Trends in Health Communication: Social Media Needs and Quality of Life among Older Adults in Malaysia.

BACKGROUND: While social media continues to dominate, social media platforms have become powerful health communication tools for older users. However, fulfilling their social media needs can be both detrimental and beneficial to their quality of life (QoL). This study assessed social media needs as they relate to QoL among older adults in Malaysia. METHODS: We conducted a cross-sectional study and adopted convenience sampling to recruit participants. The participants were required to self-report their sociodemographic profile, social media use and needs, and QoL. Social media use and needs were assessed using the Social Networking Sites Uses and Needs (SNSUN) scale, and QoL was assessed using the WHOQOL-BREF questionnaire. Multiple linear regression was performed to identify the predictors of QoL. RESULTS: The findings revealed that the fulfilment of social integrative needs was the strongest predictor of higher QoL in all domains. However, those using social media for their affective needs demonstrated lower psychological health quality. CONCLUSIONS: Fulfilling social integrative needs is the key to improving the QoL among older adults. The continuous development of age-friendly applications is essential to keep up with constantly changing social media trends and bridge the gap of social media inequalities. More importantly, it would enable older adults to utilize social media to its fullest potential and enjoy a higher QoL through accessible health communication tools.

Efficient isolation, biophysical characterisation and molecular composition of extracellular vesicles secreted by primary and immortalised cells of reproductive origin.

Effective communication between the maternal reproductive tract, gametes and the pre-implantation embryo is essential for the successful establishment of pregnancy. Recent studies have recognised extracellular vesicles (EVs) as potent vehicles for intercellular communication, potentially via their transport of microRNAs (miRNAs). The aim of the current investigation was to determine the size, concentration and electrical surface properties (zeta potential) of EVs secreted by; (1) primary cultures of porcine oviductal epithelial cells (POECs) from the isthmus and ampullary regions of the female reproductive tract; (2) Ishikawa and RL95-2 human endometrial epithelial cell line cultures; and (3) the non-reproductive epithelial cell line HEK293T. In addition, this study investigated whether EVs secreted by POECs contained miRNAs. All cell types were cultured in EV-depleted medium for 24 or 48 h. EVs were successfully isolated from conditioned culture media using size exclusion chromatography. Nanoparticle tracking analysis (NTA) was performed to evaluate EV size, concentration and zeta potential. QRT-PCR was performed to quantify the expression of candidate miRNAs (miR-103, let-7a, miR-19a, miR-203, miR-126, miR-19b, RNU44, miR-92, miR-196a, miR-326 and miR-23a). NTA confirmed the presence of EVs with diameters of 50-150 nm in all cell types. EV size distribution was significantly different between cell types after 24 and 48 h of cell culture and the concentration of EVs secreted by POECs and Ishikawa cells was also time dependent. The distribution of EVs with specific electrokinetic potential measurements varied between cell types, indicating that EVs of differing cellular origin have varied membrane components. In addition, EVs secreted by POECs exhibited significantly different time dependant changes in zeta potential. QRT-PCR confirmed the presence of miR-103, let-7a, miR-19a, miR-203, miR-126, and miR-19b in EVs secreted by POECs (CT ≥ 29). Bioinformatics analysis suggests that these miRNAs are involved in cell proliferation, innate immune responses, apoptosis and cellular migration. In conclusion, reproductive epithelial cells secrete distinct populations of EVs containing miRNAs, which potentially act in intercellular communication in order to modulate the periconception events leading to successful establishment of pregnancy.

Physician, heal thyself: the paradox of anxiety amongst house officers and work in a teaching hospital.

INTRODUCTION: Anxiety among house officers may impair functioning and health care delivery. This study aimed to determine the association between anxiety among house officers at Universiti Kebangsaan Malaysia Medical Center, sociodemographic and work-related factors. METHODS: A cross-sectional study using the self-rated and validated Malay Depressive Anxiety and Stress Scale 21, the General Stressor Questionnaire and a sociodemographic questionnaire. RESULTS: Of the 89 house officers, 60.7% were anxious. Multivariate logistic analysis showed work-related challenges, performance pressure (odds ratio [OR] = 9.000, 95% confidence interval [CI] = 1.812-44.705), poor relationship with supervisors (OR = 5.212, 95% CI = 2.033-3.365), poor relationship with colleagues (OR = 4.642, 95% CI = 1.816-11.866), bureaucratic constraints (OR = 3.810, 95% CI = 1.541-9.415) and poor job prospects (OR = 3.745, 95% CI = 1.505-9.321) strongly associated with anxiety. Family-related stressors were less significant (OR = 1.800, 95% CI = 0.760-4.266) unless they were work related (work-family conflicts [OR = 8.253, 95% CI = 2.652-25.684]). DISCUSSION: Almost two-thirds of this cohort reported work-related anxiety symptoms. Administrators need to address these mental health needs early. The subsequent improvement in communication skills, conflict resolution and anxiety reduction will result in short- and long-term benefits towards the young doctors's mental health. The cascading impact on these individuals, thus empowered, will be good work-life balance, improved patient care and safety, a satisfying medical career whilst contributing maximally to the country's health care.

Intrahepatic cholestasis of pregnancy levels of sulfated progesterone metabolites inhibit farnesoid X receptor resulting in a cholestatic phenotype.

UNLABELLED: Intrahepatic cholestasis of pregnancy (ICP) is the most prevalent pregnancy-specific liver disease and is associated with an increased risk of adverse fetal outcomes, including preterm labor and intrauterine death. The endocrine signals that cause cholestasis are not known but 3α-sulfated progesterone metabolites have been shown to be elevated in ICP, leading us to study the impact of sulfated progesterone metabolites on farnesoid X receptor (FXR)-mediated bile acid homeostasis pathways. Here we report that the 3ß-sulfated progesterone metabolite epiallopregnanolone sulfate is supraphysiologically raised in the serum of ICP patients. Mice challenged with cholic acid developed hypercholanemia and a hepatic gene expression profile indicative of FXR activation. However, coadministration of epiallopregnanolone sulfate with cholic acid exacerbated the hypercholanemia and resulted in aberrant gene expression profiles for hepatic bile acid-responsive genes consistent with cholestasis. We demonstrate that levels of epiallopregnanolone sulfate found in ICP can function as a partial agonist for FXR, resulting in the aberrant expression of bile acid homeostasis genes in hepatoma cell lines and primary human hepatocytes. Furthermore, epiallopregnanolone sulfate inhibition of FXR results in reduced FXR-mediated bile acid efflux and secreted FGF19. Using cofactor recruitment assays, we show that epiallopregnanolone sulfate competitively inhibits bile acid-mediated recruitment of cofactor motifs to the FXR-ligand binding domain. CONCLUSION: Our results reveal a novel molecular interaction between ICP-associated levels of the 3ß-sulfated progesterone metabolite epiallopregnanolone sulfate and FXR that couples the endocrine component of pregnancy in ICP to abnormal bile acid homeostasis.