METHODS: One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking).
RESULTS: Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs.
DISCUSSION: The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p
MATERIALS AND METHODS: A total of 60 inpatient substance abusers post detoxification in Fountain House, Lahore, Pakistan, participated in this study. Fountain House was selected as the Minnesota model is primarily used there. Therefore, a new treatment approach was introduced to investigate its effectiveness for individuals with substance abuse. A randomized 12-week trial was conducted as a substance use disorders (SUDs) treatment program. Persons with SUD (i.e., identified patients) enrolled in a residential treatment program were randomized into the integrated model of the Community Reinforcement Approach (CRA) and traditional Minnesota model treatment (n = 30), and traditional Minnesota model treatment only (TMM; n = 30). All the participants in the experimental group attended the group therapy sessions and other activities in the facility in addition to the treatment conditions. The participants attended the individual therapeutic sessions, which were conducted according to the CRA guidelines used in the experimental group. In this study, each individual in the CRA treatment group received 12 one-to-one sessions ranging from 45 min to 1 h. The WHOQOL-BREF scale and Happiness Scale (1) were used for data collection.
RESULT: The results showed a significant increase in the quality of life of participants in the treatment group with CRA compared with the control group with TMM. The findings also indicated that the individuals in the treatment group with CRA had improved levels of happiness compared with individuals with TMM.
DISCUSSION: The CRA is an effective and adaptable treatment approach that works well in combination with other treatment approaches. The proven efficacy, compatibility, and cost-effectiveness distinguish it from other treatment methods.
IMPLICATIONS: The CRA should be adapted, assessed, and evaluated further, especially in Pakistan, where there is a pressing need to adopt an effective treatment strategy for addiction problems.
METHODS: The study is completed in two phases. In phase I a cross-sectional study is performed using two quantitative research designs, i.e., exploratory and descriptive, to evaluate the knowledge of private pharmacy staff. The sample of 218 pharmacies was selected. While in phase II cross sectional survey is conducted in 10 facilities from where FDC anti TB drugs were sampled for analyzing their quality.
RESULT: Results revealed the presence of pharmacists only at 11.5% of pharmacies. Approximately 81% of staff at pharmacies had no awareness of MDR-TB, while 89% of pharmacies had no TB-related informative materials. The staff identified that most of the patients with TB (70%) were of poor socio-economic class, which restricted their purchase of four FDCs only up to 2-3 months. Only 23% were acquainted with the Pakistan National TB Program (NTP). Except for MDR-TB, the results showed a significant correlation between the experiences of staff with TB awareness. Findings from the quality evaluation of four FDC-TB drugs indicated that the dissolution and content assay of rifampicin were not according to the specifications, and overall, 30% of samples failed to comply with specifications. However, the other quality attributes were within the limits.
CONCLUSION: In light of the data, it can be concluded that private pharmacies could be crucial to the effective management of NTP through the timely identification of patients with TB, appropriate disease and therapy-related education and counseling, and proper storage and stock maintenance.
Design: A cross-sectional study.
Setting: Malaysia.
Participants: A subset of 96 participants aged 18 and above.
Primary and secondary outcomes: Ten facial dimensions were measured using direct measurement and 2D photogrammetry. An assessment of inter-rater reliability was performed using intra-class correlation (ICC) of the 2D images. In addition, ICC and Bland-Altman analyses were used to assess the reliability and agreement of 2D photogrammetry with direct measurement.
Results: Except for head breadth and bigonial breadth, which were also found to have low inter-rater reliability, there was no significant difference in the inter-rater mean value of the 2D photogrammetry. The mean measurements derived from direct measurement and 2D photogrammetry were mostly similar. However, statistical differences were noted for two facial dimensions, i.e., bizygomatic breadth and bigonial breadth, and clinically the magnitude of difference was also significant. There were no statistical differences in respect to the remaining eight facial dimensions, where the smallest mean difference was 0.3 mm and biggest mean difference was 1.0 mm. The ICC showed head breadth had poor reliability, whilst Bland-Altman analyses showed seven out of 10 facial dimensions using 2D photogrammetry were accurate, as compared to direct measurement.
Conclusion: Only certain facial measurements can be reliably and accurately measured using 2D photogrammetry, thus it is important to conduct a reliability and validation study before the use of any measurement methods in anthropometric studies. The results of this study also suggest that 2D photogrammetry can be used to supplement direct measurement for certain facial dimensions.
METHODS: An online questionnaire was distributed randomly to 1,050 HCWs from the Ministry of Health facilities in the Klang Valley who were involved directly in managing or screening COVID-19 cases from May to August 2020. The questionnaire was divided into five domains, which were concerns, impact on life and work, practice, perceived adequacy of preventive measures, and Revised Impact of Event Scale (IES-R). Logistic regression was used to identify sociodemographic predictors of the five domains.
RESULTS: A total of 907 respondents (86.4%) participated in this survey. Approximately half of the respondents had a low concern (50.5%), most of them had a good practice (85.1%), with 67.5% perceiving there were adequate preventive measures, and they perceived the outbreak had a low impact (92%) on their life and work. From the IES-R domain, 18.6% of respondents potentially suffered from post-traumatic stress disorder (PTSD).
CONCLUSION: During the second wave of the COVID-19 outbreak in Malaysia, HCWs practiced high levels of precautions and preventive measures because they were aware of the risk of infection as an occupational hazard. With the adequate implementation of policy and control measures, the psychological wellbeing of the majority HCWs remained well and adequately supported.
METHODS: This study aimed to conduct a 5-year budget impact analysis of the proposed stratified treatment cascade for HCV treatment in Malaysia. A disease progression model that was developed based on model-predicted HCV epidemiology data was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. Healthcare costs associated with DAA therapy and disease stage monitoring were included to estimate the downstream cost implications.
RESULTS: The stratified treatment cascade with 109 in Scenario B was found to be cost-saving compared to Scenario A. The cumulative savings for the stratified treatment cascade was USD 1.4 million over 5 years.
DISCUSSION: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can result in a budget impact reduction in overall healthcare expenditure in Malaysia.
METHODS: Data were derived from 360 inpatient medical records from six types C public and private hospitals in an Indonesian rural province. These data were accumulated from inpatient medical records from four major disciplines: medicine, surgery, obstetrics and gynecology, and pediatrics. The dependent variable was provider moral hazards, which included indicators of up-coding, readmission, and unnecessary admission. The independent variables are Physicians' characteristics (age, gender, and specialization), coders' characteristics (age, gender, education level, number of training, and length of service), and patients' characteristics (age, birth weight, length of stay, the discharge status, and the severity of patient's illness). We use logistic regression to investigate the determinants of moral hazard.
RESULTS: We found that the incidences of possible unnecessary admissions, up-coding, and readmissions were 17.8%, 11.9%, and 2.8%, respectively. Senior physicians, medical specialists, coders with shorter lengths of service, and patients with longer lengths of stay had a significant relationship with the incidence of moral hazard.
CONCLUSION: Unnecessary admission is the most common form of a provider's moral hazard. The characteristics of physicians and coders significantly contribute to the incidence of moral hazard. Hospitals should implement reward and punishment systems for doctors and coders in order to control moral hazards among the providers.
OBJECTIVE: The objective of this research is to develop and implement the Change and Health Evaluation and Response System (CHEERS) as a methodological framework, designed to facilitate the generation and ongoing monitoring of climate change and health-related data within existing Health and Demographic Surveillance Sites (HDSSs) and comparable research infrastructures.
METHODS: CHEERS uses a multi-tiered approach to assess health and environmental exposures at the individual, household, and community levels, utilizing digital tools such as wearable devices, indoor temperature and humidity measurements, remotely sensed satellite data, and 3D-printed weather stations. The CHEERS framework utilizes a graph database to efficiently manage and analyze diverse data types, leveraging graph algorithms to understand the complex interplay between health and environmental exposures.
RESULTS: The Nouna CHEERS site, established in 2022, has yielded significant preliminary findings. By using remotely-sensed data, the site has been able to predict crop yield at a household level in Nouna and explore the relationships between yield, socioeconomic factors, and health outcomes. The feasibility and acceptability of wearable technology have been confirmed in rural Burkina Faso for obtaining individual-level data, despite the presence of technical challenges. The use of wearables to study the impact of extreme weather on health has shown significant effects of heat exposure on sleep and daily activity, highlighting the urgent need for interventions to mitigate adverse health consequences.
CONCLUSION: Implementing the CHEERS in research infrastructures can advance climate change and health research, as large and longitudinal datasets have been scarce for LMICs. This data can inform health priorities, guide resource allocation to address climate change and health exposures, and protect vulnerable communities in LMICs from these exposures.
Aim: This study evaluated the QoL and its influencing factors among HCWs residing in the Arab countries.
Methods: This was a cross-sectional study using a self-administered online questionnaire based on the World Health Organization QoL-BREF instrument with additional questions related to COVID-19. The study was conducted in three different languages (Arabic, English, and French) across 19 Arab countries between February 22 and March 24, 2022.
Results: A total of 3,170 HCWs were included in the survey. The majority were females (75.3%), aged 18-40 years (76.4%), urban residents (90.4%), married (54.5%), and were living in middle-income countries (72.0%). The mean scores of general health and general QoL were 3.7 ± 1.0 and 3.7 ± 0.9, respectively. Those who attained average physical, psychological, social, and environmental QoL were 40.8, 15.4, 26.2, and 22.3%, respectively. The income per capita and country income affected the mean scores of all QoL domains. Previous COVID-19 infection, having relatives who died of COVID-19, and being vaccinated against COVID-19 significantly affected the mean scores of different domains.
Conclusion: A large proportion of the Arab HCWs evaluated in this study had an overall poor QoL. More attention should be directed to this vulnerable group to ensure their productivity and service provision.