic and private persons concerned with biodiversity conservation to formulate national guidelines that regulate the collection of plant and animal specimens in the country. Guidelines were unanimously adopted by various government agencies and academia and a Memorandum of Agreement (MOA) was signed on September 28, 1990. Very recently a new document was drafted, specifically to serve as a guideline for those who desire to undertake sample collecting in the Philippines for biodiversity prospecting. The document is now being reviewed by government departments and agencies and will be presented to the President of the Philippines for signing as an Executive Order (EO). Once signed, this EO will serve as a national policy for bioprospecting in the country. The Philippines is one of the countries in Southeast Asia that has endorsed the adoption of regional guidelines on the collection of plant and animal organisms for drug development. The ASEAN Agreement on the Conservation of Nature and Natural Resources (1985). The Manila Declaration (1992) and lately, the Melaka Accord (1994), all of which were signed by various countries in Asia, are manifestations of this interest.

Matched MeSH terms: Public Policy
Drug utilization studies: their transferability between industrialized and developing countries

Lee D, Balasubramaniam K, Ali HM

WHO Reg Publ Eur Ser, 1993;45:193-218.
PMID: 8442847
Matched MeSH terms: Health Policy
Fulltext Nutritional aspects of changes in disease patterns in the Western Pacific region

Cavalli-Sforza LT, Rosman A, de Boer AS, Darnton-Hill I

Bull World Health Organ, 1996;74(3):307-18.
PMID: 8789929

One impact of socioeconomic progress on populations has been to reduce the number of cases due to diseases of undernutrition and microbial contamination of food, which affected mostly infants and young children, and to increase those due to diseases of excessive food consumption, which are affecting adults and a growing number of children. This article reviews the main dietary factors which have an influence on cardiovascular disease and cancer, and discusses the link between economic development and increased rates of chronic diseases. There is evidence that the noncommunicable diseases and their risk factors have risen rapidly in countries of the WHO Western Pacific Region. Data from 29 countries and areas in the region indicate that 70% of them show lifestyle diseases in three or more of the top five causes of death. While public health measures have been implemented by some countries to prevent and control nutrition-related chronic diseases, further action is needed.

Matched MeSH terms: Health Policy
Disinfection: gaps between recommended and actual practice

Keah KC, Jegathesan M, Tan SC, Chan SH, Chee OM, Cheong YM, et al.

Southeast Asian J. Trop. Med. Public Health, 1995 Dec;26(4):795-8.
PMID: 9139397

Basic practices on disinfection was surveyed in 6 hospitals using an observation and interview checklist. Two surveys were done, one pre-(first survey) and one post-intervention (second survey). The disinfection and sterilization policy of the Ministry of Health was not available in 66 (70.2%) and 12 (13%) of the units in the first and second survey respectively. In the second survey, staff in all the units washed disinfectant containers before refilling compared with 41.5% of the units in the first survey. Dilution of disinfectants not recommended was found to be used in the first survey. Storing cleaned and sterile items in disinfectants, using disinfectant as a substitute for sterilization of autoclavable items and not decontaminating spillages were some of the wrong practices observed. Considerable improvements were made in the second survey. Improper usage of disinfectants was also indicated by failure of the in-use test. Rate of failure of disinfectants in-use decreased from 11.6% in the first survey to 5.0% in the second survey. To ensure proper disinfection practices, a comprehensive training program on disinfection is required for nurses and attendants.

Matched MeSH terms: Health Policy
Fulltext An evaluation of knowledge and awareness of disinfection and sterilization among health care workers

Keah KC, Jegathesan M, Tan SC, Chan SH, Che OM, Cheong YM, et al.

Southeast Asian J. Trop. Med. Public Health, 1995 Mar;26(1):51-6.
PMID: 8525420

Awareness of the disinfection and sterilization policy among hospital staff and their knowledge in basic principles and methods of disinfection and sterilization were studied before and after intervention using a self-administered questionnaire. Survey results showed that awareness (56.2%) before intervention was unsatisfactory. The nurses were more aware of the policy than other groups of medical personnel. Those unaware of the policy perform duties from memory or verbal instructions. A significant increase in awareness to 73.3% was observed after intervention (p < 0.05). Knowledge on methods of decontamination, disinfection and sterilization of equipment varies widely from 28.8% to 90.1%. 23.1% were unaware of the temperature used for sterilization while 72.4% did not know how containers of disinfectant should be refill. Only 14.7% knew the recommended method for washing containers. With education improvement was observed. The average knowledge improved from 44.4% to 57.3%. Our results indicated that continuous in-service education is needed to improve, supplement and update knowledge in this field after basic training. In addition orientation programs for new staff should also be aimed at creating awareness and providing information on guidelines and policies related to their duties.

Matched MeSH terms: Health Policy
Role of schools of public health on maternal and child health programmes in the Asia-Pacific region

Zulkifli SN, Yun-Low W, Yusof K

Asia Pac J Public Health, 1998;10(1):10-6.
PMID: 10050201

This paper assessed the role of public health schools on maternal and child health programmes in the Asia Pacific region. Economic development and its associated effects, particularly in the ASEAN countries, for example, migrant labour, ageing, environmental health, turbulence and social climate, has a tremendous impact on maternal and child health. Based on these current issues, it is evident that public health schools can play a major role in maternal and child health in terms of policy formulation and programme development. Several areas were proposed as to what schools of public health can do, namely, through networking, communication, research and training.

Matched MeSH terms: Health Policy
AIDS in Malaysia

Singh J, Che'Rus S, Chong S, Chong YK, Crofts N

AIDS, 1994;8 Suppl 2:S99-103.
PMID: 7857575
Matched MeSH terms: Health Policy
Population success

Dev Forum, 1982 Jul-Aug;10(6):1, 3.
PMID: 12279227

"The commitment to population programs is now widespread," says Rafael Salas, Executive Director of the UNFPA, in its report "State of World Population." About 80% of the total population of the developing world live in countries which consider their fertility levels too high and would like them reduced. An important impetus came from the World Conference of 1974. The Plan of Action from the conference projected population growth rates in developing countries of 2.0% by 1985. Today it looks as though this projection will be realized. While in 1969, for example, only 26 developing countries had programs aimed at lowering or maintaining fertility levels, by 1980 there were 59. The International Population Conference, recently announced by the UN for 1984, will, it is hoped, help sustain that momentum. Cuba is the country which has shown the greatest decline in birth rate so far. The birth rate fell 47% between 1965-1970 and 1975-1980. Next came China with a 34% decline in the same period. After these came a group of countries--each with populations of over 10 million--with declines of between 15 and 25%: Chile, Colombia, India, Indonesia, the Republic of Korea, Malaysia and Thailand. Though birth rates have been dropping significantly the decline in mortality rates over recent years has been less than was hoped for. The 1974 conference set 74 years as the target for the world's average expectation of life, to be reached by the year 2000. But the UN now predicts that the developing countries will have only reached 63 or 64 years by then. High infant and child mortality rates, particularly in Africa, are among the major causes. The report identifies the status of women as an important determinant of family size. Evidence from the UNFPA-sponsored World Fertility Survey shows that in general the fertility of women decreases as their income increases. It also indicates that women who have been educated and who work outside the home are likely to have smaller families. Access to contraceptives is, of course, a major influence on fertility decline. According to UNFPA some of the Latin American countries have the highest contraceptive use among developing countries. The countries of Asia come next and contraceptives are least used in sub-Saharan Africa where birth rates of 45/1000 are still common. The money for population programs, says the report, has come largely from developing countries themselves. A survey of 15 countries showed them to have contributed 67% out of their own budgets--the rest having come from external aid. And in programs aided by UNFPA the local input has been even higher. During 1979-1981 the developing countries themselves budgeted $4.6 for each dollar budgeted by UNFPA. The report also highlights some of the emerging problems for the next 2 decades--and which will be high on the agenda of the 1984 conference. These include "uncontrolled urban growth" in developing countries as well as an important change in overall population age structure as more and more old people survive. Aging populations are of particular concern to the developed countries but, as the report points out, even countries like China--which has achieved a steep drop in fertility and mortality--will face the problems of an aging population by the year 2000.

Matched MeSH terms: Public Policy
Malaysia [Population education in countries of the region]

Abu-bakar F

Bull Unesco Reg Off Educ Asia Pac, 1982 Jun.
PMID: 12265670
Matched MeSH terms: Public Policy
The HIV/AIDS epidemic country paper: Malaysia

Huang M, Hussein H

AIDS Educ Prev, 2004 Jun;16(3 Suppl A):100-9.
PMID: 15262569

Since the first case of HIV/AIDS was identified in 1986 in Malaysia, the number of infected individuals has increased steadily each year, so that by the end of 2002 the cumulative number of people living with HIV/AIDS was 57,835 (51,256 with HIV and 6,579 with AIDS), with 5,676 AIDS deaths. The epidemic in Malaysia, currently in a concentrated epidemic stage, is primarily fueled by drug use, but there is ample evidence that heterosexual transmission has increased over the last few years. A strategic plan that includes prevention, care, support, and treatment run by both the government and nongovernmental organizations has been in place since the beginning of the epidemic. However, Malaysia will need to take a more pragmatic approach to reduce new infections (which numbered 19 each day in 2002) among the youth on whom the country relies for development. Leaders need to recognize that HIV/AIDS is not just a health issue, but also a socioeconomic concern that can eliminate all the developmental gains achieved over the years. Working together, Malaysians can overcome the epidemic, but there is a need to act quickly and to act in effective ways so that the devastating effects (already evident in the number of AIDS orphans and widows) can be reduced.

Matched MeSH terms: Health Policy
Systematic review of factors affecting pharmaceutical expenditures

Mousnad MA, Shafie AA, Ibrahim MI

Health Policy, 2014 Jun;116(2-3):137-46.
PMID: 24726509 DOI: 10.1016/j.healthpol.2014.03.010

To systematically identify the main factors contributing to the increase in pharmaceutical expenditures.

Matched MeSH terms: Health Policy
Fulltext Environmental influence and intention to quit smoking among college students

Muhammad Adil Zainal Abidin, Hayati Kadir Shahar, Rosliza Abdul Manaf

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):77-77.
MyJurnal

Introduction: Secondhand tobacco smoke is a known carcinogen and has shown positive association with smok-ing status, susceptibility and cessation. Smoke free environment policy seem to reduce this exposure and influence intention to quit and frequency of quit attempts. Despite having a smoke free policy, smokers are still exposed to second hand smoke and this might influence their smoking behaviour and cessation. The objective of this study was to examine the association between environmental tobacco smoke exposures with intention to quit smoking among young adults in college with smoke free policy. Methods: Data were drawn from a cluster based randomised controlled trial in 10 government colleges in Selangor. Baseline characteristics of 160 college smokers were mea-sured using adapted questionnaire. Intention to quit was measured using Transtheoretical Model and environmental influence of tobacco smoke exposure. Results: Majority of the smokers were male (99.4%), single (100%), of Malay ethnicity (94.4%) and Muslim (95.6%). Most of them are in pre-contemplation stage where they do not have any intention to quit (65.6%). On environmental influence, at work or college environmental exposure, majority were exposed between 1 to 2 hours (36.9%) and 3 to 8 hours (40.6%). On exposure at home or hostel, majority were exposed between 1 to 4 hours (44.4%) and 5 to 14 hours (21.9%). In terms of friend’s exposures, majority have most of their friends smoking (68.1%). We found no statistically significant association between environmental influence and intention to quit smoking. Conclusion: Although we found no relationship, future research should examine the pathway between environmental influence and smoking behaviour.

Matched MeSH terms: Smoke-Free Policy
Fulltext Harnessing Telemedicine for the Provision of Health Care: Bibliometric and Scientometric Analysis

Waqas A, Teoh SH, Lapão LV, Messina LA, Correia JC

J Med Internet Res, 2020 10 02;22(10):e18835.
PMID: 33006571 DOI: 10.2196/18835

BACKGROUND: In recent decades, advances in information technology have given new momentum to telemedicine research. These advances in telemedicine range from individual to population levels, allowing the exchange of patient information for diagnosis and management of health problems, primary care prevention, and education of physicians via distance learning.
OBJECTIVE: This scientometric investigation aims to examine collaborative research networks, dominant research themes and disciplines, and seminal research studies that have contributed most to the field of telemedicine. This information is vital for scientists, institutions, and policy stakeholders to evaluate research areas where more infrastructural or scholarly contributions are required.
METHODS: For analyses, we used CiteSpace (version 4.0 R5; Drexel University), which is a Java-based software that allows scientometric analysis, especially visualization of collaborative networks and research themes in a specific field.
RESULTS: We found that scholarly activity has experienced a significant increase in the last decade. Most important works were conducted by institutions located in high-income countries. A discipline-specific shift from radiology to telestroke, teledermatology, telepsychiatry, and primary care was observed. The most important innovations that yielded a collaborative influence were reported in the following medical disciplines, in descending order: public environmental and occupational health, psychiatry, pediatrics, health policy and services, nursing, rehabilitation, radiology, pharmacology, surgery, respiratory medicine, neurosciences, obstetrics, and geriatrics.
CONCLUSIONS: Despite a continuous rise in scholarly activity in telemedicine, we noticed several gaps in the literature. For instance, all the primary and secondary research central to telemedicine was conducted in the context of high-income countries, including the evidence synthesis approaches that pertained to implementation aspects of telemedicine. Furthermore, the research landscape and implementation of telemedicine infrastructure are expected to see exponential progress during and after the COVID-19 era.

Matched MeSH terms: Health Policy
Fulltext Identifying causes of Under Five mortality for better planning

Nur Syakirah Awai, Aminah Bee Mohd Kassim

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):20-20.
MyJurnal

Introduction: Under 5 mortality is a leading indicator of the level of child health and overall development of a coun-try. In Malaysia, progressive reduction has been observed from 1990 however since 2000 progress has been static. Further understanding about this trend is crucial. The objective of this study was to identify causes of mortality for better policy development in order to further reduce this rate. Methods: Analysis of mortality trends was done using data from Department of Statistics and causes of mortality using data collected through the Stillbirth and Under 5 Mortality Reporting System (SU5MR) in 2016. Results: The trend for Under 5 mortality rate between 2006 till 2016 is still plateaued and hovered between 8 to 9 per 1000 live births at the national level. High percentage of death is seen among the neonatal group (51%), followed by children 28 days to 1year (31%) and toddlers 1-4 years (18%). Percentage of preventable deaths increased with age i.e. 21% among neonates, 41% among children 28 days to 1year and 48% among toddlers. The leading causes of death are conditions from perinatal period (34.4%), congen-ital malformation (30%), injuries and external causes (6.4%), respiratory (5.6%) and certain infectious and parasitic disease (5.1%). Conclusion: To further reduce under -5 mortality focus needs to be on preventable deaths; to reduce neonatal deaths will require political commitment to ensure adequate resources; interagency collaboration is needed to reduce toddler mortality and family and community awareness on prevention of injury and infection.

Matched MeSH terms: Policy Making
Addressing procedural challenges of ethical review system: Towards a better ethical quality of clinical trials review in Malaysia

See HY, Mohamed MS, Mohd Noor SN, Low WY

Account Res, 2019 01;26(1):49-64.
PMID: 30526066 DOI: 10.1080/08989621.2018.1556646

The review of clinical trials with human participants in Malaysia is governed by a decentralized control system. The clinical trial protocols are reviewed by 13 registered research ethics committees (RECs) in Malaysia. A governmental body, the National Pharmaceutical Control Bureau, is responsible for the inspection and oversight of these registered RECs to ensure that they comply with the regulatory requirements. However, this study highlights that each REC in Malaysia has a different standard operating procedure and ethical review process. Other procedural challenges identified include inadequate membership, poor mechanism for research monitoring after ethical approval, and insufficient resources. Establishments of a national standard of REC and a central ethics committee are suggested to ensure procedural compliance in the oversight of clinical trials in Malaysia. While there is a growing concern that procedural compliance may not have a direct impact on the protection of human subjects, our key point is that an ethical review system compliant with the national standards could serve as a strong framework to support and enhance the ethical quality of decision-making and judgement. We believe that being aware of how influential procedural compliance can be would help committees improve the ethical quality of their research review.

Matched MeSH terms: Organizational Policy
Fulltext Reducing the stigma of mental health disorders with a focus on low- and middle-income countries

Javed A, Lee C, Zakaria H, Buenaventura RD, Cetkovich-Bakmas M, Duailibi K, et al.

Asian J Psychiatr, 2021 Apr;58:102601.
PMID: 33611083 DOI: 10.1016/j.ajp.2021.102601

Mental health disorders are a burgeoning global public health challenge, and disproportionately affect the poor. Low- and middle-income countries (LMICs) bear 80 % of the mental health disease burden. Stigma associated with mental health results in delayed help seeking, reduced access to health services, suboptimal treatment, poor outcomes and an increased risk of individuals' human rights violations. Moreover, widespread co-occurrence of physical comorbidities such as noncommunicable diseases with mental health disorders makes the treatment of both conditions challenging and worsens prognosis. This paper explores various aspects of stigma towards mental health with a focus on LMICs and assesses measures to increase help-seeking and access to and uptake of mental health services. Stigma impacts persons living with mental illness, their families and caregivers and healthcare professionals (mental health professionals, non-psychiatric specialists and general practitioners) imparting mental health care. Cultural, socio-economic and religious factors determine various aspects of mental health in LMICs, ranging from perceptions of health and illness, health seeking behavior, attitudes of the individuals and health practitioners and mental health systems. Addressing stigma requires comprehensive and inclusive mental health policies and legislations; sustainable and culturally-adapted awareness programs; capacity building of mental health workforce through task-shifting and interprofessional approaches; and improved access to mental health services by integration with primary healthcare and utilizing existing pathways of care. Future strategies targeting stigma reduction must consider the enormous physical comorbidity burden associated with mental health, prioritize workplace interventions and importantly, address the deterioration of population mental health from the COVID-19 pandemic.

Matched MeSH terms: Health Policy
Fulltext Evaluation of a Multidisciplinary Antimicrobial Stewardship Program in a Saudi Critical Care Unit: A Quasi-Experimental Study

Haseeb A, Faidah HS, Al-Gethamy M, Iqbal MS, Barnawi AM, Elahe SS, et al.

Front Pharmacol, 2020;11:570238.
PMID: 33776750 DOI: 10.3389/fphar.2020.570238

Background: Antimicrobial stewardship programs (ASPs) are collaborative efforts to optimize antimicrobial use in healthcare institutions through evidence-based quality improvement strategies. With regard to critically ill patients, appropriate antimicrobial usage is of significance, and any delay in therapy increases their risk of mortality. Therefore, the implementation of structured multidisciplinary ASPs in critical care settings is of the utmost importance to promote the judicious use of antimicrobials. Methods: This quasi-experimental study evaluating a multidisciplinary ASP in a 20-bed critical care setting was conducted from January 1, 2016 to July 31, 2017. Outcomes were compared nine months before and after ASP implementation. The national antimicrobial stewardship toolkit by Ministry of health was reviewed and the hospital antibiotic prescribing policy was accordingly modified. The antimicrobial stewardship algorithm (Start Smart and Then Focus) and an ASP toolkit were distributed to all intensive care unit staff. Prospective audit and feedback, in addition to prescribing forms for common infectious diseases and education, were the primary antimicrobial strategies. Results: We found that the mean total monthly antimicrobial consumption measured as defined daily dose per 100 bed days was reduced by 25% (742.86 vs. 555.33; p = 0.110) compared to 7% in the control condition (tracer medications) (35.35 vs. 38.10; p = 0.735). Interestingly, there was a negative impact on cost in the post-intervention phase. Interestingly, the use of intravenous ceftriaxone measured as defined daily dose per 100 bed days was decreased by 82% (94.32 vs. 16.68; p = 0.008), whereas oral levofloxacin use was increased by 84% (26.75 vs. 172.29; p = 0.008) in the intensive care unit. Conclusion: Overall, involvement of higher administration in multidisciplinary ASP committees, daily audit and feedback by clinical pharmacists and physicians with infectious disease training, continuous educational activities about antimicrobial use and resistance, use of local antimicrobial prescribing guidelines based on up-to-date antibiogram, and support from the intensive care team can optimize antibiotic use in Saudi healthcare institutions.

Matched MeSH terms: Policy
Fulltext Promoting Malaysians to spend on health: what it takes to encourage Malaysians to spend on health promotion?

Yong, Kang Cheah

Int J Public Health Res, 2014;4(1):391-398.
MyJurnal

Introduction. In light of the important role of health-promoting expenditure in health, the objective of this study was to investigate the socio-demographic determinants of health-promoting expenditure such as purchase of medical equipment and services, food supplements and health education services and products among Malaysian adults.
Methods Third National Health and Morbidity Survey (NHMS III) consisting of 28771 observations was used for analysis. It was the latest nationally representative cross-sectional population-based survey conducted by the Ministry of Health Malaysia from April 2006 to January 2007. A censored regression model
(Tobit) was applied to examine the factors affecting health-promoting expenditure.
Results The results showed that age, income, gender, ethnicity, education, marital status, employment status and location of residence were able to affect health promoting expenditure. In particular, individuals who were younger, poor, males, Indian/others, less educated, unmarried, unemployed and residing in rural areas tended to spend less money on health promotion compared to others.
Conclusions This study reached a conclusion that socio-demographic factors were significantly associated with individual’s preferences for health promotion. Therefore, the government should devote its attention to these factors when
formulating nationwide health policies.
Study name: National Health and Morbidity Survey III (NHMS-2006)

Matched MeSH terms: Health Policy
Fulltext The Influence of Person-Environment Fit on the Turnover Intention of Nurses in Jordan: The Moderating Effect of Psychological Empowerment

Amarneh S, Raza A, Matloob S, Alharbi RK, Abbasi MA

Nurs Res Pract, 2021;2021:6688603.
PMID: 33815841 DOI: 10.1155/2021/6688603

There is an acute shortage of nurses worldwide, including in Jordan. The nursing shortage is considered to be a crucial and complex challenge across healthcare systems and has stretched to a warning threshold. High turnover among nurses in Jordan is an enduring problem and is believed to be the foremost cause of the nurse shortage. The purpose of this study was to investigate the multidimensional impact of the person-environment (P-E) fit on the job satisfaction (JS) and turnover intention (TI) of registered nurses. The moderating effect of psychological empowerment (PE) on the relationship between JS and TI was also investigated. Based on a quantitative research design, data were collected purposively from 383 registered nurses working at private Jordanian hospitals through self-administered structured questionnaires. Statistical Package for Social Sciences (SPSS) 25 and Smart Partial Least Squares (PLS) 3.2.8 were used to analyze the statistical data. The results showed that there is a significant relationship between person-job fit (P-J fit), person-supervisor fit (P-S fit), and JS. However, this study found an insignificant relationship between person-organization fit (P-O fit) and JS. Moreover, PE was also significantly moderate between JS and TI of nurses. This study offers an important policy intervention that helps healthcare organizations to understand the enduring issue of nurse turnover. Additionally, policy recommendations to mitigate nurse turnover in Jordan are outlined.

Matched MeSH terms: Policy

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