Exploring clinical specialists' perspectives on the future role of AI: evaluating replacement perceptions, benefits, and drawbacks.

BACKGROUND OF STUDY: Over the past few decades, the utilization of Artificial Intelligence (AI) has surged in popularity, and its application in the medical field is witnessing a global increase. Nevertheless, the implementation of AI-based healthcare solutions has been slow in developing nations like Pakistan. This unique study aims to assess the opinion of clinical specialists on the future replacement of AI, its associated benefits, and its drawbacks in form southern region of Pakistan. MATERIAL AND METHODS: A cross-sectional selective study was conducted from 140 clinical specialists (Surgery = 24, Pathology = 31, Radiology = 35, Gynecology = 35, Pediatric = 17) from the neglected southern Punjab region of Pakistan. The study was analyzed using χ2 - the test of association and the nexus between different factors was examined by multinomial logistic regression. RESULTS: Out of 140 respondents, 34 (24.3%) believed hospitals were ready for AI, while 81 (57.9%) disagreed. Additionally, 42(30.0%) were concerned about privacy violations, and 70(50%) feared AI could lead to unemployment. Specialists with less than 6 years of experience are more likely to embrace AI (p = 0.0327, OR = 3.184, 95% C.I; 0.262, 3.556) and those who firmly believe that AI knowledge will not replace their future tasks exhibit a lower likelihood of accepting AI (p = 0.015, OR = 0.235, 95% C.I: (0.073, 0.758). Clinical specialists who perceive AI as a technology that encompasses both drawbacks and benefits demonstrated a higher likelihood of accepting its adoption (p = 0.084, OR = 2.969, 95% C.I; 0.865, 5.187). CONCLUSION: Clinical specialists have embraced AI as the future of the medical field while acknowledging concerns about privacy and unemployment.

COVID-19 Vaccine Hesitancy: Umbrella Review of Systematic Reviews and Meta-Analysis.

BACKGROUND: The unprecedented emergence of the COVID-19 pandemic necessitated the development and global distribution of vaccines, making the understanding of global vaccine acceptance and hesitancy crucial to overcoming barriers to vaccination and achieving widespread immunization. OBJECTIVE: This umbrella review synthesizes findings from systematic reviews and meta-analyses to provide insights into global perceptions on COVID-19 vaccine acceptance and hesitancy across diverse populations and regions. METHODS: We conducted a literature search across major databases to identify systematic reviews and meta-analysis that reported COVID-19 vaccine acceptance and hesitancy. The AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) criteria were used to assess the methodological quality of included systematic reviews. Meta-analysis was performed using STATA 17 with a random effect model. The data synthesis is presented in a table format and via a narrative. RESULTS: Our inclusion criteria were met by 78 meta-analyses published between 2021 and 2023. Our analysis revealed a moderate vaccine acceptance rate of 63% (95% CI 0.60%-0.67%) in the general population, with significant heterogeneity (I2 = 97.59%). Higher acceptance rates were observed among health care workers and individuals with chronic diseases, at 64% (95% CI 0.57%-0.71%) and 69% (95% CI 0.61%-0.76%), respectively. However, lower acceptance was noted among pregnant women, at 48% (95% CI 0.42%-0.53%), and parents consenting for their children, at 61.29% (95% CI 0.56%-0.67%). The pooled vaccine hesitancy rate was 32% (95% CI 0.25%-0.39%) in the general population. The quality assessment revealed 19 high-quality, 38 moderate-quality, 15 low-quality, and 6 critically low-quality meta-analyses. CONCLUSIONS: This review revealed the presence of vaccine hesitancy globally, emphasizing the necessity for population-specific, culturally sensitive interventions and clear, credible information dissemination to foster vaccine acceptance. The observed disparities accentuate the need for continuous research to understand evolving vaccine perceptions and to address the unique concerns and needs of diverse populations, thereby aiding in the formulation of effective and inclusive vaccination strategies. TRIAL REGISTRATION: PROSPERO CRD42023468363; https://tinyurl.com/2p9kv9cr.

The evolving role of social media in enhancing quality of life: a global perspective across 10 countries.

BACKGROUND: Excessive or inappropriate use of social media has been linked to disruptions in regular work, well-being, mental health, and overall reduction of quality of life. However, a limited number of studies documenting the impact of social media on health-related quality of life (HRQoL) are available globally. AIM: This study aimed to explore the perceived social media needs and their impact on the quality of life among the adult population of various selected countries. METHODOLOGY: A cross-sectional, quantitative design and analytical study utilized an online survey disseminated from November to December 2021. RESULTS: A total of 6689 respondents from ten countries participated in the study. The largest number of respondents was from Malaysia (23.9%), followed by Bangladesh (15.5%), Georgia (14.8%), and Turkey (12.2%). The prevalence of social media users was over 90% in Austria, Georgia, Myanmar, Nigeria, and the Philippines. The majority of social media users were from the 18-24 age group. Multiple regression analysis showed that higher education level was positively correlated with all four domains of WHOQoL. In addition, the psychological health domain of quality of life was positively associated in all countries. Predictors among Social Media Needs, Affective Needs (ß = -0.07), and Social Integrative Needs (ß = 0.09) were significantly associated with psychological health. CONCLUSION: The study illuminates the positive correlation between higher education levels and improved life quality among social media users, highlighting an opportunity for policymakers to craft education-focused initiatives that enhance well-being. The findings call for strategic interventions to safeguard the mental health of the global social media populace, particularly those at educational and health disadvantages.

When the Going Gets Challenging-Motivational Theories as a Driver for Workplace Health Promotion, Employees Well-Being and Quality of Life.

Being characterized by high numbers of physical and mental health issues, the veterinary sector faces some negative peculiarities compared to other professions. To evaluate and possibly improve employees' well-being and to reward according to individual motivation, managing staff and the profession in general must understand every individual's motivation. Defining the motivation of veterinary professionals in a multidisciplinary way can be the first step in increasing the well-being of employees. To assemble current theories of work motivation and adapt and extend them to serve the veterinary profession, basic knowledge of the classical general psychological motivational theories and work motivational theories is inevitable. The authors aimed to illustrate the different motivational theories' key aspects and historical evolution to provide veterinary personnel with broad knowledge. In addition, the availability of already existing literature should be evaluated. A scoping review was performed. Methodological, empirical, review, and theoretical articles were evaluated. Only a minority of the studies (1.3%) evaluated motivational theories in veterinary health care. This reflects that there is a need for research in this field. Still, it is illustrated that the veterinarian profession would benefit from the implementation of general psychological as well as motivational work theories.

Effect of menstrual status on lipid profile: A cross-sectional study in a tertiary care hospital in Nepal.

Background: The ovarian follicular cell's degradation and subsequent decrease in the synthesis of estrogen results in the decreased cardiovascular protection. As a result, the incidence of cardiovascular disease (CVD) increases in postmenopausal women and is characterized by change in lipid profile. This study sought to ascertain the extent of the impact that menstrual status might have on lipid profiles among premenopausal and postmenopausal women. Methods: A cross-sectional study was conducted with 260 premenopausal and postmenopausal women (1: 1) and serum lipid component concentrations (high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), and total cholesterol (TC)) were measured. A comparison between two groups was made between premenopausal and postmenopausal women, and regression was carried out to estimate the effect of menstrual status on lipid components. Results: Compared with premenopausal women, the concentrations of the lipid components (HDL-C, LDL-C, TG, and TC) were found to be significantly higher in postmenopausal women. Using the linear regression, menstruation status was able to predict 11.7%-13.3% of the lipid components (TG and TC) when age and weight were adjusted. Conclusion: The difference in lipid components between premenopausal women and postmenopausal women exists, with menstrual status explaining 11.7%-13.3% variance for the observed lipid level. The factors influencing the lipid profile beside the menstrual status should also be explored. External intervention such as estrogen replacement therapy is also recommended in case of deviation of lipid profile from the suggested normal clinical range.

Domain and perception on community resilience: comparison between two countries.

The COVID-19 outbreak demonstrates how unprepared the world is for a different type of crisis, especially non-physical calamities. Revitalizing community involvement in disaster management is essential for making a community resilient. Due to differing sociocultural contexts, the resilience perceptions of communities in different parts of the world may vary. This study aims to understand community resilience factors after the COVID-19 disaster in Indonesia and Malaysia. Data from 2034 questionnaires using 5-interrelated domains in the Communities Advancing Resilience (CART) Toolkit Survey were collected. This study was conducted across Indonesia and Malaysia from March to April 2022. A quantitative-based cross-sectional study design and convenience sampling were applied. Respondents for this study were Indonesian and Malaysian citizens above 18 years of age who met the inclusion criteria. A total of 2034 respondents, 715 from Indonesia and 1,315 from Malaysia responded to the survey. The results suggest that Indonesian and Malaysian communities' Transformative Potential and Informative-Communication domains differ significantly. Indonesian communities demonstrated a higher mean value on Transformative Potential domains than Malaysian communities did, while Malaysian communities indicated a higher mean value on Informative-Communication domains. This study concludes that compared to Malaysian communities, Indonesian communities have a more significant potential for transformation because they can frame collective experiences, gather, and analyze pertinent data, evaluate community performance, and develop resilience-building abilities. On the other hand, Malaysian communities are more resilient in providing information and communication. We found the need to develop a community resilience model that incorporates specific cultural and local requirements. Cooperation between the two countries would open many possibilities to emphasize the capability to bounce back sooner after a catastrophe such as the COVID-19 pandemic and achieve Sustainable Development Goals.

Determinants of active aging and quality of life among older adults: systematic review.

Introduction: Population demography across the globe shows an increasing trend in the aging population due to better healthcare, improved nutrition, advanced health-related technology, and decreased fertility rate. Despite these advancements, there remains a knowledge gap in understanding the association between active aging determinants and quality of life (QoL) among older adults, particularly within diverse cultural contexts, which has not been adequately explored in previous research. Therefore, understanding the association between active aging determinants and QoL can help policymakers plan early interventions or programs to assist future older adults in both aging actively and optimizing their quality of life (QoL), as these two factors have a bidirectional relationship. Objective: This study aimed to review evidence regarding the association between active aging and quality of life (QoL) among older adults and to determine the most widely used study designs and measurement instruments in studies conducted between 2000 and 2020. Methods: Relevant studies were identified by a systematic search of four electronic databases and cross-reference lists. Original studies examining the association between active aging and QoL in individuals aged 60 years or older were considered. The quality of the included studies and the direction and consistency of the association between active aging and QoL were assessed. Results: A total of 26 studies met the inclusion criteria and were included in this systematic review. Most studies reported a positive association between active aging and QoL among older adults. Active aging had a consistent association with various QoL domains including physical environment, health and social services, social environment, economic, personal, and behavioral determinants. Conclusion: Active aging had a positive and consistent association with several QoL domains among older adults, backing the notion that the better the active aging determinants, the better the QoL among older adults. Considering the broader literature, it is necessary to facilitate and encourage the active participation of older adults in physical, social, and economic activities for the maintenance and/or improvement of QoL. Identifying other possible determinants and enhancing the methods to improve those determinants may help improve the QoL among older adults.

Factors influencing parents' hesitancy to vaccinate their children aged 5-11 years old against COVID-19: results from a cross-sectional study in Malaysia.

Introduction: Vaccination programs have been rolled out across the globe to contain and mitigate the spread of the COVID-19 infection. Until recently, such programs were limited to adults and the older population, thereby limiting children from getting vaccinated. Recently, the Malaysian government rolled out vaccination for children aged 5-11 years. However, there are certain factors that might affect vaccination uptake among children. This study explores factors influencing parents' hesitancy to vaccinate children in Malaysia. Method: A nationwide online cross-sectional convenience sampling survey from April 21, 2022 to June 3, 2022 was conducted. The study used descriptive statistics to inform about vaccine hesitancy among parents. Cross-tabulation was performed to calculate the frequency and percentage of vaccine hesitancy, quality of life, e-health literacy, and the 5C psychological antecedents of vaccination among parents with children 5-11 years in Malaysia. Graphical methods were used to portray the levels of e-health literacy and levels of 5C psychological antecedents of vaccination. The study used both bi-variate and multivariate analysis to understand the relationship between vaccine hesitancy and the socio-demo-economic factors, quality of life, e-health literacy and 5C psychological antecedents. Results: Of 382 participants, almost one-third (33%) of participants reported vaccine hesitancy for their children. For 5C's psychological antecedents of vaccination, around one quarter (26.96%) reported disagreement for confidence in vaccination, almost half (52.36%) reported disagreement for vaccination complacency, three-fifths (60.99%) reported vaccination constraint, one quarter (25.92%) reported calculation antecedent, and almost one-third reported disagreement over collective responsibility antecedent (25.92%). Chi-square test revealed that gender, employment status, and parents' COVID-19 vaccination status were significantly associated (p<0.05) with vaccine hesitancy among parents. Assessing the influence of transactional e-health literacy, only the communication component contained a significant association (p<0.05). Among the 5C psychological antecedents, confidence, calculation, and collective responsibility were significantly associated (p<0.05) with vaccine hesitancy. Parents with secondary [OR: 8.80; CI: 2.44-31.79, (p<0.05)], post-secondary [OR: 5.21; CI: 2.10-13.41, (p<0.05)], and tertiary education [OR: 6.77; CI: 2.25-20.35, (p<0.05)] had significantly higher likelihood of vaccine hesitancy than those with primary education. Conclusion: Highly educated parents are more skeptical and are more likely to perceive the vaccine as unsafe and ineffective for their children. It is critical to disseminate the required information about the vaccine safety to the educated group.

Monkeypox Virus and Other Emerging Outbreaks: An Overview and Future Perspective.

Monkeypox (MPX) is a zoonotic disease caused by the MPX virus from the poxviridae family of orthopoxviruses. Typically, endemic in central and west Africa, it has now become a matter of concern since cases have been reported in non-endemic countries around mid-June 2022, especially in the European region, with the transmission not related to travel. The diagnosis is made by PCR testing of the skin lesions. Even though treatment is symptomatic, antiretrovirals, such as tecovirimat, are used in severe cases. Vaccination with second and third generation vaccines is approved for prophylaxis in high risk individuals. Unfortunately, these options of treatment and prevention are only available in high income countries at the moment. This review, through a thorough literature search of articles from 2017 onward, focuses on epidemiology, clinical manifestations, challenges, treatment, prevention and control of MPX virus and how they can be corelated with other viral outbreaks including COVID-19, Acute Hepatitis of unknown origin, Measles and Dengue, to better predict and therefore prevent its transmission. The previous COVID-19 pandemic increased the disease burden on healthcare infrastructure of low-middle income countries, therefore, this recent MPX outbreak calls for a joint effort from healthcare authorities, political figures, and NGOs to combat the disease and prevent its further spread not only in high income but also in middle- and low-income countries.

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.

"Never Judge a Book by its Cover"-The socio-cultural aspects of non-epileptic seizures in India-A case study.

"Health for All" will never be attained if sociocultural bias and pervasive hypocrisy are not eliminated. The patient mentioned in this case study had difficulty gaining access to health care for more than two decades. The seizure history was modified due to social pressure. The primary healthcare workers' ability to provide timely access to healthcare regardless of caste, religion, or gender, even in the most remote regions of the country, is of paramount importance. The patient was diagnosed with hypoparathyroidism and treated with calcium and vitamin D in high oral doses. The case also illustrates the significance of medical examination in preventing future difficulties in patients with presenile cataract.

Assessment of Health-Related Quality of Life Among Male Patients With Controlled and Uncontrolled Hypertension in Semi Urban India.

The burden of hypertension has been growing over recent decades. In addition to risk of stroke and cardiovascular disease development, data indicates that hypertension may also pose a hazard to the quality of life (QoL) of individuals. Patient reported outcomes such as QoL are often overlooked, with physicians and healthcare professionals not routinely evaluating or customizing treatments according to QoL. In this study we aimed to assess the QoL of hypertensive men (n = 500) undergoing treatment who visited a charitable hospital in Pune, India. Clinic blood pressure was determined and the Mini Cuestionario de Calidad de Vida en Hipertensión Arterial (MINICHAL) scale was used to assess the health-related (HR)-QoL of patients. More than half of the participants (62%) had uncontrolled hypertension, with a mean systolic blood pressure (BP) of 151 ± 12 mmHg and diastolic blood pressure of 87 ± 6 mmHg as compared to those with controlled blood pressure (mean systolic blood pressure 123 ± 6 mmHg and diastolic blood pressure 84 ± 5 mmHg; P < .01 for both). Predominantly the participants were overweight with body mass index (BMI) of those with uncontrolled hypertension being greater than those with controlled blood pressure (28.4 ± 3.3 kg/m2 vs 23.3 ± 2 kg/m2, P < .01). A reduced QoL was observed for participants with uncontrolled hypertension (overall score 41 ± 5) as compared to those with controlled blood pressure (35 ± 4, P < .001). This was evident on both the mental plane [2.8 ± 2.5 (95% CI = 2.3-3.1) vs 4.1 ± 3.2 (95% CI = 2.5-3.3)] and somatic domain [3.4 ± 3.2 (95% CI = 3.0-4.0) vs 4.7.4 ± 3.5 (95% CI = 3.1-4.5)] where the QoL was poorer (P < .001) for the uncontrolled hypertensive group. Poorer QoL was observed for people with uncontrolled hypertension. This study indicates that the QoL in patients with uncontrolled hypertension attending an outpatient clinic in India is worse than those with controlled blood pressure. Future studies need to be undertaken to ascertain whether an impaired QoL impacts the outcomes associated with high blood pressure.

Infant & Child Mortality in Pakistan and its Determinants: A Review.

Over the years, several developing countries have been suffering from high infant and child mortality rates, however, according to the recent statistics, Pakistan falls high on the list. Our narrative review of copious research on this topic highlights that several factors, such as complications associated with premature births, high prevalence of birth defects, lack of vaccination, unsafe deliveries, poor breastfeeding practices, complications during delivery, sudden infant death syndrome (SIDS), poor socioeconomic conditions, and a struggling healthcare system, have influenced these rates. Bearing in mind the urgency of addressing the increased infant and child mortality rate in Pakistan, multiple steps must be taken in order to prevent unnecessary deaths. An effective initiative could be spreading awareness and education among women, as a lack of education among women has been indirectly linked to increased child mortality in Pakistan across many researches conducted on the issue. Furthermore, the government should invest in healthcare by hiring more physicians and providing better supplies and improving infrastructure, especially in underdeveloped areas, to decrease child mortality due to lack of clean water and poor hygiene. Lastly, telemedicine should be made common in order to provide easy access to women who cannot visit the hospital.

Mental health, risk perception, and coping strategies among healthcare workers in Egypt during the COVID-19 pandemic.

BACKGROUND: Coronavirus disease-19 emerged in December 2019. Healthcare workers were exposed to this highly infectious virus during the pandemic and suffered several social and psychological consequences, such as anxiety, psychological distress, and burnout. OBJECTIVES: To assess the psychological distress, anxiety, depression, coping strategies, risk perception, and attitude toward interprofessional teamwork among Egyptian healthcare workers during the COVID-19 pandemic. METHODS: We conducted a cross-sectional online survey which consisted of five sections. The primary outcomes were anxiety (GAD-7), depression (PHQ-9), risk perception towards COVID-19, interprofessional teamwork attitude, and coping strategies during the Coronavirus disease-19 pandemic. The web-based questionnaire was distributed to Egyptian healthcare workers from the 20th of April 2020 to the 20th of May 2020. A snowball sampling method was used. Regression analysis was conducted to test the relationship between the socioeconomic characteristics and the previously mentioned outcomes. RESULTS: A total of 403 participants responded to the online questionnaire. The majority were females (70.5%) and within the age group of 26-40 years (77.7%), with 2-5 years of work experience (43.2%). Most participants were pharmacists (33%) and physicians (22.1%). Eighty-two participants (21%) reported moderate to severe anxiety, and 79 participants reported (19.4%) moderate to severe depressive symptoms. In the univariate model, the marital status was associated with depression (OR 0.47, 95% CI 0.28-0.78), anxiety (OR 0.52, 95% CI 0.32-0.85), and an attitude toward interprofessional teamwork (ß = -1.96 95% CI -2.72 to -1.2). Providing direct care to the patients was associated with lower anxiety symptoms (AOR 0.256, 95% CI 0.094-0.697). More severe anxiety and depressive symptoms were associated with difficulties in everyday life and the professional work environment (AOR 4.246 and 3.3, P = 0.003 and 0.01, respectively). Availability of mental health facilities at the workplace was associated with a lower risk perception towards COVID-19 (ß = -0.79, 95% CI -1.24 to -0.34) and a more positive attitude towards teamwork (ß = 2.77 95% CI 1.38-4.15). CONCLUSIONS: According to our results, the COVID-19 pandemic was associated with mild anxiety and depression among healthcare workers in Egypt, especially pharmacists and physicians. We recommend more research targeting the mental health of healthcare workers in Egypt. If proven cost-effective and needed, wide-scale mental health screening and public health campaigns can facilitate effective prevention and treatment strategies. In addition, the availability of mental health facilities at the workplace could alleviate some of the risk perception associated with health emergencies and improve interprofessional teamwork.

Digital Well-being Through the Use of Technology-A Perspective.

"No man is an island unto himself" - John Donne According to the World Health Organization, health is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity." Our healthcare industry, public behaviors, and environment have grown exponentially with digital technologies in the era of the 4th industrial revolution. Due to rapid digitalization and easy availability of the internet, we are now online round the clock on our digital devices, leaving behind digital traces/information. These digital footprints serve as an increasingly fruitful data source for social scientists, including those interested in demographic research. The collection and use of digital data (quantitative and qualitative) also present numerous statistical and computational opportunities, further motivating the development of new research approaches to address health issues. In this paper, we have described the concept of digital well-being and proposed how we can use digital information for good health.

Influence of Sociodemographic Factors and Obstetric History on Choice of Place of Delivery: A Retrospective Study Among Post-Natal Women in Ghana.

Background and Objectives: Even though Ghana has recorded an appreciable level of facility delivery compared to other countries in sub-Saharan Africa, the country still has a lot of regional and community variations in facility delivery where professional maternal health care is guaranteed. This study assessed the main factors associated with facility delivery in the Sagnarigu Municipal Assembly of the Northern Region of Ghana. Methods: Using a simple random sampling method, a retrospective community-based cross-sectional study was conducted from July 12, 2021 to October 17, 2021, among 306 postnatal women within 15 to 49 years who had delivered within the last six months. We conducted descriptive analyses, and the Pearson chi-square test of association between the sociodemographic factors and obstetrics history with the outcome variable, choice of place of birth. Lastly, significant variables in the chi-square test were entered into adjusted multivariate logistics regression to determine their association with the place of delivery. Data analysis was performed using the Statistical Package for Social Sciences version-25, with statistical significance set at a p-value of 0.05. Results: The study reported a facility delivery rate of 82%, which is slightly higher than the national target (80%). We observed that age group [AOR 2.34 (1.07-5.14)], marital status [AOR 0.31 (0.12-0.81)], ethnicity [AOR 3.78 (1.18-12.13)], and couple's occupation [AOR 24.74 (2.51-243.91)] were the significant sociodemographic factors influencing facility delivery. The number of antenatal care (ANC) attendance [AOR 8.73 (3.41 - 22.2)] and previous pregnancy complications [AOR 2.4 (1.11 - 5.7)] were the significant obstetrics factors influencing facility delivery. Conclusion and Global Health Implications: We found that specific sociodemographic and obstetric factors significantly influence the choice of place of delivery in the study area. To address this, the study recommends targeted interventions that focus on providing support and resources for women from different age groups, marital statuses, ethnicities, and occupational backgrounds to access facility delivery services. Additionally, improving ANC attendance and effectively managing pregnancy complications were highlighted as important measures to encourage facility-based deliveries.

Burnout, resilience and the quality of life among Malaysian healthcare workers during the COVID-19 pandemic.

Background: Healthcare workers have to deal with highly demanding work situations, making healthcare as one of the most challenging professions. Up to now, far too little attention has been paid to burnout, resilience and the quality of life among Malaysian healthcare workers. Therefore, this paper explores the correlation between burnout, resilience and quality of life among Malaysian healthcare workers during the COVID-19 pandemic. Method: A total of 394 healthcare workers reported their responses on Maslach Burnout Inventory questionnaire, World Health Organization Quality of Life (WHOQOL)-BREF, and Brief Resilience Scale. Respondents were contacted through convenience sampling method and targeted population constituted Malaysian healthcare workers aged 18 years and above. Results: For occupational exhaustion, about 50.5% of participants have moderate degree, 40.6% have high degree, and 8.9% have low degree of burnout. Health workers from age 25 to 35 years have lower physical health compared to health workers aged <25 years (coefficient = -0.77, p = 0.021). Similarly, healthcare workers who were working more than 10 h every day were more likely to report poor psychological health (coefficient = -2.49, p = 0.06). Positive correlation between physical and psychological health was observed. Further, a negative correlation was found between occupational exhaustion and the quality of life. Conclusion: It is important to target physical as well as psychological wellbeing of the healthcare workers. Also, it is important to understand the contribution of long working hours in declining the quality of life of the healthcare workers. Thus, allocating fixed working hours for healthcare workers would bring a much-required change.

The Past, Present, and Future of Monkeypox: A Rapid Review Regarding Prevalence and Prevention.

While monkeypox virus (MPXV) remained endemic in central and western African countries, a sudden unusual spike of global cases among non-endemic countries is an enigma for scientists. With 257 cases reported as of 26th May 2021, a multi-country outbreak of monkeypox has been declared in countries including the UK, EU/EEA states, and North America. Even though the likelihood of transmissibility of MPXV is limited compared to COVID-19, yet a coordinated multidisciplinary effort is required to prevent any further global expansion. Few appropriate responsive approaches to contain the infection could be; limiting the contact with potential animal reservoirs, isolation of confirmed cases, using PPEs to prevent human-human transmission, awareness activities, and administration of pre and post prophylactic vaccination. In this review, we have discussed the previous and current outbreaks of MPXV along with the abrupt actions that are needed to address the situation.

Knowledge, practice and attitude toward anabolic hormones and nutritional supplements among people practicing sports in the MENA region before and during COVID-19 lockdown.

Introduction: During the COVID-19 lockdown, people's lifestyles have changed including their habits and physical activities. There has been an increase in anabolic hormones and nutritional supplement use among people who regularly do exercise in the MENA region. This study aims to assess knowledge, practice, and attitude toward the use of anabolic hormones and nutritional supplements among people who regularly exercise in the Middle East and North Africa (MENA) region and to compare their exercise habits and hormones and supplements usage between before and during COVID-19 lockdown. Methods: A self-administrated online Google form survey was carried out between February 2021 and April 2021. Five thousand eight hundred forty-five participants who regularly exercise and aged ≥18 years responded to the questionnaire. The questionnaire was distributed through social media platforms and included five sections: demographic, training characters, knowledge, practice, and attitude. Results: The participants mean age was 27.4 ± 8.6 years. Males represented 58.2 % of participants. 75.3% of the study participants had not used either hormones or supplements, and about 19% used supplements only. The mean percent score for knowledge, practice, and attitude were 39.3 ± 30.5, 1.1 ± 9.5, and 21.3 ± 23.8, respectively. Level of knowledge was higher among participants who worked in the medical field or as sports coaches. The practice was higher among male participants. The most commonly used anabolic hormones and nutritional supplements were steroids and proteins with bodybuilding being the most common purpose. Internet was the main source of information and pharmacy was the main source for procuring these substances. There was a significant decrease in proteins, carbohydrates, and sports drinks used during the COVID-19 lockdown compared to before the COVID-19 lockdown, while a statistically significant increase in vitamins used during the COVID-19 lockdown compared to before COVID-19 lockdown. Discussion: In the MENA region, there has been an increase in the use of anabolic hormones and nutritional supplements. Most of the population has low knowledge of the harmful effect of uncontrolled, uninformed and unmonitored use of these substances Therefore, increasing the awareness level of participants and sports coaches should be a priority to limit the unsupervised use of hormones and supplements.