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Article in press
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Barriers to Community Integration for Older People in Malaysia: A Qualitative Study from Occupational Therapist Perspectives
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Introduction
Existing research has addressed the importance of community integration (CI) and its benefits of dwelling in a community but has yet to address the methods and efficiency of improving these activities among older people. Thus, it is vital to understand how healthcare workers can integrate the benefits of CI among older people, especially with the use of occupational therapists (OTs). The latter are actively working to improve ageing individuals mobility within the community.
Objective
This study aims to identify Malaysian OTs’ perspectives on CI’s and its implication on older people.
Method
Occupational therapist from different states of Malaysia participated in a semi-structured interview, through a virtual medium (Zoom Cloud Meetings). The interview guide encapsulated the theory of critical incident technique (CIT).
Results
Thematic content analysis, over fourteen participants from 13 states of Malaysia, provided insights into CI’s barriers for older people in Malaysia. The findings revealed that multifaceted factors from an individual, organisational and socio-environmental perspective limit older people’s active CI engagement.
Conclusion
South-East Asia hierarchal and collectivist culture play a significant role in influencing all factors of CI. OTs must understand and incorporate appropriate cultural norms during CI practice development for the older population in Malaysia.
Keywords
Occupational therapist; Critical incident technique; Older people; Community integration; Qualitative study; Societal norms; Cultural norms.
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A Physicians Commentary on Electronic Health Records in the United States Medical Practice
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This commentary presents a point of view on how the arrival of electronic health records (EHR) in the United States (U.S.) has changed physicians’ practice. EHR implementation has pros and cons. EHR systems have been a great asset during the
pandemic and help with efficiency, safety, and cost reduction. Despite their benefits, healthcare providers and organizations still face challenges, including usability and interoperability across systems, contributing to physicians’ burnout. Can physicians adopt new technologies and adapt to current challenges? Is it the right time for physicians to stop being observers and become active
participants in the process of healthcare innovation and implementation?
Keywords
Physician; EHR; Implementation; Physicians’ burnout.
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Towards Universal Health Coverage: Designing a Community Based Intervention to Scale Up Coverage with Health Insurance, in A-Duiem Administrative Unit, Sudan 2018-2019
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Background: Community engagement has proved effective in increasing access to healthcare including health insurance, in developed and developing countries.
Aim: The study aims at designing and testing the effectiveness of engaging the community in awareness-raising and increment of health insurance coverage.
Methods: The study was a social interventional community-based study, conducted in A-Duiem Administrative Unit, A-Duiem Locality, Sudan. Baseline data on enrollment in health insurance was collected from 800 heads of households, whereas data on knowledge and attitudes about health insurance was collected from 420 heads of non-insured households using a standardized questionnaire. Strategies to scaleup health insurance through community engagement was collected from community leaders, local authorities, and health insurance policymakers through in-depth interviews and focus group discussions. The community promotion package of health insurance was implemented for one year and post-intervention data were collected from 420 heads of households. Quantitative data were analyzed using SPSS version 20. Statistical significance was set at p<0.05 when the confidence interval was 95%. Qualitative data was analyzed manually using the thematic approach. Results: The study showed significant improvement in the knowledge of the heads of the non-insured households about health insurance after the intervention; knowledge about the enrollment process and service’s package has increased from 34.4% to 61.8% and from 55.8% to 84.7% respectively (p-value 0.0001 in both). The health insurance coverage increased by 17.3% with a significant difference and p-value at 0.0001. Conclusion: The study concluded that community members have a considerable role in awareness-raising and scaling up of health insurance coverage if they are properly organized, trained, monitored, and supervised. The insufficient commitment of local officials in the unit was a challenge to address during further testing and expansion of the experience. Keywords Health insurance; Population coverage; Knowledge; Attitudes; Community engagement; Intervention; Sudan.
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Prevalence and Risk Factors of Low High-Density Lipoproteins-Cholesterol: An Analysis of the United States of America National Health and Nutrition Examination Survey, 2015-2016
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Abstract [+]
Background
Non-communicable diseases (NCDs) are the leading cause of mortality worldwide, with cardiovascular diseases (CVDs) being the most predominant. This is a similar trend in the United States (U.S.). Modifiable and non-modifiable factors are important determinants of dyslipidaemia, a known cause of CVDs.
Objective
This study aimed to explore the pattern of high-density lipoprotein cholesterol (HDL-C) distribution and its associated risk factors.
Methods
The data was collected from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 database which is part of the yearly cross-sectional survey. The NHANES uses complex multistage probability sampling method in data collection. The target population was the noninstitutionalized civilian living across the U.S. The primary sampling units were individuals. Socio-demographic characteristics, body measurement (waist circumference) and blood samples (to determine HDL-C and total cholesterol levels) were recorded. In the database, 5000 respondents were randomly selected for analysis. Statistical analyses were performed using Stata version 14.0. The results are described as means and standard deviation (SD) for group and continuous variables. Regression analyses were used to identify risk factors of low HDL-C.
Results
Of the complete cases (3989), 49.03% were males. The mean age was 46.57±15.44-years. The mean HDL-C was 1.39±0.45 mmoL/L. The prevalence of low HDL-C was 32.8% in males and 12.5% in females. The results obtained from multiple linear regression indicated that male gender, age, ethnicity, country of birth, number of children aged 0-18-years per household, waist circumference, family income to poverty ratio and total cholesterol were significantly associated with HDL-C. Multivariable logistic regression revealed male gender, age 30 to 49-years, ethnicity, smoking, enlarged waist circumference (cm), low family income to poverty ratio and high total cholesterol were associated with low HDL-C.
Conclusion
The prevalence of low HDL-C of was 22.4 %. This was distributed into 32.8% in males and 12.5% in females. The associated risk factors show that lifestyle modification is important in the prevention of low HDL-C and consequently, CVDs.
Keywords
HDL-C; Risk factors; Cardiovascular diseases; NHANES.
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Current Issue
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Determinants of Non-Insurance in A-Duiem Administrative Unit, White Nile State, Sudan 2018
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Background
Population knowledge and attitudes toward health insurance are important factors that facilitate health insurance coverage. National studies on these parameters are limited.
Aim
This study aims at assessing determinants of non-insurance in A-Duiem Administrative Unit and calculating as a secondary objective the household’s health insurance coverage.
Methods
The study was a descriptive cross-sectional community-based conducted in A-Duiem Administrative Unit, Sudan. It collected quantitative data from non-insured households and qualitative data by interviewing community leaders and conducting focus group discussions with community organizations members. Quantitative data analyzed using the Statistical Package for Social Sciences (SPSS) version 20, and the thematic analysis for the qualitative data.
Results
The study interviewed 419 non-insured households’ heads and thirteen community leaders and conducted eight focus group discussions with sixty community organizations members. Around 37.9% (95% CI: 33.4-42.7) of the heads of the non-insured households did not know the health insurance, while only 2.4% (95% CI: 1.5-4.7) had good knowledge. The knowledge of non-insured community leaders and members of the community organizations was moderate. The study participants showed positive attitudes towards health insurance, as 97% (95% CI: 95.1-98.4) of the heads of the non-insured households wanted to join the health insurance and 65% (95% CI: 59.2-70.1) of them stated that they could pay its premium. Most of the community leaders and members of the community organizations had health insurance cards. Those who were not enrolled, have limited knowledge about health insurance while almost all believe they should join it. The study identified 52.4% of non-insured households (95% CI: 48.9-55.8). The study showed low health insurance coverage among families, despite their positive attitude. This is mostly attributed to poor awareness of the heads of the non-insured households about health insurance. The National Health Insurance Fund (NHIF) should address this gap through effective communication strategies using motivated community institutions.
Keywords
Health insurance; Non-insured; Population coverage; Knowledge; Attitudes; Sudan.
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Scoping Review and Expert Reflections: Coronavirus Disease 2019 – Preparedness and Response in Selected Countries of East Africa, West Africa, and Southeast Asia
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Background
The coronavirus disease 2019 (COVID-19) outbreak, started in the Hubei province of China in December 2019. On January 31, the World Health Organization (WHO) declared COVID-19 a worldwide pandemic. We wondered what countries in Africa and South-East Asia had done to prevent infectious disease, specifically, COVID-19, from impacting the population of specific countries in that region, and what disease control measures were successful. Expert reflections on findings could guide continued successful public health approaches in managing this complex infectious disease pandemic.
Method
Using a scoping review, published papers, or program descriptions for specific geographic regions (i.e., Africa or Southeast Asia) were searched using specified key terms. Three targeted countries classified by World Bank as lower-middle-income in the two WHO selected regions [Africa (Sudan and Nigeria); Southeast Asia (India)] were reviewed with respect to COVID19 preparedness and response. Findings were organized, highlighting key points that seem particularly useful for regional learning. The evidence from each region was summarized in the aggregate to determine some common, noteworthy themes. COVID-19 epidemiologic data for these regions were also reviewed.
Result
Our findings indicate experience from prior infectious disease outbreak seems to have prepared the selected countries in their preparedness for COVID-19 outbreak on various levels. Incidence of COVID-19 increased across the selected countries. WHO recommended basic public health strategies to reduce disease transmission was initiated by the selected countries at different levels. However, feasibility and lockdown practices raise public health concerns and questions across the target regions reviewed.
Conclusion
This scoping review and expert reflections uncovers important preparedness and responses to the COVID-19 pandemic in the selected WHO regions. Further exploration and possible public health strategic plans may be needed.
Keywords
COVID-19 Pandemic; Health system; Preparedness and response; Sub-Saharan Africa; Southeast Asia; Developing countries.
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The Review on the European and the United States Healthcare Systems
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The paper investigates the main ideas and solutions of healthcare systems in leading countries such as Switzerland, the Netherlands, Denmark, Sweden, Austria, France based on the international ranking indexes such as the United Nations Human Development Index, Genuine Progress Indicator (GPI), Blumberg’s Global Health Index, World Health Organization (WHO), The Healthcare Access & Quality Index (HAQ), the European Health Consumer Index (EHCI). In conclusion, the health of
society depends to a great extent on lifestyle and climate, where such countries as Spain and Italy have fewer sick people, and it results in a lower burden on healthcare. Unites States of America healthcare must compensate for lifestyle defects with intensive treatment and expensive medicines. This costs money and, what is worse, it doesn’t bring any noticeable progress. As evidenced by the dramas caused by the 2020 pandemic.Keywords
Healthy life; Healthy lifestyle; American healthcare; Healthcare indexes.
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Elderly People During the Coronavirus Disease 2019 Epidemic: Selected Problems
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The coronavirus disease 2019 (COVID-19) infection mainly affected elderly patients in many countries. The care of elderly
patients, especially in countries where the percentage of people over 65-years of age is significant, is an important public health problem now during the COVID-19 pandemic. In this review particular attention to the problem of proper nutrition of such patients was paid, which must be preceded by an appropriate assessment of their nutritional status. The important role of physical activity and adequate rehabilitation is highlighted. The care of elderly patients should be in line with the recommendations of the relevant scientific societies and international organizations in this respect.
Keywords
COVID-19; Elderly people; Malnutrition; Food insecurity; Nutritional risk; ESPEN recommendations; Physical activity.
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Coronavirus Disease-2019 Response–Global Public Health Professionals Supporting Collaborative, Official, Organized Actions in Local Communities
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Alcohol Consumption Patterns and Associated Risk Behaviors in Three Ethnic Groups of Malaysian Millennials
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Targeting Bacterial Biofilms Using Probiotics and Medicinal Plant Taraxacum Officinale (Dandelion) Extract: A Comparative Study
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Improving Health Equity for Black Communities in the Face of Coronavirus Disease-2019
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Previous Issue
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In the Early Stages of Coronavirus Disease-2019: What It is, What Precautions to Take, and Why Social Distancing is Necessary
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Coronavirus Disease-2019 Response–Global Public Health Professionals Supporting Collaborative, Official, Organized Actions in Local Communities
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Alcohol Consumption Patterns and Associated Risk Behaviors in Three Ethnic Groups of Malaysian Millennials
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Objectives
To gain further insights into factors associated with harmful alcohol consumption patterns and other associated behaviours among Malaysians millennials.
Methods
The United States Centre for Disease, Control, and Prevention (CDC) Youth Risk Behaviour Survey was adapted and translated into Bahasa Malaysia language. The self-administered questionnaire collected information on socio-demographic characteristics and risk behaviours associated with alcohol consumption. Multi-facet sampling was used to recruit participants across six sites in the Klang Valley, Malaysia. There were 326 respondents: 103 Malays, 111 Chinese and 112 Indians; with 171 (52%) male and 155 (48%) female.
Results
Mean age of the respondents was 21-years. Twenty percent of the millennials surveyed were binge consumers: 79% of binge drinkers were male. More than half (54%) of the binge drinkers were Indians followed by Chinese at 39% and Malays at 8%. Binge consumers were at increased odds (OR=7.58: 95% CI=3.88-14.80) of driving a vehicle under the influence of alcohol and at increased odds (OR=6.88: 95% CI=3.40-13.90) of being driven by someone drunk. Those who were binge drinkers were also at higher odds than non-drinkers of being forced into sexual intercourse (OR=3.16: 95% CI=1.25-7.97) or other sexual acts (OR=3.84: 95% CI=1.74-8.47). Binge drinkers were also more prone to smoking compared to current drinkers (OR=10.82 9% CI=4.85-24.12).
Conclusion
Binge consumption among millennials was associated with a myriad of behavioural risk factors and harmful alcohol-related consequences. Multiple strategic approaches are needed that address respective cultural norms, enhancement of millennials socialisation and engagement skills within communities to improve the efficacy of preventive interventions.
Keywords
Alcohol; Communities; Malaysia; Risky behaviours; Social; Youth.
Targeting Bacterial Biofilms Using Probiotics and Medicinal Plant Taraxacum Officinale (Dandelion) Extract: A Comparative Study
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Introduction
Biofilms are a significant threat to public health as they form on medical devices, wastewater pipes, human tissue, and stagnant water bodies. The primary reason biofilms are hard to combat is the bacterial interactions that take place within the biofilm through quorum sensing (QS), a form of cell-to-cell communication that plays a crucial role in the formation of biofilms. The QS controls biofilm formation to increase cooperation and stabilize the biofilm and increased interactions between the bacterial cells, make the biofilms harder to destroy. The aggregates of cells in the biofilm are not susceptible to drugs. The slow dividing cells are less susceptible to antibiotics.
Objectives
The aim of this comparative study is to research the potential and effectiveness of treatments to combat the growth of biofilm formed by Escherichia coli and Enterobacter aerogenes by using two approaches: medicinal plant extract of Taraxacum officinale and probiotics.
Methodology
This was a comparative study in which bacterial biofilms of E. coli and E. aerogenes were grown. Each biofilm was treated with a probiotic solution or Taraxacum officinale (dandelion) extract. The effectiveness of each treatment was measured through zones of isolation.
Results
A standard t-test was run to compare the results of two groups of means for each bacteria. For E. aerogenes, the probiotic solution was more effective than dandelion extract with a t-value of 5.5 and a p-value of 0.0003, which is less than a p-value of 0.05. For E. coli, the probiotic solution was more effective than dandelion extract with a t-value of 6.5, and the p-value is less than 0.05. Results show that the probiotics treatment was more effective in destroying the biofilms than the Taraxacum officinale extract, but both treatments showed effective bactericidal properties.
Conclusion
Data from the trials were compared to traditional antibiotics for each of the bacteria, E. coli and E. aerogenes. These two methods of destruction are possible solutions to the threat the biofilms pose. If these research methods prove to be effective, they will be instrumental in combating the biofilms that lead to complications. These are promising solutions for reverting the threat that biofilms pose to public health and ecosystems.
Keywords
Bacteria; Biofilms; Extract; Public health; Quorum sensing.
Improving Health Equity for Black Communities in the Face of Coronavirus Disease-2019
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The impact of coronavirus disease-2019 (COVID-19) in the U.S. to date is staggering and Blacks across the country are being infected and dying at rates far in excess of Whites. Although health disparities have been part of America’s reality for decades, the pandemic has exposed the failure of the healthcare system to adequately serve minority patients. There are immediate solutions that can help to balance the inequity now and position us well for the future. Five suggested solutions are described which focus on greater inclusion of Blacks in activities such as clinical trials, encouraging community-based resources and providing comprehensive racial data on COVID-19 cases. We are not all in the fight against COVID-19 together. Solutions must be adopted to help to address the current disparities now as well as beyond the immediate crisis.
Keywords
Health disparities; COVID-19; Minorities; Health equity; Black communities.
Connect with us
Editor-in-Chief
Małgorzata Schlegel-Zawadzka, PhD
Vice-Dean Jagiellonian University Medical College Swietej Anny 12 31-008 Krakow, Poland
Associate Editors
Elfatih Mohamed Malik Mohamed, MD
Director General Planning and International Health Directorate Federal Ministry of Health Nile St, Khartoum, Sudan
Helena Maltezou, MD, PhD
Pediatrician- Infectious Diseases Specialist Head, Department for Interventions in Health Care Facilities Hellenic Center for Disease Control and Prevention Αγράφων 3-5, Athens 151 23, Greece