Supporting caregivers of people with dementia: insights from Demensia KITA mobile application online content development.

Dementia significantly impacts caregivers, particularly in low and middle-income countries where support is often inadequate. Given the gap in affordable and culturally relevant digital resources for Malaysian dementia caregivers, we developed "Demensia KITA," a mobile application (app) specifically tailored to their needs. This study utilized a theoretical framework proposed from existing literature and the "Model of Carer Stress and Burden". This paper discusses our app content development, highlighting key findings and challenges. To assess caregivers' needs, the Nominal Group Technique (NGT) with five dementia caregivers was conducted, followed by a Focus Group Discussion (FGD) with eight medical professionals. Both sessions were conducted online via Google Meet. In the NGT, ideas were generated, organized, prioritized, reviewed, and refined by medical professionals in the FGD. Content relevant to addressing the complexities of dementia caregiving was then discussed. Topics were either adapted from established modules or newly developed from credible sources. Subsequently, these were organized into modules and themes, and subsequently underwent expert validation. From the NGT, three key domains emerged: Knowledge, Services, and Support. These were further organized into two modules: 'Patient Care for Caregivers' and 'Caregiver Wellbeing'. Within these, twelve sub-modules were identified, covering a range of topics including basic knowledge on dementia, patient care, nutritional management, oral and dental care, simple exercises, daily activity and memory rehabilitation, service directories, support groups, emotional and stress management, welfare assistance, and daily motivation. This framework was developed to address the specific needs of dementia caregivers in terms of psychoeducation, psychosocial and caregiving skills, incorporating expert opinions in the field. This study corroborates the feasibility of online methods for mobile health app content development and encourages similar research. Future studies should evaluate Demensia KITA's effectiveness in alleviating caregiver burden across all regions, assess users' acceptance, and ensure it meets the evolving needs of Malaysian caregivers with regular updates.

Evaluation of awareness and performance towards COVID-related disinfectant use: a comparative study between Jordan and United Arab Emirates.

BACKGROUND: The World Health Organization recommended the use of chemical-based disinfectants as an effective prevention of the COVID-19 pandemic. However, calls for poisoning were reported in several medical centers. The widespread use of chemical-based disinfectants as a preventive measure during the COVID-19 pandemic has underscored potential gaps in community awareness and performance, posing health risks. This study evaluates and compares levels of awareness and performance regarding the safe use of disinfectants in Jordan and UAE. METHODS: The study was conducted between October 2022 and June 2023 via an online questionnaire. Data of respondents from Jordan (n = 828) and UAE (n = 619) were analyzed using SPSS. ANOVA, Mann-Whitney, and Kruskal-Wallis tests evaluated significant differences in awareness and performance levels across different demographic groups in Jordan/UAE and between them. Spearman's correlation test examined the correlation between awareness and performance among respondents. Multinomial logistic regression analysis explored associations between various variables and awareness/performance levels within each population. RESULTS: Findings reveal weak awareness (72.4% and 9.03% in UAE and Jordan, respectively) and moderate performance level (98.8% in UAE and Jordan), with a weak correlation (UAE, rho = 0.093; Jordan, rho = 0.164) observed between the two countries (P < 0.05). Multinomial logistic regression analysis indicates gender-related associations with awareness levels and education-related associations with performance levels. CONCLUSIONS: The study emphasizes the urgent need for awareness campaigns and workshops to promote safer disinfectant practices to develop effective interventions aligning with sustainable development goals.

Robotic assisted surgery in the United Arab Emirates: healthcare experts' perceptions.

The adoption of Robotic Assisted Surgery (RAS) has grown around the world. This is also the case in the Middle East and Gulf region and specifically to the United Arab Emirates (UAE). The perception of RAS has been studied in the USA, Europe, and Canada. However, there is limited research on the perception of RAS in the UAE. The study aims to examine the perception of RAS among healthcare experts in the UAE and potential challenges. This qualitative study is based on interviewing healthcare experts in the UAE. Most of the study participants were clinicians and surgeons. In the UAE, RAS is adopted in general surgery, urology, brain surgery, and obstetrics and gynecology. Our findings show that healthcare experts have positive perceptions of RAS. The cost and lack of RAS training program are considered as challenges to adopting RAS in healthcare practices. More research is encouraged to examine perception variations with surgical practices in the UAE, Gulf and the Middle East.

Development and Usability Assessment of a Mobile App (Demensia KITA) to Support Dementia Caregivers in Malaysia: A Study Protocol.

The impact of dementia on caregivers is complex and multi-dimensional. In low- and middle-income settings, caregivers are often left without adequate support, despite their multiple needs. These include health information, caregiving skills, social and emotional support, and access to local resources-all of which can be partially fulfilled by technology. In recent years, mobile apps have emerged and proven useful for caregivers. We found a few existing apps suitable for Malaysian users in terms of affordability and cultural and linguistic compatibility. Our study aims to design a mobile app that suits dementia caregivers in Malaysia and consists of three phases. Phase I is content development that employs Focus Group Discussion (FGD) and Nominal Group Technique (NGT) involving field experts. Phase II comprises a mobile app (Demensia KITA) designed in collaboration with a software developer specializing in mobile health apps. Phase III entails testing the usability of the app using the Malay version of the mHealth App Usability Questionnaire (M-MAUQ). This study protocol elaborates on the rigorous steps of designing a mobile app and testing its usability, along with anticipated challenges. Our protocol will provide insight for future researchers, healthcare providers, and policymakers and pave the way for better use of digital technology in the field of aging and caregiving.

A review of the environmental implications of the COVID-19 pandemic in the United Arab Emirates.

This paper reviews the environmental implications associated with the COVID-19 pandemic at the individual and community levels in the UAE. The positive effects emanating from the pandemic include improved air quality and reduced contamination of public spaces with pollutants. On the other hand, far-reaching negative effects include poor disposal of medical plastic waste and facemasks and the rise in unhygienic health practices amongst residents of UAE. The long-term ecological implications of the pandemic are still not well understood. The findings shed the light on the importance of addressing the consequences of the COVID-19 pandemic through preventative policies and strategies for better environmental health and readiness for future crises. Future research could assess the long-term environmental conse-quences of the pandemic on the UAE.

Establishment of differential model of recovery treatment for children with minor brain injury and mental disorder syndrome.

The paper established a differential equation model for 194 children with ADHD in outpatient clinics from September 2019 to August 2020 and compiled a children's clinical diagnostic interview scale based on the fourth edition of the American Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅳ). The CDIS standard divides it into three phenotypes: attention deficit predominant (ADHD-I), hyperactivity-impulsive predominance (ADHD-HI) and mixed (ADHD-C). The results of the study showed that the distribution of subtypes in the study cases: ADHD-I accounted for 45.9% (89 cases), ADHD-HI accounted for 7.7% (15 cases), ADHD-C accounted for 46.4% (90 cases); ADHD-C: ADHD-I is 1:1. CDIS scale total score: 194 cases of attention deficit symptoms were (7.2 ± 1.4) points, and hyperactivity-impulsive symptoms were (5.4 ± 2.2) points. The frequency of attention deficit symptoms in 194 cases was (79.5 ± 2.9) %, and the frequency of hyperactivity-impulsive symptoms was (59.8 ± 3.5) %. Therefore, it can be concluded that DSM-IV defines three phenotypes in this sample. The proportion of ADHD-HI is low, and the proportion of ADHD-I and ADHD-C is similar; age influences the phenotype distribution.

24-Epibrasinolide Modulates the Vase Life of Lisianthus Cut Flowers by Modulating ACC Oxidase Enzyme Activity and Physiological Responses.

Ethylene is the most important factor playing roles in senescence and deterioration of harvested crops including cut flowers. Brassinosteroids (BRs), as natural phytohormones, have been reported to differently modulate ethylene production and related senescence processes in different crops. This study was carried out to determine the effects of different levels of 24-epibrassinolide (EBL) on ACC oxidase enzyme activity, the final enzyme in ethylene biosynthesis pathway, vase life, and senescence rate in lisianthus cut flowers. Harvested flowers were treated with EBL (at 0, 3, 6, and 9 µmol/L) and kept at 25 °C for 15 days. The ACC oxidase activity, water absorption, malondialdehyde (MDA) production and vase solution absorption rates, chlorophyll and anthocyanin contents, and the vase life of the flowers were evaluated during and at the end of storage. EBL at 3 µmol/L significantly (p ≤ 0.01) enhanced the flower vase life by decreasing the ACC oxidase activity, MDA production and senescence rates, and enhancing chlorophyll and anthocyanin biosynthesis and accumulation, relative water content, and vase solution absorption rates. By increasing the concentration, EBL negatively affected the flower vase life and postharvest quality probably via enhancing the ACC oxidase enzyme activity and subsequent ethylene production. EBL at 6 and 9 µmol/L and in a concentration dependent manner, enhanced the ACC oxidase activity and MDA production rate and decreased chlorophyll and anthocyanin accumulation and water absorption rate. The results indicate that the effects of brassinosteroids on ethylene production and physiology of lisianthus cut flowers is highly dose dependent.

Dealing with pollution from conflict: Analysis of discourses around the 2006 Lebanon oil spill.

In July 2006 a war between Lebanon and Israel resulted in severe environmental damage in Lebanon from Israeli bombing raids. An attack on the Lebanese Jiyyeh Power Plant released 15,000 tons of heavy fuel oil into the Mediterranean Sea. Remarkably, a clean-up operation was effected despite a continued state of war and lack of capacity in the Lebanese government. Civil society environmentalists played a key role in dealing with the pollution and complying with pollution-control legislation. In this study we use Q-methodology to analyse discourses on the effectiveness of pollution legislation during times of conflict using the Jiyyeh oil spill as an example. We interviewed 35 people from eight different stakeholder groups involved in environmental issues. Five distinct discourses were generated covering compensation schemes, need for new legislation, role of stakeholders during wartime and strengthening government ministries.