METHODS: A total of 218 undergraduate medical students at the Health Campus, Universiti Sains Malaysia, participated in a cross-sectional study that involved an online survey. Environmental factor scales were assessed with the nine-item lighting, noise, and temperature (LNT) scale and the six-item technology scale. Analysis was performed using confirmatory factor analysis (CFA).
RESULTS: The English version of the LNT scale with nine items and three factors showed a good fit to the data, with no item deleted. For LNT, the composite reliability (CR) was 0.81, 0.81, and 0.84, respectively, while the average variance extracted (AVE) was 0.61, 0.59, and 0.6, respectively. The English version of the technology scale, with six items and one factor, also showed a good fit to the data, with no item deleted. The CR was 0.84, and the AVE was 0.51.
CONCLUSIONS: The results provide psychometric evidence for environmental questionnaire scales in evaluating the factors associated with online learning among Malaysian university medical students. All items were retained and confirmed to fit the sample data.
MAIN BODY: Recent successes in malaria control and elimination have reduced the global malaria burden, but these gains are fragile and progress has stalled in the past 5 years. Withdrawing successful interventions often results in rapid malaria resurgence, primarily threatening vulnerable young children and pregnant women. Malaria programmes are being affected in many ways by COVID-19. For prevention of malaria, insecticide-treated nets need regular renewal, but distribution campaigns have been delayed or cancelled. For detection and treatment of malaria, individuals may stop attending health facilities, out of fear of exposure to COVID-19, or because they cannot afford transport, and health care workers require additional resources to protect themselves from COVID-19. Supplies of diagnostics and drugs are being interrupted, which is compounded by production of substandard and falsified medicines and diagnostics. These disruptions are predicted to double the number of young African children dying of malaria in the coming year and may impact efforts to control the spread of drug resistance. Using examples from successful malaria control and elimination campaigns, we propose strategies to re-establish malaria control activities and maintain elimination efforts in the context of the COVID-19 pandemic, which is likely to be a long-term challenge. All sectors of society, including governments, donors, private sector and civil society organisations, have crucial roles to play to prevent malaria resurgence. Sparse resources must be allocated efficiently to ensure integrated health care systems that can sustain control activities against COVID-19 as well as malaria and other priority infectious diseases.
CONCLUSION: As we deal with the COVID-19 pandemic, it is crucial that other major killers such as malaria are not ignored. History tells us that if we do, the consequences will be dire, particularly in vulnerable populations.
METHODS: We retrospectively analyzed one-year data from our stroke registry that began with the establishment of our hyperacute stroke service at Universiti Putra Malaysia Teaching Hospital from April 2020 until May 2021.
RESULTS: Setting up acute stroke services during the pandemic with constrained manpower and implementation of COVID-19 SOPs, was challenging. There was a significant dip of stroke admission from April to June 2020 due to the Movement Control Order (MCO) implemented by the government to curb the spread of COVID-19. However, the numbers of stroke admission steadily rose approaching 2021, after the implementation of recovery MCO. We managed to treat 75 patients with hyperacute stroke interventions i.e. intravenous thrombolysis (IVT), mechanical thrombectomy (MT) or both. Despite implementing COVID-19 SOPs and using magnetic resonance imaging (MRI) as our first line acute stroke imaging modality, clinical outcomes in our cohort were encouraging; almost 40% of patients who underwent hyperacute stroke treatment had early neurological recovery (ENR), and only 33% of patients had early neurological stability (ENS). In addition, we were able to maintain our door-to-imaging (DTI) and door-to-needle (DTN) time in line with international recommendations.
CONCLUSIONS: Our data reflects that COVID-19 SOPs did not deter successful delivery of hyperacute stroke services in our center. However, bigger and multi center studies are required to support our findings.
BACKGROUND: Teledentistry is a branch of telemedicine that has rapidly advanced in the last few years and has the potential to provide solutions to oral health problems of patients and locations that do not have prompt and immediate access to a dentist or dental services. The Covid-19 has increased the adaption of all digital health technologies and teledentistry is no exception.
METHODOLOGY: The study utilized online databases such as Pubmed (Medline), Scopus (Embase) and CINAHL for the purpose of document search. Newcastle Ottawa (NOS) scale was used to determine the quality of the studies included in our systematic review. PRISMA guidelines were used as the criteria for reporting items in the systematic review.
RESULTS: A total of 1297 documents were found after applying the search criteria and the keywords for the selected study. After applying the Prisma guidelines, removal of duplicates and irrelevant entries, 10 studies that were conducted during the Covid-19 pandemic were selected, fitting the inclusion criteria. All the studies included were evaluated for quality and risk of bias through the Newcastle Ottawa scale. Only high-quality studies were included for the final review.
CONCLUSION: Teledentistry is a cost-effective solution to screen, diagnose and treat dental patients from a distance. Teledentistry also has the potential to continue seamless continuation of dental education to dental students, during disruptive and non-disruptive periods. ASEAN countries should fully utilise the potential of teledentistry, however sound and effective legislation would be the key first step to achieving that potential.
METHODS: A detailed questionnaire, comprising of 62 questions was designed and parents or caretakers of 7 to 15 years old children were invited to participate via WeChat, a multi-purpose messaging, social media and mobile payment app, which is widely used by the Chinese population. A total of 668 parents across different regions of China were included.
RESULTS: During COVID-19 pandemic, 20.7 and 7.2% children report experiencing post-traumatic stress disorder (PTSD) and depressive symptoms due to the COVID-19 pandemic. PTSD and SMFQ-P scores are significantly higher in middle school and boarding school students compared to primary and day school students. Multiple logistic regression analysis revealed that school system and province of origin are factors significantly associated with developing PSTD symptoms. 44.3% respondents feel online education is effective in gaining knowledge and improving practical and communications skills. 78.0% believe the online education system is efficient. Overall 79.8% respondents are satisfied and children can adapt to this new education system. During the COVID-19 pandemic, we found 1 in five children have PTSD and 1 in 14 children have depressive symptoms.
CONCLUSION: In summary, COVID-19 epidemic has caused PTSD and depression symptoms among Chinese children aged 7 to 15 years. In general, a large proportion of respondents are satisfied with online education, but still a substantial proportion of students are not comfortable with this new form of learning. Authorities should optimize online education systems and implement effective interventions to cope with the psychological effects of COVID-19 on children, as it is affecting the global population and remains uncertain when it will end.
METHODS: A cross-sectional population survey using an online questionnaire commenced on 14 February 2020. The study participants were residents of Taiwan ages 20 to 70 years. The 6-item state version of the State-Trait Anxiety Inventory (STAI-6) was used to assess anxiety symptoms. The questions about preventive measures asked participants about their personal protection, cough etiquette, contact precautions, voluntary quarantine, and prompt reporting. Multivariable logistic regression was used to determine the factors influencing an increase in the preventive measures scores.
RESULTS: Of a total of 3555 completed responses, a total of 52.1% (95% confidence interval [CI] 50.4-53.7) of the respondents reported moderate to severe levels of anxiety symptoms in the past week, whereas 48.8% (95%CI 47.2-50.5) reported moderate to severe anxiety symptoms at the beginning of the outbreak. With a higher score indicating greater anxiety, the median scores for anxiety symptoms in the past week and at the beginning of the outbreak were 46.7 (IQR [interquartile range] 36.7-53.3) and 43.3 (IQR 36.7-53.3), respectively. The median scores for the preventive measures taken in the past week and at the beginning of the outbreak were 26.0 (IQR 21.0-30.0) and 24.0 (IQR 19.0-28.0), respectively, out of a maximum score of 36. In the multivariable analysis, an increased anxiety symptom score from the beginning of the outbreak to the past week (adjusted OR = 7.38, 95%CI 6.28-8.66) was a strongly significant determinant of an increased preventive measures score in the past week compared with the score at the beginning of the outbreak.
CONCLUSIONS: Anxiety and preventive measures scores were high and increased with the epidemic rate. Higher anxiety was associated with an increased use of preventive measures against COVID-19.
METHOD: A content analysis was conducted on the anonymous posts retrieved from the WSIF platform between 8th March 2020 and 7th July 2022. Around 1457 posts were initially selected for analysis which was reduced to 1006 after removing duplicates and non-relevant posts, such as queries about the addresses of the doctors and other non-mental health-related issues. A thematic analysis of the data was conducted using an inductive approach.
RESULT: The 1006 posts generated four themes and nine sub-themes. All the women mentioned mental health symptoms (n = 1006; 100%). Most also mentioned reasons for seeking mental healthcare (n = 818; 81.31%), healthcare-seeking behavior (n = 667; 66.30%), and barriers to seeking mental healthcare (n = 552; 54.87%). The majority of women described symptoms of stress, depression, and anxiety-like symptoms, which were aggregated under common mental health conditions. Mental health symptoms were ascribed to various external influences, including marital relationship, intrafamilial abuse, and insecurities related to the COVID-19 pandemic. A large proportion of posts were related to women seeking information about mental healthcare services and service providers (psychologists or psychiatrists). The analysis found that most women did not obtain mental healthcare services despite their externalized mental health symptoms. The posts identified clear barriers to women accessing mental health services, including low mental health literacy, the stigma associated with mental healthcare-seeking behavior, and the poor availability of mental health care services.
CONCLUSION: The study revealed that raising mass awareness and designing culturally acceptable evidence-based interventions with multisectoral collaborations are crucial to ensuring better mental healthcare coverage for women in Bangladesh.
METHODS: Using a whole-group sampling method, we assessed SI in 2192 (male = 834, female = 1358) medical students on three occasions over a period of one year. The Suicidal Ideation Self-Assessment Scale (SISAS) and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess SI and CT. The growth mixture modeling (GMM) was used to classify the developmental trajectory of SI.
RESULTS: A greater number of medical students were experiencing suicidal ideation during the COVID-19 pandemic. The trajectory of SI among medical students was divided into two groups: a low risk, slowly rising group and a high risk, continuous group. The low risk, slowly rising group had a significant time effect (B = 1.57, p
METHOD: A descriptive cross-sectional community-based study was conducted among 1280 randomly selected participants. Respondents were sent a web-based electronic link to the survey via email. Content validity, factor analyses and known group validity were used to develop and validate a new scale to identify falsified hand sanitizer. Test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs) were used to assess the reliability of the scale. SPSS version 24 was used to conduct data analysis.
RESULTS: A total of 1280 participants were enrolled in the study. The content validity index (CVI) was 0.83 with the final scale of 12 items. The Kaiser-Meyer-Olkin (KMO) value was 0.788, with the Bartlett test of sphericity achieving statistical significance (p
METHODS: The observational study (#NCT04367337) enrolled 6064 adults residing in Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Data on handwashing adherence across 8 situations (indicated in the WHO guidelines) were collected via an online survey (March-July 2020). Individual-level handwashing data were matched with the date- and country-specific values of the 6 indices of the trajectory of COVID-19 pandemic, obtained from the WHO daily reports.
RESULTS: Multilevel regression models indicated a negative association between both accumulation of the total cases of COVID-19 morbidity (B = -.041, SE = .013, p = .013) and mortality (B = -.036, SE = .014 p = .002) and handwashing. Higher levels of total COVID-related morbidity and mortality were related to lower handwashing adherence. However, increases in recent cases of COVID-19 morbidity (B = .014, SE = .007, p = .035) and mortality (B = .022, SE = .009, p = .015) were associated with higher levels of handwashing adherence. Analyses controlled for participants' COVID-19-related situation (their exposure to information about handwashing, being a healthcare professional), sociodemographic characteristics (gender, age, marital status), and country-level variables (strictness of containment and health policies, human development index). The models explained 14-20% of the variance in handwashing adherence.
CONCLUSIONS: To better explain levels of protective behaviors such as handwashing, future research should account for indicators of the trajectory of the COVID-19 pandemic.
TRIAL REGISTRATION: Clinical Trials.Gov, # NCT04367337.
METHODS: Nasopharyngeal swabs (NPS) for SARS-CoV-2 RT-PCR and blood for SARS-CoV-2 antibody testing were obtained from staff at a large international school in Qatar at the beginning of the 2020-2021 school year and repeated at the end of the first term.
RESULTS: A total of 376 staff provided samples for testing. At the beginning of the 2020-2021 school year, the PCR positivity for SARS-CoV-2 was 13%, while seropositivity was 30.1%. A majority of those who tested positive either by PCR or serologically, were non-teaching staff. At the end of the first school term four months later, only 3.5% of the initially antibody-negative staff had seroconverted. In multivariable logistic regression analysis, male gender (OR 11.48, 95%CI 4.77-27.64), non-teaching job category (OR 3.09, 95%CI 1.10-8.64), contact with a confirmed case (OR 20.81, 95%CI 2.90-149.18), and presence of symptoms in the preceding 2 weeks [1-2 symptoms OR 4.82, 95%CI 1.79-12.94); ≥3 symptoms OR 42.30, 95%CI 3.76-476.43) independently predicted SARS-CoV-2 infection in school staff before school starting.
CONCLUSION: Male gender, non-teaching job, presence of symptoms, and exposure to a confirmed case were associated with higher risk of infection. These data can help policymakers in determining the optimal strategy for school reopening.
METHODS: This qualitative study employed the hermeneutic phenomenological study design. Purposive sampling strategies were used to recruit Malaysians that had direct experiences with friends, family members and their community who were hesitating or refusing to accept the COVID-19 vaccines. A semi-structured interview guide was developed based on the expert knowledge of the investigators and existing literature on the topic. A series of focus group interviews (FGIs) was conducted online facilitated by a multidisciplinary team of experts. The group interviews were transcribed verbatim and analysed.
RESULTS: Fifty-nine participants took part in seven FGIs. We found that "incongruence" was the overall thematic meaning that connected all the 3 main themes. These themes comprise firstly, the incongruence between the aims and implementation of the National Immunization Program which highlighted the gap between realities and needs on the ground. Secondly, the incongruence between Trust and Mistrust revealed a trust deficit in the government, COVID-19 news, and younger people's preference to follow the examples of local vaccination "heroes". Thirdly, the incongruence in communication showed the populace's mixed views regarding official media and local social media.
CONCLUSIONS: This study provided rich details on the complex picture of the COVID-19 immunization program in Malaysia and its impact on vaccine hesitancy and refusal. The inter-related and incongruent factors explained the operational difficulty and complexity of the NIP and the design of an effective health communication campaign. Identified gaps such as logistical implementation and communication strategies should be noted by policymakers in implementing mitigation plans.
METHODS: The first part of this study employed a structured online survey of 708 Malaysian adult participants. Data collected were quantitatively analyzed by means of descriptive statistics, bivariate correlations, analysis of variance (ANOVA), and multiple linear regression. The second part of this study was conducted among 28 women to better understand gender disparity in protection motivations from the perspectives of women.
RESULTS: Gender has the strongest positive association with wearing face masks (p-value < .001), followed by age (p-value = .028). The Protection Motivation Theory adequately explicated the gender disparity in wearing face masks. Additionally, women were motivated to wear face masks beyond protection from the SARS-CoV-2.
CONCLUSION: Understanding the underlying motivations for wearing face masks informs design of gender-based public health messages to increase compliance with public health regulations and reduce morbidity and mortality for present and future public health crises.
METHODS: The VicHealth Victorian Coronavirus Wellbeing Impact Study included two 20-min opt-in online panel surveys conducted in May and September 2020 in Victoria, each with a sample of 2000 adults aged 18 + . A two-part study design was used: a repeated cross-sectional study of respondents who participated in Survey One and Survey Two, followed by a longitudinal nested cohort study. The primary exposures were social solidarity, social connectedness and staying connected with family and friends. Using logistic regression modelling, we explored the associations between our exposures and primary outcomes of psychological distress and life satisfaction with and without adjustment for covariates, both cross-sectionally and longitudinally. The results from the multivariable models were summarised using adjusted Odds Ratios (aOR), 95% Confidence Intervals (CI).
RESULTS: Cross-sectional results indicated that the percentage of participants with low life satisfaction was significantly higher in the second survey sample (53%) compared to the first (47%). The percentage of participants with high psychological distress was higher but not significantly different between the two survey samples (14% first survey vs 16% second survey). Longitudinal study results indicated that lower social connectedness was significantly associated with higher psychological distress (aOR:3.3; 95% CI: 1.3-8.4) and lower life satisfaction (aOR:0.2; 95% CI: 0.1-0.4). Younger adults had higher psychological distress compared to older adults (aOR:6.8; 95% CI:1.5-31.1). Unemployment at the time of the first survey was significantly associated with lower life satisfaction at the second survey (aOR:0.5; 95% CI: 0.3-0.9).
CONCLUSION: This study supports the findings of other international studies. It also highlights the need to promote increased social connection and maintain it at times of isolation and separation, particularly amongst younger adults.
METHODS: A sequential mixed method approach was used to conduct an online survey and in-depth interviews among residents in Malaysia. A total of 827 respondents participated in the online survey from 1st May to 30th June 2020. Nineteen in-depth interviews were conducted online and by phone with key informants and members of the public, who were selected through maximum variation purposive sampling between 2nd May 2020 to 20th December 2021. The semi-structured interviews employed a phenomenological approach and transcripts were analysed using thematic analysis. The survey data were analysed using descriptive statistics in Stata 15.0.
RESULTS: The survey reflected significant economic impacts of the pandemic, the maximum number of days that people could cope during the MCO, and their coping strategies, which generally entailed changes in lifestyle. The internet and social media were vital platforms to mitigate against the impact of public health measures. Thematic analysis of the interview data revealed participant experiences and perceptions of COVID-19 and public health measures in four main themes: (1) work and business; (2) emotional impact (3) coping with change and (4) the COVID-19 vaccine.
CONCLUSIONS: This study provides insights into the experiences, coping strategies and perspectives of people in Malaysia living through the first-ever MCO during the COVID-19 pandemic. Such insights into COVID-19-related public health measures are pertinent for successfully planning and implementing future responses to pandemics.
METHODS: This approach included the use of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) as a means of screening to identify individuals at moderate (score of 5-7) to high risk (score of 8 +) alcohol use, raising awareness, and investigating the potential utility of brief advice and referrals as a means of reducing risk.
RESULTS: Of the 54,187 participants, 43.0% reported engaging in moderate-risk alcohol consumption, with 22.1% reporting high-risk alcohol consumption. Resistance to brief advice was observed to increase with higher AUDIT-C scores. Similarly, participants engaging in high-risk alcohol consumption were resistant to accepting treatment referrals, with fewer than 10% open to receiving a referral.
CONCLUSIONS: While men were most likely to report patterns of high-risk alcohol consumption, they were more resistant to accepting referrals. Additionally, participants who were willing to receive brief advice were often resistant to taking active steps to alter their alcohol use. This study highlights the need to consider how to prevent harmful patterns of alcohol use effectively and holistically, especially in low socioeconomic settings through primary health care and community services.
METHODS: Meaningful work, coping strategies, and mental health were evaluated in empirical research based on a sample of 462 SME employees working in Malaysia. Structured questionnaires were used to collect the data and analyze it through Structural Equation Modelling (SEM) using AMOS 21.0.
RESULTS: The findings of the study show the importance of meaningful work in influencing the mental health of SME employees, particularly during a crisis like the COVID-19 pandemic. This suggests that the more they value and see their work as meaningful, the more capable they are of dealing with limitations and mental health problems associated with crises. The study also discovered a partial mediating role for coping strategies between employees' mental health and meaningful work.
CONCLUSION: This study encourages employees to constantly feel connected and discover continued possibilities to work and learn even during crisis situations. In order to improve human resource efficiency in emerging markets, managers and owners of SMEs must implement the model developed by the researchers.
METHODS: The WoCKSS was developed with 20 and 31 items for knowledge and stigma domains, respectively, based on an extensive review of COVID-19 literature. Content validation was conducted by four experts using a content validation form to assess the relevancy of each item to the intended construct. Content Validity Index (CVI) was calculated to measure the agreement between the experts on the relevance of each item to the intended construct. Face validation was then conducted by randomly selecting 10 respondents from the manufacturing industry, who rated the clarity and comprehension of each item using a face validation form. The Item Face Validity Index (I-FVI) was calculated to determine the clarity and comprehension of each question, and only items with an I-FVI ≥ 0.83 were retained.
RESULTS: The WoCKSS achieved excellent content validity in both knowledge and stigma domains. Only 19 items from the knowledge domain and 24 items from the stigma domain were retained after CVI analysis. All retained items received a CVI score of 1.00, indicating perfect agreement among the experts. FVI analysis resulted in 17 items for the knowledge domain and 22 items for the stigma domain. The knowledge domain achieved a high level of agreement among respondents, with a mean I-FVI of 0.91 and a S-FVI/UA of 0.89. The stigma domain also showed high agreement, with a mean I-FVI of 0.99 and a S-FVI/UA of 0.86.
CONCLUSION: In conclusion, the WoCKSS demonstrated high content and face validity. However, further testing on a larger sample size is required to establish its construct validity and reliability.
DATA DESCRIPTION: Data were collected from 1583 (Mage = 32.22, SD = 12.90, Range = 19-82) respondents from Japan, China, the United States, and Malaysia between October to November 2020. We collected data across age and sex, marital status, number of children, and occupations. We also accounted for stay-at-home measures, change in income, COVID-19 infection status, place of residence, and subjective social status in the study. Our variables included mental health-related and resilience constructs, namely (i) fear of COVID-19, (ii) depression, anxiety, and stress; (iii) present, past, and future life satisfaction, (iv) sense of control, (v) positive emotions, (vi) ego-resilience, (vii) grit, (viii) self-compassion, (ix) passion, and (x) relational mobility. All questionnaires were assessed for their suitability across the four countries with the necessary translation checks. Results from this study can be instrumental in examining the impact of multiple resilience factors and their interaction with demographic variables in shaping mental health outcomes.