Perception of integrating complementary and alternative medicine practice in patient's treatment among the healthcare practitioners: a systematic review.

There is a growing trend in complementary and alternative medicine (CAM) usage among the population with medical conditions. However, there is hesitancy for medical practitioners to integrate its application with the current treatment modality, despite governance by the authority. Hence, our objective is to systematically evaluate the healthcare perception towards integrating CAM in their practices. We systematically searched three large and renowned databases i.e., Scopus, Web of Science and PubMed, regarding "Perception on Integrating CAM Usage in Patient's Treatment among Healthcare Practitioners" from 2016 until 2020. At least two independent reviewers comprehensively screened and extracted the data from the accepted articles. A total of 15 studies were included in the final qualitative synthesis following a strict and rigorous assessment checked using MMAT 2018 checklist. The studies included providing the richness of information due to the qualitative nature of the study design. There were three main domains extracted i.e. knowledge, attitude, and perspective of the healthcare practitioner towards CAM integration. Limited knowledge of CAM among healthcare providers may be the possible main reason for non-supportive attitude and negative perspective on CAM. However, those who showed an inclination towards CAM were found to be more open and ready to learn about CAM if it provides benefits to the patients. There is a heterogeneity of perception towards CAM integration from healthcare providers' point of view. A proactive and systematic CAM literacy awareness program may help to improve their understanding and possibly gain more trust in its application.

Post-Exposure Prophylactic Vaccination against Rabies: A Systematic Review.

Background: Post-exposure prophylaxis (PEP) is an effective method for preventing rabies, a highly fatal infection in exposed persons. Malaysia is currently using the purified Vero cell rabies vaccine (PVRV). Nonetheless, there are other commercially available vaccine types and regimens. This systematic review aimed at comparing the effectiveness of the different PEP vaccines, regimens and routes of administration among Asian populations. Methods: We systematically reviewed the PubMed and Web of Science databases for articles reporting on the effectiveness of PEP vaccination against rabies among Asian populations between 2015 and 2019. Results: Our search identified 11 relevant studies. Majority of study either used PCECV or PVRV type of vaccine, with different regimes and method. All are non-inferior to the other. Most of the studies recorded adequate response by Day 14 of vaccination. Nonetheless, the intradermal (ID) vaccination used minimal volume of vaccine used in all settings, thus cost less and the concurrent administration of RIG to the wound(s) doesn't affect the RVNA GMT response. Conclusion: PCECV, using either the Essen or Zagreb regimen, might be a useful alternative for the healthy population in the context of PVRV shortage, especially during an outbreak. Use of the Zagreb or Thai Red Cross (TRC) regimens can be considered (either PVRV or PCECV), as both demonstrate good immunogenic outcomes in Asian populations.

Factors Associated with Handgrip Strength Among Older Adults in Malaysia.

Purpose: Handgrip strength (HGS) is indicative of overall physical health among older adults. A decrease in HGS may be associated with an increased risk of disease. The aim of this study is to determine the factors associated with HGS among older adults in Malaysia. Patients and Methods: One thousand two hundred four (1204) participants from urban and rural areas in Selangor state, Malaysia, were recruited. Sociodemographic and health-related conditions were gathered through a comprehensive face-to-face interview, followed by HGS assessments by a handgrip dynamometer. Subsequently, multiple linear regression was used to test the main association with the HGS. Results: A total of 691 participants (57.4%) were male, and 513 (42.6%) were female. Males had a mean HGS of 30.0 (SD 7.53) kg, and females had a mean HGS of 19.4 (SD 5.28) kg. Males' handgrip strength was significantly reduced with increasing age, physically inactive, and diabetes (all at the level p<0.001) after adjusting for social-demographic characteristics and health-related variables. Meanwhile, for females, the HGS was significantly decreased with age (p<0.001), physically inactive (p<0.001) and hypertension (p=0.03). However, female HGS was positively related to BMI (p<0.001). Conclusion: The study contributed to a better understanding of factors associated with HGS, and thus, the HGS is recommended as a section in the health evaluation among high-risk older adults as the strategy of disease control and prevention.

Unmet Healthcare Needs Among Elderly Malaysians.

PURPOSE: Older people often have chronic diseases which require a continuity of care over the long term. Countries undergoing population aging need to ensure that older people are receiving the care they need. This study assesses the prevalence of, reasons for, and factors associated with unmet healthcare needs among older people individuals in Malaysia. PATIENTS AND METHODS: This cross-sectional study used data collected during 2018-2020 from 1204 older adults aged 60 and older selected from Selangor state, Malaysia. A comprehensive face-to-face interview based on the Bahasa Malaysia version of the Japan Gerontological Evaluation Study (JAGES-BM) questionnaire was administered to gain information on unmet healthcare needs, socioeconomic factors, health-related factors, and measures of function (activities of daily living, depression, visual impairment, hearing impairment, memory impairment, and walking impairment). Multivariate logistic regression was used to analyze factors associated with their unmet healthcare needs. RESULTS: Overall, the percentage of older people respondents with unmet healthcare needs is 6.6%. The most reported reasons for forgoing or delaying healthcare were lack of knowledge about healthcare and financial barriers to care. The inability to travel alone (adjusted odds ratio [aOR] 2.51), being overweight (aOR 1.88), and having self-reported depression (aOR 2.23) were each associated with a higher likelihood of having unmet healthcare needs in their daily life. CONCLUSION: The prevalence of unmet healthcare needs among older people in this part of Malaysia is lower than that reported in some other countries. However, it is possible to further reduce unmet healthcare needs by improving people's knowledge and attitudes about appropriate healthcare utilization, strengthening financial protection measures and providing support to people at high risk of having unmet healthcare needs.

Factors Associated with Happiness among Malaysian Elderly.

Happiness is an essential component to experience healthy ageing. Hence, understanding the factors that contribute to happiness is important. This study aimed to determine the factors associated with happiness among the elderly population in Malaysia. In this study, 1204 respondents were recruited from urban and rural areas in Selangor. A face-to-face interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study questionnaire. The inclusion criteria include Malaysians who are 60-years old and above and can converse in the Malaysian language. Those who encounter less than seven scores for the Abbreviated Mental Test were excluded from the study. Among the 1204 respondents, 953 (79.2%) were happy. Sociodemographic characteristics showed that being a men, age of 60 to 74 years, and living in urban areas were significantly associated with happiness. A logistic regression model showed that locality (aOR 1.61), income category (Bottom 40% aOR 0.49; Middle-class group 40% aOR 1.40), social engagement (active aOR 1.77; less active aOR 1.25), receiving emotional support (aOR 2.11) and handgrip strength (aOR 1.02) were significantly associated with happiness. Thus, ensuring the elderly population in receiving emotional support and active social engagement among them can enhance their happiness level.

Factors Associated with the Need for Assistance among the Elderly in Malaysia.

The need for assistance among the elderly is rising, which poses challenges for healthcare systems. Thus, this study aims to determine the factors associated with the need for assistance in the daily living activities of Malaysia's elderly population. A total of 1204 elderly individuals, aged 60 years and above, were recruited. An interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study (JAGES-BM) questionnaire. Overall, 7.7% of the elderly participants required assistance. A logistic regression model showed that difficult financial statuses (aOR 4.56), hearing difficulties (aOR 1.78), and severe limitations in daily activity over the past 6 months (aOR 11.99) were associated with a higher likelihood of needing assistance. In addition, daily activities such as an inability to feed (aOR 8.46), stand without support (aOR 2.06), or walk for 15 min without stopping (aOR 1.99) were significantly associated with the need for assistance. Factors associated with the need for assistance are health status, disability, and the financial status of the elderly. Preventive measures should be included in policies to ensure the sustainability of the care provided to the elderly in terms of promoting healthy ageing and a good quality of life.