Relationship between performance barriers and pharmacist competency towards the implementation of an expanded public health pharmacy role.

OBJECTIVE: The objective of this study was to examine the relationship between performance barriers and competency, and implementation of an expanded public health role for community pharmacists. METHODS: A validated questionnaire was utilised for this study whereby three variables of the study (performance barriers, competency and public health role) were measured using a 5-point Likert scale. Three hundred questionnaires were distributed to target respondents of registered community pharmacies in five states (Johor, Negeri Sembilan, Selangor, Perak and Penang) in Malaysia. The data were analysed utilising the principles of structural equation modelling. KEY FINDINGS: There were 191 completed and usable responses received, which represented a 66.7% response rate. This study showed perceived competency had a direct relationship with delivering a general public health role. A perceived lack of competency was shown to be a barrier to fulfilling a public health role. However, other factors, such as design of premises, IT infrastructure and pay, were not viewed as barriers to carrying out a public health role. CONCLUSION: Perceived competency is an obstacle for community pharmacists to undertake a public health role in Malaysia. Adequate training programmes in pharmaceutical public health have to be put in place to address this concern and this should therefore be a priority

Pattern of antidepressant utilization at a tertiary hospital in Malaysia (2009-2011)

The specific goals of this study are to determine trends in the usage and comparison of clinical patterns of antidepressant treatment modality in a tertiary hospital between year 2009-2011. We retrospectively reviewed prescription records in the Outpatient Pharmacy Department (OPD) of a tertiary hospital in central Malaysia from 2009 to 2011.About 3000 prescriptions, containing at least one anti-depressant drug, were systematically sampled and evaluated. Malay patients had a decreasing trend of 3% in anti-depressant usage over the study.Escitaloprom (SSRI) group was found to be the most widely utilized antidepressant with a steady increase of 9% while usage of Fluvoxamine was found to show a decreasing trend over the three years.The overall pattern profoundly favoured monotherapy modality rather than combination therapy among practitioners.This study also found an increasing pattern in the use of antidepressants with antianxiety and antipsychotic.In general, this study has contributed additional information regarding the prescribing pattern of anti-depressants in Malaysia at the current moment

PHYSICAL ACTIVITY AND MEDIA ENVIRONMENT AS ANTECEDENTS OF CHILDHOOD OBESITY IN MALAYSIA

Objective: The aim of this study was to explore the influence of physical activity and media viewing on the occurrence of childhood obesity in Malaysia.Methods: A 42-item validated questionnaire in the Malay and English language, containing Likert scale close-ended questions was used to explore the degree of physical activity practiced by families as well as trends on media viewing restrictions among parents in 5 selected states of Peninsular Malaysia. A total of 1200 self-administered questionnaires were sent out to schools in rural and urban areas of the respective 5 states and body mass index (BMI) for children was measured using the WHO 2007 reference standards. A total of 802 completed and usable questionnaires were obtained yielding a response rate of 66.6%. Chi-square and descriptive statistics were used to analyze the results.Results: The findings revealed that while children may have agreed limits on media viewing (television/computer/video games), as the child's BMI increased the rate of agreed limits decreased. However, the enforcement of these limits was not consistent. Interestingly, 70% of the parents who did not enforce restrictions on media viewing were also obese themselves. In terms of physical activity, this was far lower among obese and severe obese children and family activities involving physical activity was scarce with a rate of 25%.Conclusion: The study affirms the fact that Malaysia needs to promote engagement in physical activity as a national policy and shows that the importance of enforcing media viewing restrictions should be highlighted to the community at large

A review on hearing loss caused by occupational hazard and trauma

Occupational hearing loss (OHL) is known to be one of the most common occupational diseases. Common causes are being exposed to workplace hazardous noise levels, ototoxic chemicals, head injuries and barotrauma. Occupational noise-induced hearing loss is mostly due to the death or damage of hair cells in our ear, which do not grow back. On the other hand, ototoxic chemicals affect the structures in cochlear and auditory neurological pathways leading to hearing loss. In occupational head trauma, the parts of the ear that are damaged are the tympanic membrane, middle ear and cochlea which leads to hearing disability. Huge changes in pressure on the outside and the inside of the ear leads to barotrauma causing potential hearing loss. Many of the research available are regarding noise-induced OHL or chemicals causing OHL followed by barotrauma. More studies on OHL due to workplace head trauma should be conducted. Preventative measures should be taken by the worker’s supervisors or the government to implement safety measures to prevent and reduce OHL. This can be done via providing equipment and facilities that prevent hearing loss and education on OHL.</jats:p

Relationship between performance barriers and pharmacist competency towards the implementation of an expanded public health pharmacy role.

OBJECTIVE: The objective of this study was to examine the relationship between performance barriers and competency, and implementation of an expanded public health role for community pharmacists. METHODS: A validated questionnaire was utilised for this study whereby three variables of the study (performance barriers, competency and public health role) were measured using a 5-point Likert scale. Three hundred questionnaires were distributed to target respondents of registered community pharmacies in five states (Johor, Negeri Sembilan, Selangor, Perak and Penang) in Malaysia. The data were analysed utilising the principles of structural equation modelling. KEY FINDINGS: There were 191 completed and usable responses received, which represented a 66.7% response rate. This study showed perceived competency had a direct relationship with delivering a general public health role. A perceived lack of competency was shown to be a barrier to fulfilling a public health role. However, other factors, such as design of premises, IT infrastructure and pay, were not viewed as barriers to carrying out a public health role. CONCLUSION: Perceived competency is an obstacle for community pharmacists to undertake a public health role in Malaysia. Adequate training programmes in pharmaceutical public health have to be put in place to address this concern and this should therefore be a priority.</p

Role of physical activity and metabolic syndrome in determining the risk of postmenopausal breast cancer: a systematic review

Physical activity (PA) and metabolic syndrome (MetS) have emerged as crucial factors in facilitating the incidence of postmenopausal (PM) breast cancer (BC). The association of PA, MetS and its components with PM BC was explored in this study. PRISMA guideline was followed and online databases were searched comprehensively to find relevant cohort and case-control studies until 18 February 2021 using keywords such as “physical activity”, “metabolic syndrome” and “breast cancer”. Eligible studies evaluating BC in postmenopausal women with a clear definition and measure of PA, MetS and its individual components were selected. A total of twenty-three articles related to PA and fifteen articles for MetS met the eligibility criteria and were assessed thoroughly. PA and MetS were significantly associated with PM BC. There was evidence of dose-response effect of PA and Mets on PM BC. Obesity, diabetes and dyslipidaemia were independently associated with PM BC and posed an increased risk on PM BC whereas the association of HPTN with PM BC was not prominent. Consistent and sustained long term PA throughout one’s lifetime was observed to decrease PM BC risk whereas increasing number of MetS components increased the risk of PM BC. Routine screening for PM women with ≥2 MetS components and obese or overweight women with any of the MetS components may be beneficial in early BC detection. Lifestyle modifications with emphasis on long term PA would be beneficial to public health in preventing and improving MetS outcomes as well as a primary prevention of sporadic PM BC.</jats:p

Prognostic biomarkers in cardiovascular diseases

The use of biomarkers as a reliable and reproducible indicative of the risk, severity, and progression of cardiovascular diseases (CVDs) may greatly enhance the prognostic capability of primary healthcare clinicians. In primary healthcare, the realistic and wise use of reliable biomarkers could minimize the time and costs for effective diagnosis and suitable personalized therapy for CVD patients. Therefore, the aim of the present scoping review is to evaluate the prognostic significance of biomarkers in the progression and monitoring of CVDs. The review was conducted according to the PRISMA-ScR guidelines. Eight databases were searched for articles published as of June 2021 using search terms: cardiovascular diseases AND biomarkers AND prognosis. A total of 21 studies were included in this scoping review. This review identified biomarkers BNP, cTnT yielded better accuracy of disease progression prediction in ACS and HF respectively. The availability of CVDs prognostic biomarkers in primary healthcare clinics could promote improved clinical outcomes of patients.</jats:p

Prognostic biomarkers in cardiovascular diseases

The use of biomarkers as a reliable and reproducible indicative of the risk, severity, and progression of cardiovascular diseases (CVDs) may greatly enhance the prognostic capability of primary healthcare clinicians. In primary healthcare, the realistic and wise use of reliable biomarkers could minimize the time and costs for effective diagnosis and suitable personalized therapy for CVD patients. Therefore, the aim of the present scoping review is to evaluate the prognostic significance of biomarkers in the progression and monitoring of CVDs. The review was conducted according to the PRISMA-ScR guidelines. Eight databases were searched for articles published as of June 2021 using search terms: cardiovascular diseases AND biomarkers AND prognosis. A total of 21 studies were included in this scoping review. This review identified biomarkers BNP, cTnT yielded better accuracy of disease progression prediction in ACS and HF respectively. The availability of CVDs prognostic biomarkers in primary healthcare clinics could promote improved clinical outcomes of patients