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Fulltext Cariprazine in an Adolescent with Tourette Syndrome with Comorbid Attention Deficit Hyperactive Disorder and Depression: A Case Report

Gill JS

Healthcare (Basel), 2023 Sep 13;11(18).
PMID: 37761728 DOI: 10.3390/healthcare11182531

Tourette syndrome is a complex neuropsychiatric condition that manifests in childhood and is often associated with other psychiatric comorbidities. This case report describes a young male with Tourette syndrome with major depressive disorder and attention deficit hyperactivity disorder (ADHD) who experienced troublesome side effects due to his existing medications (escitalopram, risperidone, and methylphenidate). In order to control his tics, ameliorate depressive symptoms, and eliminate side effects of stiffness and sedation, risperidone was switched to cariprazine, a third-generation antipsychotic medication with D3-D2 partial agonism. In addition, the antidepressant dose was also increased. With the new combination, the patient reported good control of his tics, together with significant improvement in depressive symptoms and no side effects. Based on this case and the reviewed literature, cariprazine might be a viable option for patients with Tourette syndrome with other comorbid illnesses who are prone to side effects of medication.
Fulltext Digital Device Use, Risk of Cognitive Impairment, and Cognition in Healthy Older Adults: The Role of Cognitive Reserve

Liang C, Subramaniam P, Mohd Ridzwan Goh NS, Kok Wai T, Moustafa AA

Healthcare (Basel), 2023 Oct 25;11(21).
PMID: 37957967 DOI: 10.3390/healthcare11212822

Neuroprotective factors are essential to successful ageing. As such, digital device use was proposed as an easily accessible and stimulating available cognitive activity to enhance brain function. Nonetheless, there was a lack of studies inspecting the connection between digital device use and cognitive reserve, the risk of cognitive impairment, and cognition. This study aims to investigate the potential mediator and moderator of the association between digital device use, cognitive reserve, the risk of cognitive impairment, and cognition among healthy older adults. A quantitative cross-sectional study was conducted to investigate the relationship between digital device use and cognitive reserve, the risk of cognitive impairment, and cognition. A total of 210 healthy older adults were recruited through purposive sampling. The results obtained from this study revealed that there was a significant difference in cognitive reserve and cognition between healthy older adults who use a digital device for communication purpose only and who use a digital device for multiple purposes. A significant relationship was also found between cognitive reserve, the risk of cognitive impairment, and cognition. Although digital device use was found to be significantly associated with cognitive reserve and cognition, it was not significantly associated with the risk of cognitive impairment. Cognitive reserve partially mediated the relationship between digital device use and cognition, supporting the notion that cognitive reserve acts as an underlying mechanism in the relationship between digital device use and cognition. Hence, digital device use was suggested to be a good daily intervention for healthy older adults to build on their cognitive reserve and potentially protect their cognition from declining. Nevertheless, relying on digital device use alone is not sufficient, and other activities should be explored to enhance cognitive reserve among healthy older adults.
Fulltext Trends in Health Communication: Social Media Needs and Quality of Life among Older Adults in Malaysia

Chen HWJ, Marzo RR, Sapa NH, Ahmad A, Anuar H, Baobaid MF, et al.

Healthcare (Basel), 2023 May 17;11(10).
PMID: 37239741 DOI: 10.3390/healthcare11101455

BACKGROUND: While social media continues to dominate, social media platforms have become powerful health communication tools for older users. However, fulfilling their social media needs can be both detrimental and beneficial to their quality of life (QoL). This study assessed social media needs as they relate to QoL among older adults in Malaysia.
METHODS: We conducted a cross-sectional study and adopted convenience sampling to recruit participants. The participants were required to self-report their sociodemographic profile, social media use and needs, and QoL. Social media use and needs were assessed using the Social Networking Sites Uses and Needs (SNSUN) scale, and QoL was assessed using the WHOQOL-BREF questionnaire. Multiple linear regression was performed to identify the predictors of QoL.
RESULTS: The findings revealed that the fulfilment of social integrative needs was the strongest predictor of higher QoL in all domains. However, those using social media for their affective needs demonstrated lower psychological health quality.
CONCLUSIONS: Fulfilling social integrative needs is the key to improving the QoL among older adults. The continuous development of age-friendly applications is essential to keep up with constantly changing social media trends and bridge the gap of social media inequalities. More importantly, it would enable older adults to utilize social media to its fullest potential and enjoy a higher QoL through accessible health communication tools.
Fulltext Geo-Mapping of the Spatial Accessibility to Public Oral Health Facilities among Schoolchildren in Selangor, Malaysia

Ali NIM, Marhazlinda J

Healthcare (Basel), 2023 May 12;11(10).
PMID: 37239694 DOI: 10.3390/healthcare11101405

Spatial accessibility to health services influences service utilisation and eventually impacts the disease burden. This cross-sectional study analysed the spatial accessibility of schoolchildren to public oral health facilities and school dental services (SDS) and vice versa in Selangor. Overlay and proximity analysis from geo-mapping software was employed to map the primary dental clinics with SDS, the public schools, and the proximity between primary dental clinics with SDS and public schools by travelling distance (5 km, 10 km, 20 km) and travelling time (15 min, 30 min). Over half of the schoolchildren in Selangor are within 5 km of accessibility to primary dental clinics and SDS teams. Meanwhile, nearly half of the primary and secondary schools, particularly in rural areas, are located within a more than 5 km service area of public oral health facilities. The SDS teams have a travel burden of more than 20 km to the public schools in Selangor's northern and north-western districts of large geographical areas. Simultaneously, most public primary and secondary schools are within 15 min of driving time from primary dental clinics. Geo-mapping highlights the inequalities in spatial accessibility to public oral health facilities with SDS among schoolchildren in Selangor. It is time to prioritise the resources, SDS, and preventive programmes to reduce inequalities in oral health accessibility among schoolchildren in Selangor.
An Integrated Model for Evaluating the Sustainability of Gamified Mobile Health Apps: An Instrument Development and Validation

Mustafa AS, Ali N, Dhillon JS, Sedera D

Healthcare (Basel), 2023 Apr 06;11(7).
PMID: 37046978 DOI: 10.3390/healthcare11071051

Mobile health (mHealth) apps are designed to support health behavior outcomes and improve well-being. The existing body of literature confirms mHealth's overall efficacy in promoting physical activity; however, more research on its utility in sustaining user engagement is needed. Understanding the determinants of an individual's willingness to continue using mHealth is vital to improving the intervention's success. This study developed a unified model and survey instrument adapted from extant literature while introducing new constructs to predict the sustained use of gamified mHealth. A pilot study was conducted to validate the survey instrument using 48 gamified fitness app users in Malaysia. The survey instrument was tested following rigorous guidelines for quantitative research in the information system context. According to the findings, the reliabilities of most measurement items met the criterion, and those items were retained. Overall, this paper contributes by integrating social comparison theory and the self-determination theory for sustaining user engagement with gamified mHealth through an extrinsic and intrinsic motivation perspective.
Knowledge of Human Monkeypox Infection among Final Year Medical, Pharmacy, and Nursing Students: A Multicenter, Cross-Sectional Analysis from Pakistan

Masood S, Alkubaisi NA, Aslam M, Salman M, Baraka MA, Mustafa ZU, et al.

Healthcare (Basel), 2023 Oct 20;11(20).
PMID: 37893851 DOI: 10.3390/healthcare11202777

The World Health Organization (WHO) declared the monkeypox outbreak a public health emergency in June 2022. In Pakistan, positive cases of monkeypox were reported in April 2023. Healthcare workers (HCWs) are considered as a front-line force to combat such outbreaks. A questionnaire-based cross-sectional study was conducted among 11 public sector educational institutions in Punjab, Pakistan, during May and June 2023 among final year medical, pharmacy, and nursing students concerning their knowledge of monkeypox. This included the signs/symptoms of monkeypox. Healthcare students were chosen as they are the HCWs of tomorrow. A total of 389 healthcare students participated in the study, with a mean age of 23.17 ± 1.72 years, and the majority were female. The mean knowledge score was 17.69 ± 4.55 (95% CI 17.24-18.14) out of a maximum total knowledge score of 26 (each correct answer was given a score of 1). The proportion of students with good, moderate, and poor knowledge was 21.6%, 43.2%, and 35.2%, respectively. Age (p = 0.017), gender (p < 0.001), and education (p < 0.001) had a significant impact on the knowledge score. In the multivariate linear regression model, education was the only significant factor linked to knowledge scores. Overall, the majority of future HCWs had moderate knowledge of monkeypox. Consequently, educational activities are needed to improve monkeypox-related knowledge among future HCWs. Furthermore, emerging infectious diseases should be routinely incorporated into HCW curricula.
Fulltext Development of the Active Ageing Awareness Questionnaire in Malaysia

Ahmad Bahuri NH, Rizal H, Abdul Majid H, Said MA, Su TT

Healthcare (Basel), 2021 Apr 22;9(5).
PMID: 33922206 DOI: 10.3390/healthcare9050499

The world's ageing population is associated with increased morbidity, disability, and social and financial insecurity, which may affect quality of life (QoL). Therefore, the World Health Organization (WHO) endorsed the Active Ageing Framework (AAF) in 2002 to enhance QoL as people age. However, little is known about the status of awareness of active ageing among the population, and there is no appropriate tool for assessment. Hence, the Awareness of Active Ageing Questionnaire (AAAQ) was developed. The content, linguistic and face validations together with test-retest reliability were conducted. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test the structural validity of the AAAQ. A total of 110 participants (mean ± SD = 50.19 ± 5.52) were selected for the pilot, 81 participants (mean ± SD = 49.40 ± 5.70) for the test-retest, and 404 participants (mean ± SD = 49.90 ± 5.80) for CFA and EFA tests. The 16-item AAAQ Malay version showed satisfactory reliability and validity. The Cronbach's alpha was more than 0.7 and showed good fit: Cmin/df = 2.771, GFI = 0.903, TLI = 0.951, RMSEA = 0.08. The AAAQ is suitable for measuring the awareness of active ageing among the middle-aged population in Malaysia.
Fulltext Capturing Semantic Relationships in Electronic Health Records Using Knowledge Graphs: An Implementation Using MIMIC III Dataset and GraphDB

Aldughayfiq B, Ashfaq F, Jhanjhi NZ, Humayun M

Healthcare (Basel), 2023 Jun 15;11(12).
PMID: 37372880 DOI: 10.3390/healthcare11121762

Electronic health records (EHRs) are an increasingly important source of information for healthcare professionals and researchers. However, EHRs are often fragmented, unstructured, and difficult to analyze due to the heterogeneity of the data sources and the sheer volume of information. Knowledge graphs have emerged as a powerful tool for capturing and representing complex relationships within large datasets. In this study, we explore the use of knowledge graphs to capture and represent complex relationships within EHRs. Specifically, we address the following research question: Can a knowledge graph created using the MIMIC III dataset and GraphDB effectively capture semantic relationships within EHRs and enable more efficient and accurate data analysis? We map the MIMIC III dataset to an ontology using text refinement and Protege; then, we create a knowledge graph using GraphDB and use SPARQL queries to retrieve and analyze information from the graph. Our results demonstrate that knowledge graphs can effectively capture semantic relationships within EHRs, enabling more efficient and accurate data analysis. We provide examples of how our implementation can be used to analyze patient outcomes and identify potential risk factors. Our results demonstrate that knowledge graphs are an effective tool for capturing semantic relationships within EHRs, enabling a more efficient and accurate data analysis. Our implementation provides valuable insights into patient outcomes and potential risk factors, contributing to the growing body of literature on the use of knowledge graphs in healthcare. In particular, our study highlights the potential of knowledge graphs to support decision-making and improve patient outcomes by enabling a more comprehensive and holistic analysis of EHR data. Overall, our research contributes to a better understanding of the value of knowledge graphs in healthcare and lays the foundation for further research in this area.
Fulltext Self-Compassion, Work Engagement and Job Performance among Intensive Care Nurses during COVID-19 Pandemic: The Mediation Role of Mental Health and the Moderating Role of Gender

Bahrami Nejad Joneghani R, Bahrami Nejad Joneghani R, Dustmohammadloo H, Bouzari P, Ebrahimi P, Fekete-Farkas M

Healthcare (Basel), 2023 Jun 29;11(13).
PMID: 37444718 DOI: 10.3390/healthcare11131884

(1) Background: The COVID-19 pandemic has highlighted attention on the importance of certain variables in predicting job performance. Among these, mental health is one of the main variables affected by this pandemic. It can have an important mediating role in predicting job performance by individual, occupational, and organizational variables, especially in the nursing community. However, there is little information about its mediation role among the predictors of job performance. This cross-sectional study aimed to examine the role of mental health as a mediating factor in the influence of self-compassion and work engagement on ICU nurses' job performance during the COVID-19 pandemic, as well as the moderating effect of gender on all model relations. A survey of 424 ICU nurses (men 193 and women 231) was undertaken in three Coronavirus hospitals in Isfahan, Iran. (2) Method: Questionnaires were distributed and collected among the statistical sample, and the data from the questionnaires were analyzed using AMOS24 software (version 24). The research model was evaluated in two stages (the main model and the two sub-models in two gender groups). (3) Result: The analysis revealed that work engagement (β = 0.42, p < 0.001), mental health (β = 0.54, p < 0.001) and job performance (β = 0.51, p < 0.001) were discovered to be positively related to self-compassion. Work engagement is positively associated with mental health (β = 0.16, p < 0.01) and job performance (β = 0.21, p < 0.001), and mental health is linked positively to job performance (β = 0.23, p < 0.001). Furthermore, the effects of self-compassion and work engagement on job performance are mediated by mental health. According to the findings, gender moderates the link between self-compassion and work engagement, work engagement and job performance, and self-compassion and job performance. (4) Conclusion: Mental health has a mediating role in the effect of self-compassion and work engagement on ICU nurses' job performance. Gender also acted as a moderator in some relationships. Males are dominant in all of these relationships as compared to females.
Fulltext Fighting Cancer around the World: A Framework for Action

Horgan D, Mia R, Erhabor T, Hamdi Y, Dandara C, Lal JA, et al.

Healthcare (Basel), 2022 Oct 25;10(11).
PMID: 36360466 DOI: 10.3390/healthcare10112125

Tackling cancer is a major challenge right on the global level. Europe is only the tip of an iceberg of cancer around the world. Prosperous developed countries share the same problems besetting Europe-and the countries and regions with fewer resources and less propitious conditions are in many cases struggling often heroically against a growing tide of disease. This paper offers a view on these geographically wider, but essentially similar, challenges, and on the prospects for and barriers to better results in this ceaseless battle. A series of panels have been organized by the European Alliance for Personalised Medicine (EAPM) to identify different aspects of cancer care around the globe. There is significant diversity in key issues such as NGS, RWE, molecular diagnostics, and reimbursement in different regions. In all, it leads to disparities in access and diagnostics, patients' engagement, and efforts for a better understanding of cancer.
Fulltext Exploring Critical Components of Physician-Patient Communication: A Qualitative Study of Lay and Professional Perspectives

Mohd Salim NA, Roslan NS, Hod R, Zakaria SF, Adam SK

Healthcare (Basel), 2023 Jan 05;11(2).
PMID: 36673530 DOI: 10.3390/healthcare11020162

(1) Background: The ability to communicate with patients and their relatives is a crucial skill for a physician. Unfortunately, many physicians and medical students are not well-equipped in this area. Therefore, this study aims to better understand the views on critical components of physician-patient communication to improve their skills. (2) Methods: This qualitative study utilized focus group discussions (FGDs) and in-depth interviews (IDIs). Through a purposive sampling technique, 32 medical students and physicians from the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (FMHS UPM) and Universiti Putra Malaysia Teaching Hospital (HPUPM), as well as patients and relatives from government and private hospitals or clinics were recruited. All sessions were audio-recorded, transcribed, and analyzed thematically. (3) Results: Seven themes were identified: professionalism, content of communication, verbal, non-verbal and paraverbal communication skills, environment, and visual communication. Good eye contact, providing treatment plans, and ensuring patient privacy and confidentiality were emphasized by physicians and medical students. In comparison, patients and relatives focused on the prognosis of disease, physician's empathy and advice, and physician's skills in building rapport with their patients and relatives. (4) Conclusion: The critical components that were highlighted by both professionals and laymen in the study should be practiced to ensure effective communication between physician and patient. There were different expectations in terms of the content of information between both groups. Patients and relatives were more interested in the physician's advice regarding their diet, care plans, physical activities, and daily routine. They were also focused on the prognosis of the disease, which indicates how quickly they would get better. Meanwhile, physicians and medical students were concentrating on management and treatment strategies, such as what additional procedures should be considered and what medications might work best for their patients. We also found that the patients and relatives had a lack of awareness on confidentiality issues. These findings provide an insight on the improvement of medical training and patient education to improve patient care. Patients have a right to privacy protection, and physicians should be well trained to carry out all procedures and treatment plans to ensure patients are treated with respect.
Fulltext Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review

Ahmed A, Tanveer M, Shrestha S, Khatiwada AP, Khanal S, Dujaili JA, et al.

Healthcare (Basel), 2022 Aug 26;10(9).
PMID: 36141242 DOI: 10.3390/healthcare10091630

Pharmacists are essential members of the healthcare team. The emergence of the novel coronavirus disease 2019 (COVID-19) pandemic has led pharmacists to undertake additional clinical roles. We aim to conduct a systematic review on the interventions and impact of pharmacist-delivered services in managing COVID-19 patients. We searched PubMed, Embase, Scopus, CINAHL plus, International Pharmaceutical Abstracts, and Web of Science from 1 December 2019 (the first case of COVID-19 emerged) to 13 January 2022 to retrieve the articles. Cochrane handbook and PRISMA guidelines were followed respectively to perform and report the review. The pharmacist-led interventions were reported following the Descriptive Elements of Pharmacist Intervention Characterization Tool (DEPICT) version 2. The protocol of systematic review was registered on PROSPERO (CRD42021277128). Studies quality was assessed with the modified NOS scale. In total, 7 observational studies were identified from 10,838 studies. Identification of dosage errors (n = 6 studies), regimen modifications (n = 5), removal of obsolete/duplicate medications (n = 5), identification and management of adverse drug reactions (n = 4), drug interactions prevention (n = 2), and physicians acceptance rate (n = 3) of therapy-related services delivered in-person or via tele-pharmacy were among the pharmacist-delivered services. Common interventions delivered by pharmacists also included optimizing the use of antibacterial, antivirals, and anticoagulants in COVID-19 infected patients. The acceptance of pharmacist-delivered services by physicians was high (88.5-95.5%). Included studies have described pharmacists' beneficial role in managing patients with COVID-19 including detection, resolution, and prevention of medication-related problems, with physicians demonstrating high trust in pharmacists' advice. Future research should assess the feasibility and scalability of such roles in real-world settings.
Fulltext Recent Advancements in Emerging Technologies for Healthcare Management Systems: A Survey

Junaid SB, Imam AA, Balogun AO, De Silva LC, Surakat YA, Kumar G, et al.

Healthcare (Basel), 2022 Oct 03;10(10).
PMID: 36292387 DOI: 10.3390/healthcare10101940

In recent times, the growth of the Internet of Things (IoT), artificial intelligence (AI), and Blockchain technologies have quickly gained pace as a new study niche in numerous collegiate and industrial sectors, notably in the healthcare sector. Recent advancements in healthcare delivery have given many patients access to advanced personalized healthcare, which has improved their well-being. The subsequent phase in healthcare is to seamlessly consolidate these emerging technologies such as IoT-assisted wearable sensor devices, AI, and Blockchain collectively. Surprisingly, owing to the rapid use of smart wearable sensors, IoT and AI-enabled technology are shifting healthcare from a conventional hub-based system to a more personalized healthcare management system (HMS). However, implementing smart sensors, advanced IoT, AI, and Blockchain technologies synchronously in HMS remains a significant challenge. Prominent and reoccurring issues such as scarcity of cost-effective and accurate smart medical sensors, unstandardized IoT system architectures, heterogeneity of connected wearable devices, the multidimensionality of data generated, and high demand for interoperability are vivid problems affecting the advancement of HMS. Hence, this survey paper presents a detailed evaluation of the application of these emerging technologies (Smart Sensor, IoT, AI, Blockchain) in HMS to better understand the progress thus far. Specifically, current studies and findings on the deployment of these emerging technologies in healthcare are investigated, as well as key enabling factors, noteworthy use cases, and successful deployments. This survey also examined essential issues that are frequently encountered by IoT-assisted wearable sensor systems, AI, and Blockchain, as well as the critical concerns that must be addressed to enhance the application of these emerging technologies in the HMS.
Fulltext IoT-Based Healthcare-Monitoring System towards Improving Quality of Life: A Review

Abdulmalek S, Nasir A, Jabbar WA, Almuhaya MAM, Bairagi AK, Khan MA, et al.

Healthcare (Basel), 2022 Oct 11;10(10).
PMID: 36292441 DOI: 10.3390/healthcare10101993

The Internet of Things (IoT) is essential in innovative applications such as smart cities, smart homes, education, healthcare, transportation, and defense operations. IoT applications are particularly beneficial for providing healthcare because they enable secure and real-time remote patient monitoring to improve the quality of people's lives. This review paper explores the latest trends in healthcare-monitoring systems by implementing the role of the IoT. The work discusses the benefits of IoT-based healthcare systems with regard to their significance, and the benefits of IoT healthcare. We provide a systematic review on recent studies of IoT-based healthcare-monitoring systems through literature review. The literature review compares various systems' effectiveness, efficiency, data protection, privacy, security, and monitoring. The paper also explores wireless- and wearable-sensor-based IoT monitoring systems and provides a classification of healthcare-monitoring sensors. We also elaborate, in detail, on the challenges and open issues regarding healthcare security and privacy, and QoS. Finally, suggestions and recommendations for IoT healthcare applications are laid down at the end of the study along with future directions related to various recent technology trends.
Fulltext Undertreatment and Underachievement of LDL-C Target among Individuals with High and Very High Cardiovascular Risk in the Malaysian Community

Razman AZ, Baharudin N, Mohd Kasim NA, Al-Khateeb A, Ismail Z, Nawawi H, et al.

Healthcare (Basel), 2022 Dec 05;10(12).
PMID: 36553972 DOI: 10.3390/healthcare10122448

Dyslipidaemia is a major cause of morbidity and mortality. The aims of this study are to determine the prevalence of dyslipidaemia subtypes, the proportions of lipid-lowering therapy (LLT) use, and the achievement of low-density lipoprotein cholesterol (LDL-C) treatment targets for high-risk (HR) and very high-risk (VHR) Malaysians. This cross-sectional study involves 5279 participants across 11 states in Malaysia. The data were obtained through a standardised questionnaire, anthropometric measurements, venous glucose and lipid profile. The participants with existing cardiovascular disease (CVD) or diabetes with at least one of the other major risk factors (smoking, hypertension or dyslipidaemia) were grouped into the VHR category. Other participants were risk-categorised using the Framingham General CVD Risk Score (FRS-CVD). The prevalence of elevated LDL-C, LLT use and LDL-C target were set according to respective risk categories. Pearson's chi-squared test was used to test the difference in the proportions. The mean ± standard deviation (SD) age was 41.1 ± 14.8 years, and 62.2% (3283/5279) of the group were females. Within the participant group, 51.5% were found to have elevated total cholesterol, 28.8% had low HDL-C, and 33.8% had high triglyceride. As for elevated LDL-C, 9.8% were in VHR, 8.6% in HR, 5.8% in MR and 34.9% in LR categories. Among the VHR group, 75.8% were not on LLT, and only 15.9% achieved the LDL-C target. As for the HR category, 87.7% were not on LLT, and only 16.1% achieved the LDL-C target. Dyslipidaemia is highly prevalent among Malaysians. The majority of VHR and HR participants were not on LLT and did not achieve LDL-C treatment targets. Proactive programs are warranted to combat dyslipidaemia-associated CVD events in these groups.
Fulltext Physician's Perspectives on Factors Influencing Antibiotic Resistance: A Qualitative Study in Vietnam

Di KN, Tay ST, Sri La Sri Ponnampalavanar S, Pham DT, Wong LP

Healthcare (Basel), 2022 Dec 31;11(1).
PMID: 36611587 DOI: 10.3390/healthcare11010126

(1) Background: The antibiotic resistance (ABR) rates are escalating to seriously high levels worldwide. This study was conducted to determine physicians' perspectives on factors influencing ABR in Vietnam. (2) Methods: Focus group discussion (FGD) was conducted through in-depth interviews on ABR perspectives with 5-6 physicians from different geographical locations and hospitals in Vietnam between March and June 2020. The research questions were focused on three main themes of (a) knowledge deficiency on ABR and hospital-acquired infection, (b) antibiotic prescribing practice among clinicians in the healthcare setting, and (c) regulations and hospital policies on antibiotic use. The descriptive analysis was performed using QRS NVivo software. (3) Results: A total of six FGDs were conducted among 34 physicians (18 males, 16 females) aged 26-53 years old from six public and six private hospitals in Vietnam. Most of the participants were attending physicians (85.3%) and had 5-10 years of experience in surgical wards (55.9%). For theme (a), a majority of participants agreed that they had adequate information updates on how ABR develops in their clinical setting; and were well aware of hospital-acquired infections. For theme (b), the participants agreed that WHO guidelines and Vietnam national guidelines were two important reference documents in guiding physicians in antibiotic use. For theme (c), the FGD study revealed awareness of ABR, hospital antibiotic policies, and procedures for administrators on antibiotic use that were updated and complied with. (4) Conclusions: While different levels of control measures against ABR are ongoing in Vietnam, several weaknesses in the current antibiotic prescribing strategies in the hospital and clinical setting management policies have been identified in the healthcare system. The research findings will be helpful for policymakers to have better plans of action against ABR in Vietnam.
Fulltext Understanding Factors Associated with Motivation to Quit Vaping among Vapers in the Federal Territory of Kuala Lumpur, Malaysia

Wee LH, Galvan JAA, Patil SS, Madhavan P, Mahalingam D, Yeong CH, et al.

Healthcare (Basel), 2023 Jul 08;11(14).
PMID: 37510421 DOI: 10.3390/healthcare11141980

The prevalence of vaping worldwide is showing an upward trend. This study aimed to determine the factors associated with motivation to quit vaping among vapers in the Federal Territory of Kuala Lumpur, Malaysia, through a cross-sectional, purposive sampling study. Respondents were required to complete a questionnaire consisting of vapers' sociodemographic questions, habitual behavioral pattern questions, the e-Fagerström Test of Nicotine Dependence, the Glover-Nilsson Smoking Behavioral Dependence Questionnaire, perception questions, motivation to quit questions, and withdrawal symptom questions. A total of 311 vapers participated in this study. The majority of the vapers were male (84.6%), younger (18-25 years) (55.3%), and with monthly income less than RM 4000 (USD 868; 83.9%). The level of motivation to quit vaping was found to have a significant association with the perception of vaping being as satisfying as cigarette smoking (p = 0.006) and mild to very strong nicotine dependence (p = 0.001). Participants who recorded moderate and strong habitual vaping behaviors had lower odds of having high motivation to quit vaping compared to those recording slight habitual behaviors (OR = 0.279, 95%CI(0.110-0.708), p = 0.007 and OR = 0.185, 95%CI(0.052-0.654), p = 0.009, respectively). Factors associated with higher motivation to quit vaping could be explored to gain better understanding of how to increase their motivation level for future quit attempts.
Fulltext Beyond Patient Characteristics: A Narrative Review of Contextual Factors Influencing Involuntary Admissions in Mental Health Care

Aluh DO, Aigbogun O, Ukoha-Kalu BO, Silva M, Grigaitė U, Pedrosa B, et al.

Healthcare (Basel), 2023 Jul 09;11(14).
PMID: 37510426 DOI: 10.3390/healthcare11141986

Variations in the rates of involuntary admission (IA) reflect the influence of unexplained contextual variables that are typically too heterogeneous to be included in systematic reviews. This paper attempts to gather and analyze factors unrelated to the patients that have been linked to IA. The articles included in this review were selected by iteratively searching four electronic databases (PubMed, PsychINFO, EMBASE, and Web of Science). A total of 54 studies from 19 different countries and regions, including 14 European countries, the United States, Canada, China, Vietnam, and Taiwan, were selected. The factors were categorized as service-related factors, impactful events, seasonal and temporal factors, mental health legislation, staff factors, and public attitudes. The factors rarely act in isolation but rather interact and reinforce each other, causing a greater influence on IA. This paper explains how these factors present opportunities for robust and sustainable interventions to reduce IAs. The paper also identifies future directions for research, such as examining the effects of economic recessions. Enhancing global reporting standards is essential to validate future research and support further in-depth studies. The complexity of the factors influencing IA and the implicit role of society suggest that resolving it will require social change.
Social Support among Older Persons and Its Association with Smoking: Findings from the National Health and Morbidity Survey 2018

Krishnapillai A, Kee CC, Ariaratnam S, Jaffar A, Omar MA, Sanaudi RB, et al.

Healthcare (Basel), 2023 Aug 10;11(16).
PMID: 37628448 DOI: 10.3390/healthcare11162249

BACKGROUND: Globally, the average age of the world's population of older people continues to rise and having a good social support network becomes increasingly relevant with the aging populace. Overall, in Malaysia, social support prevalence was low among older persons. This study was conducted to determine the association between social support and smoking status among the older Malaysian population.
METHODS: Data were obtained from the National Health and Morbidity (NHMS) 2018 survey on the health of older Malaysian adults and analyzed. This cross-sectional population-based study used a two-stage stratified random sampling design. Sociodemographic characteristics, smoking status, and social support data were collected from respondents aged 60 years and more. A validated Malay language interviewer-administered questionnaire of 11-items, the Duke Social Support Index, was utilized to assess the social support status. A multivariable logistic regression analysis was used to assess the association of social support and smoking status among the respondents.
RESULTS: The prevalence of good social support was significantly higher among the 60-69 years old (73.1%) compared to the ≥80 years old respondents (50%). Multivariate logistic regression analysis showed that respondents aged ≥80 years old were 1.7 times more likely to have poor social support compared to those aged 60-69 years. Respondents with no formal education were 1.93 times more likely to have poor social support compared to respondents who had tertiary education. Respondents with an income of MYR 3000. Former smokers had good social support compared to current smokers (73.6% vs. 78.7%). For current smokers, they had poor social support, which is almost 1.42 times higher than that for non-smokers.
CONCLUSION: There was poor social support among older people who were current smokers, had an increased age, had no formal education and had a low income. The findings obtained from this study could assist policymakers to develop relevant strategies at the national level to enhance the social support status among older smokers and aid in their smoking cessation efforts.
Assessing Mental Health Outcomes in Quarantine Centres: A Cross-Sectional Study during COVID-19 in Malaysia

Mohamad N, Ismail R, Ibrahim MF, Abdul Shukor IH, Mohamad MZ, Mahmud MF, et al.

Healthcare (Basel), 2023 Aug 18;11(16).
PMID: 37628536 DOI: 10.3390/healthcare11162339

During the COVID-19 pandemic, persons under surveillance (PUS) were isolated in quarantine centres instead of at home. However, there is limited knowledge regarding the mental health issues experienced by these persons. This study aimed to assess mental health outcomes and associated factors among PUS and frontline workers at quarantine centres. This study conducted an analysis of secondary data from a cross-sectional survey carried out by the Mental Health and Psychosocial Support Services (MHPSS). The MHPSS employed the Depression, Anxiety, and Stress Scale (DASS-21) to evaluate mental health outcomes across 49 quarantine centres in Malaysia. The study included a total of 4577 respondents. The prevalence of stress, anxiety, and depression was found to be 0.9%, 11.4%, and 10.2%, respectively. Frontline workers and being part of the younger age group were found to be associated with depression, anxiety, and stress. Other factors associated with mental health issues were being female, staying at an institution-type centre, and a longer duration of the stay or work at the centre. In conclusion, assessing the mental health status and its associated factors among quarantine centre occupants is crucial for developing future strategies to safeguard their mental well-being.

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