ABSTRACT
Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT’s efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.
ABSTRACT
@#As cognition declines with age, cognitive impairment rates are expected to increase ranging from 100% to 300% in this region. It could be higher among elderly who had any chronic diseases. The aim of the present work was to determine the prevalence and associated factors of cognitive impairment among elderly with hypertension. A clinic-based, cross-sectional study was conducted at several community clinics in Sabak Bernam and Hilir Perak districts from July to December 2015. A total of 480 patients were recruited. The prevalence of cognitive impairment was 13.13% (95%CI: 13.11, 13.15). Factors associated with cognitive impairment among elderly hypertensive were no formal educational level [OR: 3.95 (95%CI: 1.80, 8.67)]; history of high cholesterol [OR: 3.24 (95%CI: 1.15, 9.16)]; underweight [adj. OR: 4.88 (95%CI: 1.34, 17.67)]; and increasing age [OR: 1.03 (95%CI: 1.01, 1.06)]. Public health policy makers and geriatric practitioners should emphasise on early cognitive function assessment among elderlies who are hypertensive, unemployed, poor educational background, males, high cholesterol level and underweight to enhance the quality of geriatric services. Earlier establishment of diagnosis may prevent from greater rate of decline in cognitive functioning among this vulnerable group.
ABSTRACT
The risk factors associated with mental health among adolescents are usually described by researchers at an individual level. Neighbourhood factors and health have opened a new insight into the field of epidemiology. The aim of this study was to assess the reliability and validity of a newly developed Neighbourhood Factors on Mental Health Questionnaire among Malaysian adolescents. A cross-sectional study was conducted in four secondary schools in Kuala Lumpur, Malaysia using a newly developed questionnaire which comprised of two main domains and seven items. Exploratory factor analysis and Cronbach’s alpha were used to measure the instrument’s construct validity and reliability. A total of 106 adolescents participated in this research. The majority of adolescents were 13 years old (40.6%), female (55.7%), Malays (68.9%), have parents who only studied until secondary school (66.0%) and lived in flats (32.1%). Bartlett’s Test of Sphericity was significant (Chi-square = 258.361, p<0.001) and Kaiser-Meyer-Olkin (KMO) value was 0.820. The final model of the instrument contained two domains, the neighbourhood physical environment and neighbourhood social environment factors. Factor loadings for all items were satisfactory ranging from 0.591 to 0.870. The overall Cronbach’s alpha was 0.810. The Neigbourhood Factors on Mental Health Questionnaire was found to be a valid and reliable instrument. It can be used to assess neighbourhood physical and social factors that can influence mental health of adolescents in Malaysia.
ABSTRACT
In the middle of January 2014 during the winter season, three post graduate students from Community Health Department, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) were invited to have a taste of experience on public health practice in Niigata Graduate School of Medicine & Dental Sciences (NU) under Division of International Health (Public Health). This is the fourth group which was invited through the student exchange program between both universities. The journey took almost 7 hours from Kuala Lumpur International Airport to Narita International Airport by plane; and another 2 hours by bullet train (shinkansen) ride from Tokyo City to Niigata prefecture. The cold weather, which was below 2 degree Celsius, did not stop our burning desire to step into the country which was well known for its modernization and yet still upholding its ancient and renowned tradition. Not many would know that Niigata was known as the “Rice Capital of Japan”. The large variation of seasons and temperature between night and day, the fertile soil and the pristine melting snow that feeds into the rice paddies create a natural environment for nurturing Niigata’s exquisite rice. Niigata boasts Japan's biggest harvest of rice, which is essential to Japanese cuisine, crackers and sake production. During our visit, we were made known on the Japanese code of etiquette, which governs the expectations of social behaviour in the country and is considered very essential. Bowing for example, is considered extremely important in Japan, so much so that, although children normally begin learning how to bow from a very young age, companies commonly provide training to their employees in how to execute bows correctly. There are also certain etiquette applied during eating, drinking, exchanging gifts and visiting. Giving a personal business card is essentially important and therefore we were made the effort to prepare our own cards during the visit. Upon our arrival, we were welcomed by the Head of Public Health Division; Prof. Dr. Reiko Saito and her colleague, Dr. Yugo Shobugawa. The introduction to the division was given and we were introduced to the staff in the division. The division is currently prioritising on the research related to avian influenza as well as Norvovirus through genetic study and Geographical Information System (GIS). During the first day of the visit, we were astonished to know that Niigata city possess its own “public health hospital” which was developed to cater disease outbreak and disaster. Recently it has been used for influenza outbreak as well as providing healthcare services for the victims of earthquake. During the usual operating hours, the hospital will provide a specialist health clinic ranging from internal medicine, orthopedics, pediatrics and obstetrics speciality. It has its own disaster wards, complete with laboratory as well as radiological investigation equiptments.