Displaying publications 141 - 160 of 604 in total

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  1. Fulltext An Exploratory Qualitative Study With Older Malaysian Stroke Survivors, Caregivers, and Healthcare Practitioners About Falls and Rehabilitation for Falls After Stroke
    Ahmad Ainuddin H, Romli MH, Hamid TA, Sf Salim M, Mackenzie L
    Front Public Health, 2021;9:611814.
    PMID: 33987161 DOI: 10.3389/fpubh.2021.611814
    Background: Studies on rehabilitation for falls after a stroke remain limited despite its impact being profound. This scenario justifies a deeper understanding of why falls in stroke rehabilitation received less attention. Current investigations on the perception of falls and stroke also proved inadequate. Therefore, this study aims to explore the perceptions and experiences of older Malaysian stroke survivors, spousal caregivers, and healthcare practitioners on falls in stroke rehabilitation. Method: A qualitative study of three focus groups with 18 individuals from one community-based stroke rehabilitation center was conducted. The discussions were audio-recorded, video-recorded, transcribed, summarized, and analyzed using thematic analysis. Results: Three themes emerged from the analysis: (i) perceived factors and consequences of falls after stroke, (ii) physical-based interventions predominate in rehabilitation for falls after stroke, and (iii) the role of home hazards in fall prevention is taken for granted. Although, awareness of falls is high, they are regarded as a peripheral issue in stroke. Rehabilitation interventions such as improved functionality are believed to be adequate and can indirectly prevent falls. Other interventions for fall prevention such as home hazards management are relatively less known. Conclusion: There is a need for more attention regarding home environment risk assessment and intervention among healthcare professionals, and more education for clients and caregivers is required. Although, other stroke interventions may also benefit stroke survivors, falls prevention should be a central component in stroke rehabilitation. As this study focused on a specific population, the findings should be validated with larger populations, and in diverse settings.
    Matched MeSH terms: Delivery of Health Care
  2. Fulltext E2EE enhanced patient-centric blockchain-based system for EHR management
    Haddad A, Habaebi MH, Elsheikh EAA, Islam MR, Zabidi SA, Suliman FEM
    PLoS One, 2024;19(4):e0301371.
    PMID: 38557695 DOI: 10.1371/journal.pone.0301371
    To secure sensitive medical records in the healthcare clouds, this paper proposes an End-to-End Encryption (E2EE) to enhance a patient-centric blockchain-based system for electronic health record (EHR) management. The suggested system with a focus on the patient enables individuals to oversee their medical records within various involved parties by authorizing or withdrawing permission for access to their records. Utilizing the inter-planetary file system (IPFS) for record storage is chosen due to its decentralized nature and its ability to guarantee the unchangeability of records. Then an E2EE enhancement maintains the medical data integrity using dual level-Hybrid encryption: symmetric Advanced Encryption Standard (AES) and asymmetric Elliptic Curve Cryptography (ECC) cryptographic techniques. The proposed system is implemented using the Ethereum blockchain system for EHR data sharing and integration utilizing a web-based interface for the patient and all users to initiate the EHR sharing transactions over the IPFS cloud. The proposed system performance is evaluated in a working system prototype. For different file sizes between 512 KB to 100 MB, the performance metrics used to evaluate the proposed system were the time consumed for generating key, encryption, and decryption. The results demonstrate the proposed system's superiority over other cutting-edge systems and its practical ability to share secure health data in cloud environments.
    Matched MeSH terms: Delivery of Health Care
  3. Fulltext Priorities for cancer research in low- and middle-income countries: a global perspective
    Pramesh CS, Badwe RA, Bhoo-Pathy N, Booth CM, Chinnaswamy G, Dare AJ, et al.
    Nat Med, 2022 Apr;28(4):649-657.
    PMID: 35440716 DOI: 10.1038/s41591-022-01738-x
    Cancer research currently is heavily skewed toward high-income countries (HICs), with little research conducted in, and relevant to, the problems of low- and middle-income countries (LMICs). This regional discordance in cancer knowledge generation and application needs to be rebalanced. Several gaps in the research enterprise of LMICs need to be addressed to promote regionally relevant research, and radical rethinking is needed to address the burning issues in cancer care in these regions. We identified five top priorities in cancer research in LMICs based on current and projected needs: reducing the burden of patients with advanced disease; improving access and affordability, and outcomes of cancer treatment; value-based care and health economics; quality improvement and implementation research; and leveraging technology to improve cancer control. LMICs have an excellent opportunity to address important questions in cancer research that could impact cancer control globally. Success will require collaboration and commitment from governments, policy makers, funding agencies, health care organizations and leaders, researchers and the public.
    Matched MeSH terms: Delivery of Health Care
  4. Benefits and challenges of teleconsultation service for non-communicable disease follow-up in public healthcare clinics in Malaysia: a qualitative study
    Rambli R, Aznida FAA, Azimatun Noor A
    Med J Malaysia, 2023 Jul;78(4):449-457.
    PMID: 37518911
    INTRODUCTION: Teleconsultation gained popularity to provide safe medical care during the pandemic. However, literature on the sustainability of teleconsultation service at primary care beyond pandemic situations is scarce. This study aimed to determine the use of teleconsultation services for non-communicable disease (NCD) follow-up and explore the benefits and challenges of the service implementation during and beyond COVID-19 pandemic in Malaysia.

    MATERIALS AND METHODS: An exploratory qualitative study was conducted using videoconferencing. Fourteen medical officers working in public primary healthcare clinics from various regions of Malaysia were chosen using purposive sampling process, and participants underwent a total of seven paired in-depth interview (IDI) sessions. IDIs were video recorded, transcribed and subjected to interpretive thematic analysis.

    RESULTS: The two main themes which emerged were the benefits and challenges of NCD teleconsultation service. Various categories relating to benefits of teleconsultation for NCD care are as follows: (1) Improved efficiency for patient care delivery (improved effectiveness, convenient, improved safety, better disease monitoring, patient empowerment) and (2) Benefits for Health Care Providers (improved healthcare and service delivery). Main challenges identified were as follows: (1) Challenges for Delivery of Care (Patients' adaptation in using teleconsultation service, Patients abusing the system, Poor digital literacy, No proper disease monitoring record), (2) Challenges for Health Care Providers (Lack of dedicated team and training, Higher workload and time-consuming) and (3) Challenges for Health Care System (Institutional policy, legal and regulatory weakness, Medical record documentation and prescription updates).

    CONCLUSION: Optimisation of NCD patient healthcare delivery via teleconsultation is beneficial during and after pandemic. Targeted improvements to address current challenges are crucial to optimise its use beyond the pandemic period in the Malaysian public healthcare system.

    Matched MeSH terms: Delivery of Health Care
  5. Fulltext Structural Determinants and Children's Oral Health: A Cross-National Study
    Baker SR, Foster Page L, Thomson WM, Broomhead T, Bekes K, Benson PE, et al.
    J Dent Res, 2018 09;97(10):1129-1136.
    PMID: 29608864 DOI: 10.1177/0022034518767401
    Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors-the so-called structural determinants of health-play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health-related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries ( N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda.
    Matched MeSH terms: Delivery of Health Care/legislation & jurisprudence; Delivery of Health Care/organization & administration; Delivery of Health Care/statistics & numerical data
  6. Fulltext Materiovigilance in Perspective: Understanding Its Concept and Practice in the Global Healthcare System
    Sapkota B, Palaian S, Shrestha S, Ibrahim MIM
    Ther Innov Regul Sci, 2023 Jul;57(4):886-898.
    PMID: 37106236 DOI: 10.1007/s43441-023-00514-4
    Materiovigilance (Mv) has the same purpose and approach in ensuring patient safety as pharmacovigilance but deals with medical devices associated with adverse events (MDAEs) and their monitoring. Mv has been instrumental in recalling many defective or malfunctioning devices based on their safety data. All MDAEs, such as critical or non-critical, known, or unknown, those with inadequate or incomplete specifications, and frequent or rare events should be reported and evaluated. Mv helps to improve medical devices' design and efficiency profile and avoid device-related complications and associated failures. It alerts consumers and health professionals regarding counterfeit or substandard devices. Common events reported through Mv are device breakage and malfunction, entry- and exit-site infections, organ perforations or injuries, need for surgery and even death, and life cycle assessment of devices. Health authorities globally have developed reporting frameworks with timeframes for MDAEs, such as MedWatch in the USA, MedSafe in New Zealand, and others. Health professionals and consumers need to be made aware of the significance of Mv in ensuring the safe use of medical devices and getting familiar with the reporting procedures and action plans in case of a device-induced adverse event.
    Matched MeSH terms: Delivery of Health Care
  7. Fulltext Approaches and methodological as well as interpretative issues in quality of life research in malaysia
    Hasanah CI
    Malays J Med Sci, 2003 Jul;10(2):60-5.
    PMID: 23386798
    Quality of life measures are designed to enable patients' perspectives on the impact of health and healthcare interventions on their lives to be assessed and taken into account in clinical decision-making and research. This paper discusses some approaches, methodological as well as interpretative issues of health related quality of life research.
    Matched MeSH terms: Delivery of Health Care
  8. Fulltext A scoping review of clinical reasoning research with Asian healthcare professionals
    Lee CY, Jenq CC, Chandratilake M, Chen J, Chen MM, Nishigori H, et al.
    Adv Health Sci Educ Theory Pract, 2021 Dec;26(5):1555-1579.
    PMID: 34254202 DOI: 10.1007/s10459-021-10060-z
    Clinical reasoning is the thought process that guides practice. Although a plethora of clinical reasoning studies in healthcare professionals exists, the majority appear to originate from Western cultures. A scoping review was undertaken to examine clinical reasoning related research across Asian cultures. PubMed, SciVerse Scopus, Web of Science and Airiti Library databases were searched. Inclusion criteria included full-text articles published in Asian countries (2007 to 2019). Search terms included clinical reasoning, thinking process, differential diagnosis, decision making, problem-based learning, critical thinking, healthcare profession, institution, medical students and nursing students. After applying exclusion criteria, n = 240 were included in the review. The number of publications increased in 2012 (from 5%, n = 13 in 2011 to 9%, n = 22) with a steady increase onwards to 12% (n = 29) in 2016. South Korea published the most articles (19%, n = 46) followed by Iran (17%, n = 41). Nurse Education Today published 11% of the articles (n = 26), followed by BMC Medical Education (5%, n = 13). Nursing and Medical students account for the largest population groups studied. Analysis of the articles resulted in seven themes: Evaluation of existing courses (30%, n = 73) being the most frequently identified theme. Only seven comparative articles showed cultural implications, but none provided direct evidence of the impact of culture on clinical reasoning. We illuminate the potential necessity of further research in clinical reasoning, specifically with a focus on how clinical reasoning is affected by national culture. A better understanding of current clinical reasoning research in Asian cultures may assist curricula developers in establishing a culturally appropriate learning environment.
    Matched MeSH terms: Delivery of Health Care
  9. Fulltext A lightweight and robust authentication scheme for the healthcare system using public cloud server
    Abbasi IA, Jan SU, Alqahtani AS, Khan AS, Algarni F
    PLoS One, 2024;19(1):e0294429.
    PMID: 38289970 DOI: 10.1371/journal.pone.0294429
    Cloud computing is vital in various applications, such as healthcare, transportation, governance, and mobile computing. When using a public cloud server, it is mandatory to be secured from all known threats because a minor attacker's disturbance severely threatens the whole system. A public cloud server is posed with numerous threats; an adversary can easily enter the server to access sensitive information, especially for the healthcare industry, which offers services to patients, researchers, labs, and hospitals in a flexible way with minimal operational costs. It is challenging to make it a reliable system and ensure the privacy and security of a cloud-enabled healthcare system. In this regard, numerous security mechanisms have been proposed in past decades. These protocols either suffer from replay attacks, are completed in three to four round trips or have maximum computation, which means the security doesn't balance with performance. Thus, this work uses a fuzzy extractor method to propose a robust security method for a cloud-enabled healthcare system based on Elliptic Curve Cryptography (ECC). The proposed scheme's security analysis has been examined formally with BAN logic, ROM and ProVerif and informally using pragmatic illustration and different attacks' discussions. The proposed security mechanism is analyzed in terms of communication and computation costs. Upon comparing the proposed protocol with prior work, it has been demonstrated that our scheme is 33.91% better in communication costs and 35.39% superior to its competitors in computation costs.
    Matched MeSH terms: Delivery of Health Care
  10. Initiation of social pharmacy research in Nepal: our experiences
    Palaian S, Poudel A, Alam K, Mohamed Ibrahim MI, Mishra P
    Int J Clin Pharm, 2011 Aug;33(4):591-6.
    PMID: 21562802 DOI: 10.1007/s11096-011-9512-3
    Nepal experiences several medicine-use problems like any other developing country. In the recent years, there have been initiatives to introduce the concept of social pharmacy in Nepal, and there has been only a limited research in this area. The staff members at the Manipal College of Medical Sciences, Pokhara have shown keen interest in initiating several social pharmacy-related researches in the country. The members of this institute have been collaborating with two international universities, namely Universiti Sains Malaysia located in Malaysia and Chulalongkorn University located in Thailand, to get academic and technical supports. In this manuscript, the authors share their experiences in initiating social pharmacy research in the country. Authors have also mentioned the priority areas of social pharmacy research in Nepal and the importance of initiating this concept in the country.
    Matched MeSH terms: Delivery of Health Care/methods; Delivery of Health Care/trends*
  11. The impact of immigration on health systems: a legal analysis from a three-country perspective
    Blum J, Carstens P, Talib N
    Med Law, 2005 Jun;24(2):323-36.
    PMID: 16082868
    The focus of this paper will be on how health care systems in three countries, Malaysia, South Africa and the United States, are responding to the health needs of immigrants with a strong focus on the legal aspects of the respective national responses. The Malaysia portion emphasizes legal immigration and analyses as to how the country's Ministry of Health and the delivery system itself is responding to the demands of immigrant's health. In the context of South Africa, the paper explores implications of the South African Constitution, which establishes a right to access health care, and explores whether such a right can be extended to non-citizens, or can be tempered by economic constraints. In the American discussion the focus is on whether publicly supported health care programs can be accessed to provide coverage for undocumented residents, and highlights recent constraints in using government monies in this area.
    Matched MeSH terms: Delivery of Health Care/legislation & jurisprudence; Delivery of Health Care/organization & administration*
  12. Faith-based health care
    McAdam D
    Lancet, 2016 Jan 30;387(10017):429-30.
    PMID: 26869565 DOI: 10.1016/S0140-6736(16)00169-0
    Matched MeSH terms: Delivery of Health Care/economics; Delivery of Health Care/organization & administration*
  13. The patient's view
    Rachagan SS, Sharon K
    Med J Malaysia, 2003 Mar;58 Suppl A:86-101.
    PMID: 14556356
    The medical practitioner has always had to juggle several roles. First and foremost, the doctor is a healer, a provider of curative services. Second, he is an examiner, an assessor of the patient's health status. Third, he is a researcher, always trying to push the boundaries of medical knowledge. Fourth, he is a rationer of services, he decides how best to apportion the limited resources at his disposal. Traditionally, the patient-doctor relationship has been largely exclusive in nature and the doctor would quite comfortably slip in and out of these roles, his focus centred on his patient's interests. In this era of large corporate health care providers, multi-billion-biotechnology industry, mammoth pharmaceutical companies, medical insurance schemes and international trade instruments, it has become increasingly difficult for the doctor to juggle these four roles. He is constantly subjected to conflicting demands. Patients' interests do not always come first anymore and patients are beginning to realise this. They no longer trust the medical profession unreservedly. There has been steady erosion of the patient-doctor relationship most clearly evidenced by the rising tide of litigation against doctors. There needs to be a reappraisal of these roles that the doctor plays. The conflicts must be recognised and addressed. Patients need to be informed and their interests must be protected if the doctor-patient relationship is to be restored. Medical malpractice suits are on the increase. The tort system as it exists is failing both doctors and patients. The question we must ask is what are patients looking for when they sue doctors? Most of the time they need compensation for the injuries suffered. Sometimes they are looking for accountability, they want the doctor to be punished in some way. Sometimes they merely want to air their grievances and know that they are heard. The current system more often than not takes too long to compensate, the process is a gamble and doctors who are clearly negligent quietly settle and are rarely censured. We need to revamp the existing system to allow for speedy and equitable compensation; true accountability; and articulation and auditing of standards of practice.
    Matched MeSH terms: Delivery of Health Care/economics*; Delivery of Health Care/legislation & jurisprudence*
  14. Perspectives in tackling medico-legal controversies. Proceedings of the Commonwealth Medico-Legal Conference. January, 17-19, 2003
    Med J Malaysia, 2003 Mar;58 Suppl A:1-150.
    PMID: 14692413
    Matched MeSH terms: Delivery of Health Care/methods; Delivery of Health Care/ethics
  15. 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: Delivery of Health Care/economics; Delivery of Health Care/organization & administration
  16. Fulltext Health-care data collecting, sharing, and using in Thailand, China mainland, South Korea, Taiwan, Japan, and Malaysia
    Aljunid SM, Srithamrongsawat S, Chen W, Bae SJ, Pwu RF, Ikeda S, et al.
    Value Health, 2012 2 1;15(1 Suppl):S132-8.
    PMID: 22265060 DOI: 10.1016/j.jval.2011.11.004
    This article sought to describe the health-care data situation in six selected economies in the Asia-Pacific region. Authors from Thailand, China mainland, South Korea, Taiwan, Japan, and Malaysia present their analyses in three parts. The first part of the article describes the data-collection process and the sources of data. The second part of the article presents issues around policies of data sharing with the stakeholders. The third and final part of the article focuses on the extent of health-care data use for policy reform in these different economies. Even though these economies differ in their economic structure and population size, they share some similarities on issues related to health-care data. There are two main institutions that collect and manage the health-care data in these economies. In Thailand, China mainland, Taiwan, and Malaysia, the Ministry of Health is responsible through its various agencies for collecting and managing the health-care data. On the other hand, health insurance is the main institution that collects and stores health-care data in South Korea and Japan. In all economies, sharing of and access to data is an issue. The reasons for limited access to some data are privacy protection, fragmented health-care system, poor quality of routinely collected data, unclear policies and procedures to access the data, and control on the freedom on publication. The primary objective of collecting health-care data in these economies is to aid the policymakers and researchers in policy decision making as well as create an awareness on health-care issues for the general public. The usage of data in monitoring the performance of the heath system is still in the process of development. In conclusion, for the region under discussion, health-care data collection is under the responsibility of the Ministry of Health and health insurance agencies. Data are collected from health-care providers mainly from the public sector. Routinely collected data are supplemented by national surveys. Accessibility to the data is a major issue in most of the economies under discussion. Accurate health-care data are required mainly to support policy making and evidence-based decisions.
    Matched MeSH terms: Delivery of Health Care/organization & administration*; Delivery of Health Care/statistics & numerical data*
  17. Fulltext Current state of acute stroke care in Southeast Asian countries
    Ng JC, Churojana A, Pongpech S, Vu LD, Sadikin C, Mahadevan J, et al.
    Interv Neuroradiol, 2019 Jun;25(3):291-296.
    PMID: 30463501 DOI: 10.1177/1591019918811804
    Acute stroke care systems in Southeast Asian countries are at various stages of development, with disparate treatment availability and practice in terms of intravenous thrombolysis and endovascular therapy. With the advent of successful endovascular therapy stroke trials over the past decade, the pressure to revise and advance acute stroke management has greatly intensified. Southeast Asian patients exhibit unique stroke features, such as increased susceptibility to intracranial atherosclerosis and higher prevalence of intracranial haemorrhage, likely secondary to modified vascular risk factors from differing dietary and lifestyle habits. Accordingly, the practice of acute endovascular stroke interventions needs to take into account these considerations. Acute stroke care systems in Southeast Asia also face a unique challenge of huge stroke burden against a background of ageing population, differing political landscape and healthcare systems in these countries. Building on existing published data, further complemented by multi-national interaction and collaboration over the past few years, the current state of acute stroke care systems with existing endovascular therapy services in Southeast Asian countries are consolidated and analysed in this review. The challenges facing acute stroke care strategies in this region are discussed.
    Matched MeSH terms: Delivery of Health Care/trends*; Delivery of Health Care/statistics & numerical data
  18. Fulltext Consensus statement on the role of health systems in advancing the long-term well-being of people living with HIV
    Lazarus JV, Safreed-Harmon K, Kamarulzaman A, Anderson J, Leite RB, Behrens G, et al.
    Nat Commun, 2021 07 16;12(1):4450.
    PMID: 34272399 DOI: 10.1038/s41467-021-24673-w
    Health systems have improved their abilities to identify, diagnose, treat and, increasingly, achieve viral suppression among people living with HIV (PLHIV). Despite these advances, a higher burden of multimorbidity and poorer health-related quality of life are reported by many PLHIV in comparison to people without HIV. Stigma and discrimination further exacerbate these poor outcomes. A global multidisciplinary group of HIV experts developed a consensus statement identifying key issues that health systems must address in order to move beyond the HIV field's longtime emphasis on viral suppression to instead deliver integrated, person-centered healthcare for PLHIV throughout their lives.
    Matched MeSH terms: Delivery of Health Care/organization & administration; Delivery of Health Care/standards*
  19. Private healthcare quality: applying a SERVQUAL model
    Butt MM, de Run EC
    Int J Health Care Qual Assur, 2010;23(7):658-73.
    PMID: 21125961
    This paper seeks to develop and test the SERVQUAL model scale for measuring Malaysian private health service quality.
    Matched MeSH terms: Delivery of Health Care/organization & administration*; Delivery of Health Care/standards
  20. Challenges in the management of breast cancer in low- and middle-income countries
    Yip CH, Taib NA
    Future Oncol, 2012 Dec;8(12):1575-83.
    PMID: 23231519 DOI: 10.2217/fon.12.141
    The incidence of breast cancer is rising in low- and middle-income countries (LMICs) due to 'westernization' of risk factors for developing breast cancer. However, survival remains low because of barriers in early detection and optimal access to treatment, which are the two main determinants of breast cancer outcome. A multidisciplinary approach to treatment gives the best results. An accurate diagnosis is dependent on a reliable pathology service, which will provide an adequate pathology report with prognostic and predictor information to allow optimal oncological treatment. Stratification of clinical practice guidelines based on resource level will ensure that women will have access to treatment even in a low-resource setting. Advocacy and civil society play a role in galvanizing the political will required to meet the challenge of providing opportunities for breast cancer control in LMICs. Collaboration between high-income countries and LMICs could be a strategy in facing these challenges.
    Matched MeSH terms: Delivery of Health Care/economics; Delivery of Health Care/methods
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