Mental health awareness of secondary schools students: Mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health

Purpose

The mental health situation among adolescents in Malaysia has reached a worrying state with the rising number of cases. Despite a significant increase in the literature on mental health, there is a lack of studies that focused on mental health awareness. Therefore, this study aimed to investigate the factors affecting Malaysian youth's mental health awareness as well as the mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health.

Methods

Self-administered questionnaires were distributed to 450 secondary school students aged 15-19 years old in Kuala Lumpur and Melaka who were recruited via purposive sampling. Data analysis was performed using SPSS and SmartPLS to obtain the descriptive analysis, measurement model, and structural model.

Results

The results indicated that mental health awareness was influenced by knowledge on mental health and attitude towards mental health. The findings also revealed that familiarity and media exposure were important determinants of knowledge on mental health, knowledge on professional help, and attitude towards mental health. Moreover, the results indicated that knowledge on mental health positively mediated the relationship between media exposure and mental health awareness. Besides, attitude towards mental health also found to play mediating roles between familiarity and mental health awareness, as well as between media exposure and mental health awareness.

Conclusion

This study contributed important knowledge to the limited literature in this contemporary domain. An effective public mental health campaign is needed to reduce the burden of disease and the cost of mental illness.

E-Wallet: A Study on Cashless Transactions Among University Students

E-wallet is an application that enable users to download payment cards using a mobile device. It is a new trend for consumers to use an e-wallet application to replace the traditional payment method. With E-wallet, a user does not need to bring cash or a credit card along with them. It enables users to make purchases in a more convenient way. Hence, this research analyses the factors that affect university students' intention to use e-wallet. The Technology Acceptance Model (TAM) serves as the theory underpinning this research A total of 140 respondents from a Malaysian private institution participated in this study. Convenience sampling was used to select samples, and respondents completed the questionnaire using a Google form and a paper and pencil approach. The questionnaire was created using a nominal scale and a five-point Likert scale. Descriptive analysis, reliability analysis, and multiple regression analyses were utilised to analyse the data in this study. Students, supervisors, academics, researchers, learning institutions, commercial organisations, and the government will all benefit immensely from the data and information gathered from this study as we will be able to examine and understand the factors that influence students' decision to use an e-Wallet for their daily financial operations. This study, however, has certain limitations as it does not reflect the complete student population in Malaysian tertiary education and only examines four variables: perceived usefulness, perceived ease of use, perceived risk, and trust. Future studies could focus on other impacting elements such as risk, complexity, pervasive technology use and tech-savvy future generations.

Obstetrics services in Malaysia: factors influencing patient loyalty

Purpose

This study aims to investigate the link of functional service quality (hospital’s reputation, administrative procedures, trustworthiness, patient-care provider relationship and waiting time), satisfaction and patient loyalty on the obstetrics services in private health-care in Malaysia.

Design/methodology/approach

A total of 419 mothers who had obtained obstetrics services had participated in this study in a continuous and coordinated manner. The study was conducted in 10 private hospitals in Malaysia throughout April 2018.

Findings

Results show that providing excellent service had increased the level of patient satisfaction and achieved patient loyalty. Patients tend to switch to other obstetricians if they are unhappy with the current services that are being offered. The findings showed that patient satisfaction was found to be mediating the relationship between hospital reputation and patient loyalty; trustworthiness and patient loyalty; patient care relationship and patient loyalty; and waiting time and patient loyalty. However, this study also found that administrative procedures do not influence patient satisfaction significantly.

Practical implications

The outcome of this study able to assist the management of the private hospitals to have more operational and practical strategies that would enhance their service quality for the betterment in their services for their patients in this competitive industry.

Originality/value

This paper provides patients’ perception of their loyalty towards obstetrics services offered by private hospitals in Malaysia.

A rapid, automated enzymatic fluorometric assay for determination of D-arabinitol in serum

A rapid enzymatic fluorometric assay for measuring D-arabinitol in serum was developed using recombinant D-arabinitol dehydrogenase from Candida albicans (rArDH). rArDH was produced in Escherichia coli and purified by dye-ligand affinity chromatography. rArDH was highly specific for D-arabinitol, cross-reacting only with xylitol (4.9%) among all polyols tested. A Cobas Fara II centrifugal autoanalyzer (Roche) was used to measure NADH fluorometrically when rArDH and NAD were added to serum extracts, and D-arabinitol concentrations were calculated from standard curves derived from pooled human serum containing known amounts of D-arabinitol. The method was precise (mean intra-assay coefficients of variation [CVs], 0.8%, and mean interassay CVs, 1.6%) and rapid (3.5 min per assay) and showed excellent recovery of added D-arabinitol in serum (mean recovery rate, 101%). The mean and median D-arabinitol/creatinine ratios were 2.74 and 2.23 microM/mg/dl, respectively, for the 11 patients with candidemia compared to 1.14 and 1.23 microM/mg/dl, respectively, for 10 healthy controls (P < 0.01). These results confirm earlier studies showing that serum D-arabinitol measurement may help to promptly diagnose invasive candidiasis. The technique shows a significant improvement in terms of accuracy, cost, simplicity, specificity, and speed compared with gas chromatography, mass spectrometry, and earlier enzymatic assays.

Can susceptibility to an antimicrobial be restored by halting its use? The case of streptomycin versus Enterobacteriaceae

To test the widespread view that resistance disappears in the absence of antimicrobial use, we tested streptomycin against 477 Enterobacteriaceae from the Royal London Hospital. Twenty per cent proved resistant although streptomycin is little used at the hospital and streptomycin resistance in gram-negative bacteria is caused by mechanisms that do not compromise the drugs that are used. Up to 70% of the observed resistance was associated with cross-resistance to spectinomycin and the presence of ant(3")-Ia, an integron-associated gene carried in Tn21-type transposons. This genetic organization may have conserved streptomycin resistance in the absence of direct selection pressure.

Susceptibility testing of Haemophilus influenzae--an international collaborative study in quality assessment

In order to compare the prevalence of antibiotic resistance in different geographical areas, it is necessary to ensure that agreement is achieved between laboratories on the assignment of strains to 'susceptible' and 'resistant' categories. An international quality assessment study, involving 15 laboratories in eight countries, was performed to investigate the standard of performance of the susceptibility testing of Haemophilus influenzae. One hundred and fifty strains of H. influenzae were distributed from the London Hospital Medical College (LHMC) to all laboratories who were asked to test the susceptibility of the strains to ampicillin, chloramphenicol, tetracycline, trimethoprim, cephalosporins and ciprofloxacin. Laboratories were also asked to provide the details of methodology to test the susceptibility. Significant discrepancy between the LHMC and the participating laboratories appeared in the detection of resistance to ampicillin (especially beta-lactamase-negative strains resistant to ampicillin) as well as the assignment of susceptibility and resistance to chloramphenicol, tetracycline and trimethoprim. Often these reflected the use of inappropriate breakpoints which led to erroneous assignment of susceptibility. Other variations including disc content, medium and supplement, inoculum as well as failure to measure zone sizes properly also led to some repeating anomalies.

Susceptibility of Haemophilus influenzae isolates with known resistance mechanisms to five cephalosporins

The in vitro activities of cefaclor, cefetamet, cefixime, cefotaxime and cefuroxime were determined against 150 isolates of Haemophilus influenzae. These included 50 ampicillin-susceptible, 50 beta-lactamase-producing and 50 intrinsically ampicillin-resistant isolates. A closer relationship was apparent between the intrinsic resistance to ampicillin and reduced susceptibility to cephalosporins. Both MIC and disc diffusion methods showed that the activities of cephalosporins were reduced against most, though not all, isolates with intrinsic resistance to ampicillin. All intrinsically ampicillin-resistant isolates should be considered resistant to all cephalosporins at the present time since the clinical significance of the reduction in susceptibility is uncertain. Amongst the five cephalosporins tested, cefaclor susceptibility may facilitate the detection of intrinsic ampicillin resistance since it predicts isolates with this type of resistance mechanism.

Effect of inoculum size on the in-vitro susceptibility to beta-lactam antibiotics of Moraxella catarrhalis isolates of different beta-lactamase types

The effect of inoculum size on the results of agar dilution MIC tests was assessed for 20 Moraxella catarrhalis isolates with BRO-1 enzyme, 20 with BRO-2 enzyme and 15 isolates that did not produce beta-lactamase. The compounds tested were ampicillin, coamoxiclav, cefaclor, cefixime and cefetamet, and the inocula were 10(4), 10(5), 10(6) and 10(7) cfu/spot. The MICs of ampicillin for BRO-1 and BRO-2 producers were consistently higher than those for non-producers at inocula of 10(7) cfu/spot but overlapped with those for non-producers at lower inocula. A small beta-lactamase-related inoculum effect was seen with coamoxiclav; small inoculum effects also occurred with cefaclor and cefixime but were not related to enzyme presence or type. MICs of cefetamet were the least affected by the inoculum size. For all the compounds, the degree of correlation between MICs and the inhibition zones observed in disk diffusion tests was independent of the inoculum used in the MIC tests. These data suggest that high inocula should be used to determine MICs of ampicillin for M. catarrhalis but that this precaution is unnecessary with the cephalosporins tested or with coamoxiclav.

Susceptibility of Moraxella catarrhalis isolates to beta-lactam antibiotics in relation to beta-lactamase pattern

Moraxella catarrhalis isolates (n = 413) were collected from 20 clinical laboratories in England and Scotland in 1991 and were examined for beta-lactamase production by isoelectric focusing. beta-Lactamases were found in 375 isolates of which, 349 (93.1%) had BRO-1 enzyme and 26 (6.9%) had BRO-2. Minor variation in electrofocusing pattern occurred within both enzyme types. Ampicillin MICs for BRO-1 producers were 25-fold higher than for non-producers, but those for BRO-2 producers were raised only four-fold. MICs of cefaclor, cefixime, loracarbef, co-amoxiclav and cefetamet generally were two- to four-fold higher for BRO-1 producers than for BRO-2 producers and enzyme non-producers. Similarly, the inhibition zones of discs containing cefaclor, cefixime, loracarbef or co-amoxiclav were smaller for BRO-1 producers than for non-producers. Amongst the compounds tested, cefetamet seemed the least affected by beta-lactamase production in both MIC and disc tests. Overall, these results indicate that BRO-1 enzyme predominates amongst M. catarrhalis isolates from the UK, as in other countries, and suggest that BRO-1 production gives slight protection against many of the newer oral beta-lactams as well as causing ampicillin resistance.

Antimicrobial resistance in Haemophilus influenzae from England and Scotland in 1991

Twenty-two laboratories in England and Scotland sent 2212 clinical isolates of Haemophilus influenzae to The London Hospital Medical College (LHMC) between 1 January and 31 March 1991. After confirmation of identity, the prevalence of resistance was determined and compared with results from previous similar surveys. beta-Lactamase was produced by 8.3% of non-capsulate isolates and 21% of 52 type b isolates; both figures were higher than the 6% and 18% figures recorded, respectively, in 1986. There was an increase in the prevalence of non-beta-lactamase-mediated diminished susceptibility to ampicillin (5.8%) and co-amoxiclav (6.1%) compared with 1986 (4%). Whereas fewer H. influenzae isolates were resistant to tetracycline (1.4%) or chloramphenicol (0.8%), there was an increase in resistance to trimethoprim (6.8%) and to sulphamethoxazole (16.9%) compared with 1986 (4.2% and 3.5% respectively). In addition, 95 isolates (4.3%) were resistant to both of these anti-folate antimicrobials. Six isolates (one type b from CSF) were resistant to all drugs tested, except for co-amoxiclav. Overall, the results demonstrated that changes have occurred in the last decade in England and Scotland, such that H. influenzae isolates are increasingly likely to be resistant to ampicillin, co-amoxiclav and co-trimoxazole.