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Introduction Pharmacy students should be eHealth literate by being skilful in searching, evaluating and applying online health information. Mobile health applications should be utilised when making clinical decisions to achieve op...
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Introduction Pharmacy students should be eHealth literate by being skilful in searching, evaluating and applying online health information. Mobile health applications should be utilised when making clinical decisions to achieve optimal patient care with the ever-changing pharmacy practice. This study aims to explore the eHealth literacy and mobile health application utilisation amongst pharmacy undergraduates. Methods A cross-sectional study was conducted from March to April 2021. An online survey, consisting of socio-demographic characteristics, Internet use, eHealth Literacy Scale and mobile health application utilisation, was distributed amongst pharmacy undergraduates in public and private universities in Malaysia. Data analysis included descriptive statistics, one-way analysis of variance test, Mann-Whitney U test and Kruskal-Wallis test Results A total of 415 participants completed the survey (response rate = 82.5%). The median eHealth Literacy Scale score (out of 40) was 31.0 +/- 3.0 (interquartile range). More than one-third of participants (34.7%) were found to have low eHealth literacy. Many lacked confidence in making health decisions from online information (42.4%) and skills in distinguishing between high-quality and low-quality health resources (35.2%). Only 70.4% of the participants had mobile health applications installed on their smartphones and/or tablets. Some students felt that they were neither knowledgeable nor skilful enough to utilise mobile health applications (24.8%), whereas 23.9% were unaware of the mobile health applications available. Conclusion In summary, the eHealth literacy of Malaysian pharmacy students can be further enhanced by incorporating eHealth literacy-focused programmes into the curriculum. Moreover, pharmacy students' mobile health application utilisation can be improved through increased awareness and support from universities.
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Objectives This study aims to examine and develop a better understanding of (1) the factors that affect the stress of both their professional and personal lives, (2) the aspects of professional and personal life that affect their ...
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Objectives This study aims to examine and develop a better understanding of (1) the factors that affect the stress of both their professional and personal lives, (2) the aspects of professional and personal life that affect their satisfaction and fulfilment and (3) what they need to achieve satisfaction and fulfilment in their professional and personal lives. Methods A cross-sectional study using a questionnaire was developed. The questionnaire contained 8 questions designed to collect qualitative data on the factors affecting the stress, satisfaction and fulfilment in the professional and personal lives of early career pharmacists (ECPs). Questionnaire responses were analysed using a qualitative content analysis approach and themes describing influential factors were developed. Key findings Some of the factors that contribute to the stress, satisfaction and fulfilment of ECPs were identified. The stressors identified include the workplace environment and relationships with colleagues, the demands of a pharmacist career, the lack of career advancement pathways, job insecurity, relationships and their weaknesses. Factors contributing to satisfaction and fulfilment included supportive work environments and relationships, being appreciated and making a difference, growth, supportive relationships and self-care. Conclusions Supporting the well-being of ECPs is important for a resilient, engaged and effective pharmacy workforce. Key interventions include eliminating job insecurity, establishing clear career pathways, improving work environments and relationships and investing in the development of clinical, technical, communication and managerial skills.
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PurposeDue to the high burden of cancer-related suffering, it is paramount to understand the gaps in cancer care that lead to suffering. Advanced cancer patients have unmet needs and challenges that differ from those with early-st...
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PurposeDue to the high burden of cancer-related suffering, it is paramount to understand the gaps in cancer care that lead to suffering. Advanced cancer patients have unmet needs and challenges that differ from those with early-stage cancer due to the rapid disease progression. By exploring advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects, this study aims to identify gaps in the Malaysian health system and propose contextualised measures to improve cancer care.MethodsSemi-structured, in-depth interviews were conducted to explore advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects. The interviews were then transcribed and coded. Themes were developed from the codes using iterative thematic approach.ResultsThe lived experiences and needs of nineteen patients converged into four major themes: disruption to daily lives, psychosocial and spiritual support system, information needs, and financial needs. This study described predominantly how cancer impacted patients' lives and livelihood, how patients coped with their psychological conditions after diagnosis, the need for effective communication and trust in a multicultural society, and how finance affected access to and experience of cancer care.ConclusionAdvanced cancer patients had different needs beyond receiving medical treatments. A concerted effort is required from clinicians, allied health professionals, social workers, support groups, and family members to understand and fulfil these needs.
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Objectives: The paramedics' role is pivotal in ensuring eligible stroke patients reach the hospital within 4.5 hours, as this increases the chance of patients being treated with recombinant tissue plasminogen activator (rTPA) and ...
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Objectives: The paramedics' role is pivotal in ensuring eligible stroke patients reach the hospital within 4.5 hours, as this increases the chance of patients being treated with recombinant tissue plasminogen activator (rTPA) and improves their outcome. The lack of reviews on interventions done on paramedic services and the outcomes associated with them necessitates further investigation to enable policymakers to make guided decisions in improving the management of acute ischaemic strokes. Hence, our study aimed to identify interventions done and their impact on thrombolysis rate and onset-to-door (OTD) time. Methods: We searched PubMed, Embase, CINAHL and RCN to identify studies published between 1 January 2010 and 30 June 2020. The primary outcome of this study is investigating the impact of interventions done on paramedics services on the rTPA administration rate and OTD timing. Other outcomes include improvement in door-to-needle (DTN), door-to-imaging (DTI) and onset -to-needle (OTN) time. Random effect models were used to analyse the effects of the interventions carried out. Results: We gathered 621 papers, of which 11 met the eligibility criteria. The interventions carried out were bypass (n=3), education (n=2), pre-notification (n=4) and telemedicine (n=2). Based on the random effect model, rTPA administration was significantly higher in the intervention arm of ischemic stroke patients (n=7) with an OR of 1.45 (95%CI, 1.01-2.06). The trend was significantly higher with bypass intervention (OR 2.23 95%CI, 1.55-3.2), while the result with pre-notification (OR 0.53 95%CI, 0.09-2.95) and education (OR 1.51 95%CI, 0.87-2.60) were not significant. Conclusions: Paramedic interventions appear to have considerable effectiveness in improving the rates of rTPA, especially when the interventions used bypass mechanisms. This study provides detailed information on the net and quantitative benefits of the interventions and suggests the use of such interventions to reduce the pre-hospital delay of stroke patients and improve the rates of intravenous thrombolysis.
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Messenger RNA (mRNA) recently emerged as an appealing alternative to treat and prevent diseases ranging from cancer and Alzheimer's disease to COVID-19 with significant clinical outputs. The in vitro-transcribed mRNA has been engi...
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Messenger RNA (mRNA) recently emerged as an appealing alternative to treat and prevent diseases ranging from cancer and Alzheimer's disease to COVID-19 with significant clinical outputs. The in vitro-transcribed mRNA has been engineered to mimic the structure of natural mRNA for vaccination, cancer immunotherapy and protein replacement therapy. In past decades, significant progress has been noticed in unveiling the molecular pathways of mRNA, controlling its translatability and stability, and its evolutionary defense mechanism. However, numerous unsolved structural, biological, and technical difficulties hamper the successful implementation of systemic delivery of mRNA for safer human consumption. Advances in designing and manufacturing mRNA and selecting innovative delivery vehicles are mandatory to address the unresolved issues and achieve the full potential of mRNA drugs. Despite the substantial efforts made to improve the intracellular delivery of mRNA drugs, challenges associated with diverse applications in different routes still exist. This study examines the current progress of mRNA therapeutics and advancements in designing biomaterials and delivery strategies, the existing translational challenges of clinical tractability and the prospects of overcoming any challenges related to mRNA.
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Balance control is essential for postural adjustment in physical activities. This study investigates the behavior of human postural control and the coordination and adaptation strategy of hip, knee, and ankle when standing on an u...
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Balance control is essential for postural adjustment in physical activities. This study investigates the behavior of human postural control and the coordination and adaptation strategy of hip, knee, and ankle when standing on an unstable surface. Twenty participants were recruited. Four different conditions were investigated: a quiet bipedal stance with eyes open and eyes closed, and standing on an unstable surface with eyes open and eyes closed. Other than the joint angle, the standard body sway measures, such as sway area and sway velocity, were computed. A nonlinear time series measure, that is, sample entropy, was used to determine the regularity of the time series and body adaptability to change and perturbation. The results show that the body sway increases as the difficulty increases. This study also confirms the coordination of the hip, knee, and ankle to maintain body balance on the unstable surface by decreasing the joint angle and adopting a lower posture. Even though the individual joint has lower sample entropy value and is deemed to be rigid and less adaptive to perturbation, the postural control exhibits higher sample entropy value, particularly in the anterior-posterior direction, and has the ability to stabilize the body by manipulating the joints simultaneously. These outcomes suggest that an unstable surface not only challenges the human postural control, but also reduces the hip, knee, and ankle adaptability to perturbation, thus making it a great tool to train body balance.
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Background: A multidisciplinary approach is required to tackle the tuberculosis (TB) epidemic, which is one of the most pressing public health concerns worldwide. However, community pharmacists are underutilized in TB programs.Obj...
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Background: A multidisciplinary approach is required to tackle the tuberculosis (TB) epidemic, which is one of the most pressing public health concerns worldwide. However, community pharmacists are underutilized in TB programs.Objective: To identify community pharmacists-led interventions in TB management with their corresponding impacts in TB case detection and treatment outcomes.Methods: A systematic search was performed in six electronic databases and health organization websites, from database inception to August 2, 2022. Studies which described TB screening, referral and/or treatment moni-toring by community pharmacists with their corresponding outcomes were screened and reviewed independently by two reviewers. The studies were checked for the risk of bias using Cochrane risk of bias tools. All data of included studies were analysed qualitatively and presented narratively.Results: The search yielded 8,121 studies and five reports for initial screening. Sixteen studies and two case study reports were included in this review. Community pharmacists were involved throughout the TB care cascade, contributing their services in TB screening, referrals and in directly observed treatment-short course (DOTS) program. These interventions showed improvements in the effective control and prevention of further spread of TB, which improves individual, community and population level outcomes.Conclusions: The inclusion of community pharmacists into TB program can improve the continuity of care, bridging the gaps in TB case detection and treatment monitoring. Adequate training and support are essential, to further empower the role of community pharmacists in TB control and prevention, in building a TB-free world.
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The lack of reliable electricity access persists as a global issue, particularly in rural areas. Off-grid electrification using diesel generators is commonly practiced by rural communities, but using diesel is not environmentally ...
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The lack of reliable electricity access persists as a global issue, particularly in rural areas. Off-grid electrification using diesel generators is commonly practiced by rural communities, but using diesel is not environmentally sustainable. In this paper, we proposed a new concept to create renewable energy access in rural areas by co -producing biodiesel in rural palm oil mills using non-edible sludge palm oil (SPO) as a feedstock. We per-formed a case study based on a medium-sized palm oil mill in Central Kalimantan, the Indonesian part of Borneo. A one-pot batch process catalyzed by low-cost liquid lipase was selected to convert SPO into biodiesel. To determine the environmental viability of this rural electrification concept, we compared two electrification routes using different generator fuels (i.e., commercial B30 diesel and enzymatic biodiesel co-produced in palm oil mills from SPO) via a cradle-to-grave comparative life cycle assessment. Our results revealed that electrifi-cation using enzymatic biodiesel offers significantly improved climate benefits compared to commercial B30 diesel. Furthermore, assuming that a mill processing 40 tonnes of fresh fruit bunches daily were to adopt this concept, its biodiesel co-production facility would be able to support about 940 surrounding households. Conclusively, this electrification concept is feasible and can be readily implemented in many developing and under-developed palm oil producing countries.
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Influenza A (IAV) is a major human respiratory pathogen that contributes to a significant threat to health security, worldwide. Despite vaccinations and previous immunisations through infections, humans can still be infected with ...
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Influenza A (IAV) is a major human respiratory pathogen that contributes to a significant threat to health security, worldwide. Despite vaccinations and previous immunisations through infections, humans can still be infected with influenza several times throughout their lives. This phenomenon is attributed to the antigenic changes of hemagglutinin (HA) and neuraminidase (NA) proteins in IAV via genetic mutation and reassortment, conferring antigenic drift and antigenic shift, respectively. Numerous findings indicate that slow antigenic drift and reassortment-derived antigenic shift exhibited by IAV are key processes that allow IAVs to overcome the previously acquired host immunity, which eventually leads to the annual re-emergence of seasonal influenza and even pandemic influenza, in rare occasions. As a result, current therapeutic options hit a brick wall quickly. As IAV remains a constant threat for new outbreaks worldwide, the underlying processes of genetic changes and alternative antiviral approaches for IAV should be further explored to improve disease management. In the light of the above, this review discusses the characteristics and mechanisms of mutations and reassortments that contribute to IAV's evolution. We also discuss several alternative RNA-targeting antiviral approaches, namely the CRISPR/Cas13 systems, RNA interference (RNAi), and antisense oligonucleotides (ASO) as potential antiviral approaches against IAV.
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Purpose Natural materials have been extensively studied for oral drug delivery due to their biodegradability and other unique properties. In the current research, we fabricated sodium caseinate nanomicelles (NaCNs) using casein as...
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Purpose Natural materials have been extensively studied for oral drug delivery due to their biodegradability and other unique properties. In the current research, we fabricated sodium caseinate nanomicelles (NaCNs) using casein as a natural polymer to develop a controlled-release oral delivery system that would improve the therapeutic potential of doxorubicin (DOX) and reduce its toxicity. Methods DOX-loaded NaCNs were synthesized and thoroughly characterized, then subjected to in vivo anti-tumor evaluation and bio-distribution analysis in a 4T1-induced breast cancer model. Results Our findings indicated that the tumor would shrink by eight-fold in the group orally treated with DOX-NaCNs when compared to free DOX. The tumor accumulated drug 1.27-fold more from the orally administered DOX-NaCNs compared to the intravenously administered DOX-NaCNs, 6.8-fold more compared to free DOX, and 8.34-times more compared to orally administered free DOX. In comparison, the orally administered DOX-NaCNs lead to a significant reduction in tumor size (5.66 +/- 4.36 mm(3)) compared to intravenously administered DOX-NaCNs (10.29 +/- 4.86 mm(3)) on day 17 of the experiment. NaCNs were well tolerated at a single dose of 2000 mg/kg in an acute oral toxicity study. Conclusion The enhanced anti-tumor effects of oral DOX-NaCNs might be related to the controlled release of DOX from the delivery system when compared to free DOX and the intravenous formulation of DOX-NaCNs. Moreover, NaCNs is recognized as a safe and non-toxic delivery system with excellent bio-distribution profile and high anti-tumor effects that has a potential for oral chemotherapy.
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