RESUMEN
This study aimed to assess the health literacy (HL) related knowledge, attitude, perceived barriers, and practice among primary care doctors (PCDs) in Malaysia, and to determine the factors associated with HL-related practice. A cross-sectional study was conducted using an online questionnaire. Sociodemographic and work-related details were collected. HL-related knowledge, attitude, perceived barriers, and practice were assessed. Descriptive and inferential analyses using linear regression were performed. 373 PCDs were included in the study with a mean (SD) age of 37.9 (8.1) years old. The mean (SD) HL-related knowledge, attitude, and practice scores were 6.89 (1.27), 36.33 (7.04), and 30.14 (4.7), respectively. 90.9% of the participants had good HL-related knowledge scores, and 89.5% had positive HL-related attitude. More than 80% of participants found that "time constraint to implement health literacy screening" and "lack of human resources to administer HL screening tools in their settings" were among the barriers for them to implement HL practices. PCDs of Chinese and other ethnicities had lower HL-related practice scores compared to those of Malay ethnicity (adjusted b = - 1.74; 95% CI - 2.93, - 0.54, and - 2.94; 95% CI - 5.27, - 0.60, respectively). PCDs who had heard of the term "health literacy" were associated with higher HL-related practice scores (adjusted b = 2.32; 95% CI 1.17, 3.47). Age (adjusted b = 0.10; 95% CI 0.04, 0.16) had significant linear positive relationship with HL-related practice. In conclusion, the HL-related knowledge, attitude, and practice among PCDs in Malaysia were at an acceptable level. Along with educating PCDs on HL, the perceived barriers identified need to be addressed to improve the HL-related practice and ultimately patient care.
Asunto(s)
Alfabetización en Salud , Humanos , Adulto , Malasia , Conocimientos, Actitudes y Práctica en Salud , Estudios Transversales , Encuestas y Cuestionarios , Atención Primaria de SaludRESUMEN
Integrated microfluidic biosensors enable powerful microscale analyses in biology, physics, and chemistry. However, conventional methods for fabrication of biosensors are dependent on cleanroom-based approaches requiring facilities that are expensive and are limited in access. This is especially prohibitive toward researchers in low- and middle-income countries. In this topical review, we introduce a selection of state-of-the-art, low-cost prototyping approaches of microfluidics devices and miniature sensor electronics for the fabrication of sensor devices, with focus on electrochemical biosensors. Approaches explored include xurography, cleanroom-free soft lithography, paper analytical devices, screen-printing, inkjet printing, and direct ink writing. Also reviewed are selected surface modification strategies for bio-conjugates, as well as examples of applications of low-cost microfabrication in biosensors. We also highlight several factors for consideration when selecting microfabrication methods appropriate for a project. Finally, we share our outlook on the impact of these low-cost prototyping strategies on research and development. Our goal for this review is to provide a starting point for researchers seeking to explore microfluidics and biosensors with lower entry barriers and smaller starting investment, especially ones from low resource settings.
RESUMEN
BACKGROUND: The principal cause of iron overload in patients with haematological malignancies is recurrent red cell transfusions for anaemia. The serum ferritin level reflects the iron burden in the body, in the absence of inflammation or liver disease. In Malaysia, data are lacking on the association between pre-transplant serum ferritin levels and outcome after allogeneic haemopoietic stem cell transplant. METHODS: We did a cross-sectional study using retrospective data of 106 post-allogeneic haemopoietic stem cell transplant patients (HLA-matched sibling) with haematological malignancies at Hospital Ampang to determine the relationship between pre-transplant serum ferritin levels and post-transplant outcome, post-transplant complications and survival time. Patients were divided into two groups according to the iron status: serum ferritin level >1000 µg/L (iron overload) and <1000 µg/L. RESULTS: The median age for patients was 30.5 (18-58) years. The median pre-transplantation serum ferritin level and the prevalence of pre-transplantation iron overload were 2423 (408.2-7664) µg/L and 87.5%, respectively. No significant association was found between iron status and demographic factors, type of haematological malignancy and post-transplant complications. Although insignificant, patients with iron overload had a shorter survival time (36 months) compared to those with no iron overload (40 months). There was also no significant association between the iron status and post-transplant outcome. Significant post-transplant complications associated with post-transplant outcome were the need for total parenteral nutrition (TPN) (p=0.014) and chronic graft-versus-host disease (GVHD) (p=0.008). Similarly, significant associations were found between age group (p=0.003), TPN (p=0.035) and chronic GVHD (p=0.012) with survival time using Kaplan-Meir analysis. However, after Cox regression, only age group was found to be significantly associated with survival time (p=0.014). CONCLUSION: Serum ferritin is an acute phase reactant and its levels increase in the presence of tissue necrosis and inflammation. Both these events occur in haematological malignancies. Although serum ferritin level is a non-invasive, relatively cost-effective, widely available and practical indicator of iron status, it is not specific to iron overload. Therefore, a true association between the serum ferritin level and iron burden is problematic in patients with haematological malignancies.