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Bisphosphonates, healthcare professionals and oral health

Raj DV, Abuzar M, Borromeo GL

Gerodontology, 2016 Mar;33(1):135-43.
PMID: 25039439 DOI: 10.1111/ger.12141

OBJECTIVE: General medical and dental practitioner and pharmacists all encounter patients on bisphosphonates and as such require adequate knowledge regarding osteonecrosis of the jaw, a potential complication associated with its use. The cross-sectional study investigated perceived implications of and attitudes towards bisphosphonate use in oral health among general medical and dental practitioners and pharmacists.
MATERIALS AND METHODS: Medical and dental practitioners and pharmacists registered in Victoria, Australia, completed an online survey (SurveyMonkey©). Data analysis consisted of chi-square tests with significance as p < 0.05.
RESULTS: One hundred and thirty six doctors (general medical practitioners, GMPs), 283 dentists (GDPs) and 26 pharmacists (PHs) participated. 70, 38 and 80%, respectively, reviewed patients prescribed bisphosphonates (BPs). GMPs (88%), GDPs (76%) and PHs (85%) were aware of osteonecrosis of the jaws (ONJ). GMPs (76%) and PHs (100%) advised patients to inform dentists. GMPs (45%) referred patients for dental assessments prior to commencing BPs with 71.9% of GDPs received such referrals. In terms of available information on oral health and BPs, GMPs (56%), GDPs (50%) and PH (53.8%) were either unsure any existed or reported receiving sufficient information.
CONCLUSIONS: Discrepancies exist amongst different healthcare professionals in terms of BP use and oral health, and common consensus guidelines are warranted.
KEYWORDS: bisphosphonates; clinical guidelines; drug therapy; oral health; osteonecrosis.

Matched MeSH terms: Delivery of Health Care*
Role of village practitioners in family planning service delivery system

Rahman S

Malays J Reprod Health, 1985 Dec;3(2):133-7.
PMID: 12314740
Matched MeSH terms: Delivery of Health Care*
Fulltext The United Nations (UN) Card, Identity, and Negotiations of Health among Rohingya Refugees

Rahman MM, Dutta MJ

Int J Environ Res Public Health, 2023 Feb 15;20(4).
PMID: 36834082 DOI: 10.3390/ijerph20043385

Being persecuted and expelled from Myanmar, Rohingya refugees are now distributed throughout the world. The Southeast Asian nation of Malaysia has been a preferred destination for Rohingyas fleeing Myanmar's state-sponsored genocide and more recently in a bid to change their fates from the refugee camps in Bangladesh. Refugees are one of the most vulnerable groups in Malaysia and often face dire circumstances, in which their health and wellbeing are compromised. Amidst a plethora of structural challenges, Rohingya refugees try to claim some of their rights with the aid of the UN card (UNHCR ID cards) in Malaysia. Guided by the culture-centered approach (CCA), this study examined the perspectives and experiences of healthcare among Rohingya refugees while living in Malaysia, now resettled in Aotearoa, New Zealand. The participants' narratives showed that the UN card not only materialized their refugee status in Malaysia but also offered them a way of living in a world where documents anchor the materiality of health.

Matched MeSH terms: Delivery of Health Care
The role of traditional healers in the provision of health care and family planning services: Malay traditional and indigenous medicine

Raden Sanusi HR, Werner R

Malays J Reprod Health, 1985;3(1 Suppl):S82-9.
PMID: 12319996
Matched MeSH terms: Delivery of Health Care*
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*
Fulltext From nature to nanotechnology: The interplay of traditional medicine, green chemistry, and biogenic metallic phytonanoparticles in modern healthcare innovation and sustainability

Puri A, Mohite P, Maitra S, Subramaniyan V, Kumarasamy V, Uti DE, et al.

Biomed Pharmacother, 2024 Jan;170:116083.
PMID: 38163395 DOI: 10.1016/j.biopha.2023.116083

As we navigate the modern era, the intersection of time-honoured natural remedies and contemporary scientific approaches forms a burgeoning frontier in global healthcare. For generations, natural products have been foundational to health solutions, serving as the primary healthcare choice for 80% to 85% of the world's population. These herbal-based, nature-derived substances, significant across diverse geographies, necessitate a renewed emphasis on enhancing their quality, efficacy, and safety. In the current century, the advent of biogenic phytonanoparticles has emerged as an innovative therapeutic conduit, perfectly aligning with principles of environmental safety and scientific ingenuity. Utilizing green chemistry techniques, a spectrum of metallic nanoparticles including elements such as copper, silver, iron, zinc, and titanium oxide can be produced with attributes of non-toxicity, sustainability, and economic efficiency. Sophisticated herb-mediated processes yield an array of plant-originated nanomaterials, each demonstrating unique physical, chemical, and biological characteristics. These attributes herald new therapeutic potentials, encompassing antioxidants, anti-aging applications, and more. Modern technology further accelerates the synthesis of natural products within laboratory settings, providing an efficient alternative to conventional isolation methods. The collaboration between traditional wisdom and advanced methodologies now signals a new epoch in healthcare. Here, the augmentation of traditional medicine is realized through rigorous scientific examination. By intertwining ethical considerations, cutting-edge technology, and natural philosophy, the realms of biogenic phytonanoparticles and traditional medicine forge promising pathways for research, development, and healing. The narrative of this seamless integration marks an exciting evolution in healthcare, where the fusion of sustainability and innovation crafts a future filled with endless possibilities for human well-being. The research in the development of metallic nanoparticles is crucial for unlocking their potential in revolutionizing fields such as medicine, catalysis, and electronics, promising groundbreaking applications with enhanced efficiency and tailored functionalities in future technologies. This exploration is essential for harnessing the unique properties of metallic nanoparticles to address pressing challenges and advance innovations across diverse scientific and industrial domains.

Matched MeSH terms: Delivery of Health Care
Female sterilization using Filshie clip in private practice

Puraviappan, Hamid Arshat, Jaffar Ali

Malays J Reprod Health, 1983 Jan;1(1):40-5.
PMID: 12279888
Matched MeSH terms: Delivery of Health Care
Maternal mortality in developing countries: challenges in scaling-up priority interventions

Prata N, Passano P, Sreenivas A, Gerdts CE

Womens Health (Lond), 2010 Mar;6(2):311-27.
PMID: 20187734 DOI: 10.2217/whe.10.8

Although maternal mortality is a significant global health issue, achievements in mortality decline to date have been inadequate. A review of the interventions targeted at maternal mortality reduction demonstrates that most developing countries face tremendous challenges in the implementation of these interventions, including the availability of unreliable data and the shortage in human and financial resources, as well as limited political commitment. Examples from developing countries, such as Sri Lanka, Malaysia and Honduras, demonstrate that maternal mortality will decline when appropriate strategies are in place. Such achievable strategies need to include redoubled commitments on the part of local, national and global political bodies, concrete investments in high-yield and cost-effective interventions and the delegation of some clinical tasks from higher-level healthcare providers to mid- or lower-level healthcare providers, as well as improved health-management information systems.

Matched MeSH terms: Delivery of Health Care/organization & administration*
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
Miscellaneous notes concerning a partly developed region

Portelly J

Malayan Medical Journal, 1934;9:49-52.

Matched MeSH terms: Delivery of Health Care
Fulltext Simulation-Based Education in the Training of Newborn Care Providers-A Malaysian Perspective

Pong KM, Teo JT, Cheah FC

Front Pediatr, 2021;9:619035.
PMID: 33643974 DOI: 10.3389/fped.2021.619035

Simulation-based education (SBE) is increasingly used as an education tool to improve learning for healthcare providers. In newborn care practice, SBE is used in the Neonatal Resuscitation Program (NRP) and training in procedural skills. The NRP is a mandatory course in Malaysia for all house officers (interns) and medical officers (residents) during their pediatric rotation. Almost 30,000 of NRP providers have been trained over the last 5 years. The recent establishment of the Allied Healthcare Center of Excellence (AHCoE), an organization dedicated to promoting SBE, and Malaysian Society for Simulation in Healthcare (MaSSH) aims to enhance the integration of SBE into the healthcare training curriculum and set up a local healthcare simulation educator training program. Our experience in implementing SBE necessitated that we made several important choices. As there was no strong evidence to favor high-fidelity over low-fidelity simulation, and because simulation centers can be very costly to set up with limited resources, we chose SBE mainly in the form of low-fidelity and in situ simulation. We also identified an important developmental goal to train Malaysian instructors on structured debriefing, a critical activity for learning in SBE. Currently, debriefing is often carried out in our centers at an ad hoc basis because of time limitation and the lack of personnel trained. Finally, we aim to implement SBE further in Malaysia, with two axes: (1) the credentialing and recertification of physicians and nurses, and (2) the education of lay caregivers of high-risk infants before discharge from the neonatal intensive care unit.

Matched MeSH terms: Delivery of Health Care
Fulltext Reflections on migrant and refugee health in Malaysia and the ASEAN region

Pocock NS, Suphanchaimat R, Chan CK, Faller EM, Harrigan N, Pillai V, et al.

BMC Proc, 2018;12(Suppl 4):4.
PMID: 30044886 DOI: 10.1186/s12919-018-0100-6

Migrants and refugees face challenges accessing both healthcare and good social determinants of health in Malaysia. Participants at the "Migrant and Refugee Health in Malaysia workshop, Kuala Lumpur, 9-10 November 2017" scoped these challenges within the regional ASEAN context, identifying gaps in knowledge and practical steps forward to improve the evidence base in the Malaysia.

Matched MeSH terms: Delivery of Health Care
Healthcare seeking during travel: an analysis by the GeoSentinel surveillance network of travel medicine providers

Piyaphanee W, Stoney RJ, Asgeirsson H, Appiah GD, Díaz-Menéndez M, Barnett ED, et al.

J Travel Med, 2023 May 18;30(3).
PMID: 36637429 DOI: 10.1093/jtm/taad002

BACKGROUND: International travellers may seek care abroad to address health problems that arise during their trip or plan healthcare outside their country of residence as medical tourists.
METHODS: Data were collected on travellers evaluated at GeoSentinel Network sites who reported healthcare during travel. Both unplanned and planned healthcare were analysed, including the reason and nature of healthcare sought, characteristics of the treatment provided and outcomes. Travellers that presented for rabies post-exposure prophylaxis were described elsewhere and were excluded from detailed analysis.
RESULTS: From May 2017 through June 2020, after excluding travellers obtaining rabies post-exposure prophylaxis (n= 415), 1093 travellers reported care for a medical or dental issue that was an unanticipated part of the travellers' planned itinerary (unplanned healthcare). Travellers who sought unplanned healthcare abroad had frequent diagnoses of acute diarrhoea, dengue, falciparum malaria and unspecified viral syndrome, and obtained care in 131 countries. Thirty-four (3%) reported subsequent deterioration and 230 (21%) reported no change in condition; a third (n = 405; 37%) had a pre-travel health encounter. Forty-one travellers had sufficient data on planned healthcare abroad for analysis. The most common destinations were the US, France, Dominican Republic, Belgium and Mexico. The top reasons for their planned healthcare abroad were unavailability of procedure at home (n = 9; 19%), expertise abroad (n = 9; 19%), lower cost (n = 8; 17%) and convenience (n = 7; 15%); a third (n = 13; 32%) reported cosmetic or surgical procedures. Early and late complications occurred in 14 (33%) and 4 (10%) travellers, respectively. Four travellers (10%) had a pre-travel health encounter.
CONCLUSIONS: International travellers encounter health problems during travel that often could be prevented by pre-travel consultation. Travellers obtaining planned healthcare abroad can experience negative health consequences associated with treatments abroad, for which pre-travel consultations could provide advice and potentially help to prevent complications.

Matched MeSH terms: Delivery of Health Care
Fulltext Primary care interventions and current service innovations in modifying long-term outcomes after stroke: a protocol for a scoping review

Pindus DM, Lim L, Rundell AV, Hobbs V, Aziz NA, Mullis R, et al.

BMJ Open, 2016 Oct 24;6(10):e012840.
PMID: 27798023 DOI: 10.1136/bmjopen-2016-012840

INTRODUCTION: Interventions delivered by primary and/or community care have the potential to reach the majority of stroke survivors and carers and offer ongoing support. However, an integrative account emerging from the reviews of interventions addressing specific long-term outcomes after stroke is lacking. The aims of the proposed scoping review are to provide an overview of: (1) primary care and community healthcare interventions by generalist healthcare professionals to stroke survivors and/or their informal carers to address long-term outcomes after stroke, (2) the scope and characteristics of interventions which were successful in addressing long-term outcomes, and (3) developments in current clinical practice.
METHODS AND ANALYSIS: Studies that focused on adult community dwelling stroke survivors and informal carers were included. Academic electronic databases will be searched to identify reviews of randomised controlled trials (RCTs) and controlled trials, trials from the past 5 years; reviews of observational studies. Practice exemplars from grey literature will be identified through advanced Google search. Reports, guidelines and other documents of major health organisations, clinical professional bodies, and stroke charities in the UK and internationally will be included. Two reviewers will independently screen titles, abstracts and full texts for inclusion of published literature. One reviewer will screen search results from the grey literature and identify relevant documents for inclusion. Data synthesis will include analysis of the number, type of studies, year and country of publication, a summary of intervention components/service or practice, outcomes addressed, main results (an indicator of effectiveness) and a description of included interventions.
ETHICS AND DISSEMINATION: The review will help identify components of care and care pathways for primary care services for stroke. By comparing the results with stroke survivors' and carers' needs identified in the literature, the review will highlight potential gaps in research and practice relevant to long-term care after stroke.

Matched MeSH terms: Delivery of Health Care*
Redesigning healthcare systems to meet the health challenges associated with climate change in the twenty-first century

Phua KL

J Emerg Manag, 2015;13(3):255-63.
PMID: 26150369 DOI: 10.5055/jem.2015.0239

In the twenty-first century, climate change is emerging as a significant threat to the health and well-being of the public through links to the following: extreme weather events, sea level rise, temperature-related illnesses, air pollution patterns, water security, food security, vector-borne infectious diseases, and mental health effects (as a result of extreme weather events and climate change-induced population displacement). This article discusses how national healthcare systems can be redesigned through changes in its components such as human resources, facilities and technology, health information system, and health policy to meet these challenges.

Matched MeSH terms: Delivery of Health Care/organization & administration*
Perspectives in dermatology: Malaysia

Petit JH

Int J Dermatol, 1976 Sep;15(7):505-12.
PMID: 965135
Matched MeSH terms: Delivery of Health Care
Fulltext Enhanced Primary Health Care Intervention: Perceived Sustainability and Challenges Among Implementers

Perialathan K, Johari MZ, Jaafar N, Yuke Lin K, Lee Lan L, Sodri NA, et al.

J Prim Care Community Health, 2021 5 11;12:21501327211014096.
PMID: 33966530 DOI: 10.1177/21501327211014096

PURPOSE: This study aimed to assess and explore perceived sustainability and challenges of the intervention among Health Care Providers (HCPs) who were involved.
METHODS: The study applied mixed-method embedded design to analyze both quantitative and qualitative data. Quantitative approach was used to evaluate sustainability perception from 20 intervention clinics via self-reported assessment form whereas qualitative data were obtained through in-depth interview (IDI) and focus group discussions (FGDs) 14 health care professionals participated in IDI session and were either care coordinators, liaison officers (LOs)/clinic managers, or medical officers-in-charge for the clinic's intervention. Nine FGDs conducted comprised 58 HCPs from various categories.
RESULTS: HCPs from all the 20 clinics involved responded to each listed Enhanced Primary Healthcare (EnPHC) intervention components as being implemented but the perceived sustainability of these implementation varies between them. Quantitative feedback showed sustainable interventions included risk stratification, non-communicable disease (NCD) screening form, referral within clinics and hospitals, family health team (FHT), MTAC services and mechanisms and medical adherence status. Qualitative feedback highlighted implementation of each intervention components comes with its challenges, and most of it are related to inadequate resources and facilities in clinic. HCPs made initiatives to adapt based on clinical setting to implement the interventions at best level possible, whereby this seems to be one of the core values for sustainability.
CONCLUSION: Overall perceptions among HCPs on sustainability of EnPHC interventions are highly influenced by current experiences with existing resources. Components perceived to have inadequate resources are seen as a challenge to sustain. It's crucial for stakeholders to understand implications affecting implementation process if concerns raised are not addressed and allocation of needed resources to ensure overall successfulness and long term sustainability.

Matched MeSH terms: Delivery of Health Care
Village midwives deliver

Peng JY

IDRC Rep, 1977;6(2):8.
PMID: 12335042
Matched MeSH terms: Delivery of Health Care
Law, policy and the use of non-physicians in family planning service delivery

Paxman JM

IGCC News, 1979 Apr;4(4):1-3.
PMID: 12179400

PIP: A great deal of attention is being devoted to the use of nonphysicians to provide such fertility control services as contraception, sterilization, and abortion. Legal obstacles exist, however, which must be overcome before the role of nonphysicians can be expanded. Such obstacles include medical practice statutes, nursing and midwifery legislation, and laws and regulations directly related to such fertility control measures as the provision of contraceptions and the performance of sterilizations. On the other hand, the following 3 main approaches have been used to permit increased participation of nonphysicians: delegation of tasks by physicians, liberal interpretation of existing laws, and authorization. Thus, the important elements in expanding the roles of nonphysicians are 1) authorization; 2) training; 3) qualification; 4) supervision; and 5) opportunities for referrals to physicians. The ultimate role of paramedicals will depend upon the continued simplification of technology, the results of research on the quality of care which they can provide, the attitudes of the medical profession, and the elimination of the legal ambiguities and obstacles which exist.

Matched MeSH terms: Delivery of Health Care
Fulltext Patient’s confidentiality policy breach among nursing students

Patricia Sator

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):58-0.
MyJurnal

Introduction: Nursing is a regulated profession. Hence, the global commitment for nurses to maintain standards of practice is vital to deliver safe and competent care. Written policies will eliminate uncertainty, ambiguity, and legal issues. For this study, it focused on the importance of the nursing students to understand and practice the regulation on patient’s confidentiality in healthcare setting with the usage of technology such as social media. There is a case like nursing student infringe the privacy of patients with the information they posted on social media, such as posting a patient’s photos or videos without valid consent. Methods: This study is a quantitative, cross-sectional survey de- sign. The respondents were selected as convenience sampling of 120 nursing students from the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah (FMHS, UMS). Results: There are 7.4% nursing students intention- ally posted in social media, 18.0% maybe and 73.8% unintentionally. And for their guilty feeling after committing confidentially policy breach on patient, there are 8.2% said NO, 32.8% said MAYBE and 59% said YES. Overall, the nursing students are aware of the patient’s confidentiality but there is still a leakage in practicing full nursing standards and regulation. Further study recommended to explore more on this issue. Conclusion: As a conclusion, this study is relevant to conduct among the nursing students to gain their understanding regarding the responsibilities as a future nurse in maintaining the patient’s confidentiality as one of the most important nursing practices to ensure quality of care and continuation of professional service of nursing profession.

Matched MeSH terms: Delivery of Health Care

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