Health-related quality of life in osteoporosis: a systematic review of measurement properties of the QUALEFFO-41

The 41-item Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) is a widely used and freely available patient-reported outcome measure (PROM). However, data on its reliability, validity, and responsiveness remain unclear. Therefore, this study aimed to systematically review the measurement properties of the QUALEFFO-41. A systematic search of MEDLINE, EBSCOhost, and Cochrane Library from their inception up to December 2022 was performed. Data were extracted, and the methodological quality of each measurement property was evaluated according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. The evidence of the measurement properties was rated against the updated criteria for good measurement properties, and the quality of evidence was graded using the modified GRADE approach. A total of 99 articles were identified, of which eight studies were included in the review. The QUALEFFO-41 is categorized as B as it demonstrated moderate quality evidence for sufficient content validity, moderate-to-high quality evidence for sufficient hypothesis testing for construct validity (except for the social function domain for convergent validity), and very low-quality evidence for sufficient responsiveness. For structural validity and internal consistency, only the domains of pain and general health perception were sufficient with low-quality evidence. For reliability, only the domain of physical function was sufficient with low-quality evidence. None of the studies reported measurement error, cross-cultural validity, and criterion validity. The QUALEFFO-41 may be a promising, valid, and reliable PROM to assess HRQoL in osteoporosis patients with vertebral fractures. However, future studies must focus on good methodological quality to strengthen the evidence of measurement properties, especially on structural validity, reliability, responsiveness, and cross-cultural validity. The systematic review evaluated the measurement properties of the QUALEFFO-41 questionnaire for assessing Health-Related Quality of Life (HRQoL) in osteoporosis patients. The review found moderate-to-high-quality evidence for construct validity but limited evidence for responsiveness and other properties. Future studies should focus on strengthening the evidence, particularly for structural validity, reliability, responsiveness, and cross-cultural validity. The QUALEFFO-41 shows promise as a valid and reliable PROM for HRQoL assessment in osteoporosis patients.

Facilitators and barriers of digital health technologies implementation in hospital settings in lower-income and middle-income countries since the COVID-19 pandemic: a scoping review protocol

INTRODUCTION

The implementation of digital health technologies (DHTs) in hospitals worldwide has been uneven since the COVID-19 pandemic. Ambiguity in defining the landscape of DHTs adds to the complexity of this process. To address these challenges, this scoping review aims to identify the facilitators and barriers of implementing DHTs in hospitals in lower-income and middle-income countries (LMIC) since COVID-19, describe the DHTs that have been adopted in hospital settings in LMIC during this period, and develop a comprehensive classification framework to define the landscape of DHTs implemented in LMIC.

METHODS AND ANALYSIS

We will conduct a systematic search in PubMed, Scopus, Web of Science and grey literature. Descriptive statistics will be used to report the characteristics of included studies. The facilitators and barriers to DHTs implementation, gathered from both quantitative and qualitative data, will be synthesised using a parallel-results convergent synthesis design. A thematic analysis, employing an inductive approach, will be conducted to categorise these facilitators and barriers into coherent themes. Additionally, we will identify and categorise all available DHTs based on their equipment types and methods of operation to develop an innovative classification framework.

ETHICS AND DISSEMINATION

Formal ethical approval is not required, as primary data collection is not involved in this study. The findings will be disseminated through peer-reviewed publications, conference presentations and meetings with key stakeholders and partners in the field of digital health.

COVID-19 pandemic and the changing views of mobility: the case of Nepal-Malaysia migration corridor

For decades, Malaysia has been heavily dependent on unskilled and temporarily contracted migrant workers to fulfil labour gaps in the country. While Malaysia's economy continues to rely on migrant workers, the COVID-19 pandemic has further aggravated their precarious working and living conditions. In-depth interviews with Nepali migrant workers and community leaders in Malaysia and Nepal in 2021 revealed the incidence of labour rights violations, compounded by the lack of access to justice and effective remedies. Besides, workers are allegedly no longer benefiting from the competitive wages, subsequently limiting the value of their remittance to Nepal. We argue that these incidents serve as the drivers of the changing views of mobility, eventually influencing the emigration environment in which the social construction of migration exists in Nepal. This study examines the migratory realities in the Nepal-Malaysia migration corridor during the pandemic, subsequently contributing to current debate on the aspiration-ability model as a class of research.

Attitude Towards Suicide and Help-Seeking Behavior Among Medical Undergraduates in a Malaysian University

OBJECTIVE

The attitude of medical personnel towards suicide may influence the outcome of suicidal-patients management. This study aimed to determine the attitudes of medical undergraduates towards suicide and its association with their help-seeking behavior.

METHODS

A cross-sectional study involving 290 medical undergraduates was conducted in a Malaysian university. The questionnaires on the attitude towards suicide and general help-seeking behavior were used as research instruments.

RESULTS

The mean age of the participants was 22.4 years. Participants who did psychiatry posting indicated a greater tendency to agree on suicide as a way of communication (p = 0.008) than those who did not. Participants previously diagnosed with a psychiatric illness indicated a greater ability to understand and accept suicide (p < 0.001) as well as a greater tendency to agree on the normality of suicide (p = 0.019) than those without a previous diagnosis. Those who attended a suicide prevention program also indicated a greater tendency to agree that loneliness and avoidance could be triggers to suicide (p = 0.037) than those who did not. No correlation was found between the "attitude towards suicide" and "general help-seeking behavior" variable.

CONCLUSION

Education programs in suicide prevention and management need to be incorporated early into the undergraduate medical curriculum to cultivate a more positive attitude towards suicide and help-seeking behavior.

The determinant factors for macroinvertebrate assemblages in a recreational river in Negeri Sembilan, Malaysia

The determinant factors for macroinvertebrate assemblages in river ecosystems are varied and are unique and specific to the type of macroinvertebrate family. This study aims to assess the determinant factors for macroinvertebrate assemblages in a recreational river. The study was conducted on the Ulu Bendul River, Negeri Sembilan, Malaysia. A total of ten sampling stations were selected. The research methodology included (1) water quality measurement, (2) habitat characterization, and (3) macroinvertebrate identification and distribution analysis. The statistical analysis used in this study was canonical correspondence analysis (CCA) to represent the relationship between the environmental factors and macroinvertebrate assemblages in the recreational river. This study found that most of the families of macroinvertebrates were very dependent on the temperature, DO, NH₃-N, type of riverbed, etc. All of these factors are important for the survival of the particular type of macroinvertebrate, plus they are also important for selecting egg-laying areas and providing suitable conditions for the larvae to grow. This study advises that improved landscape design for watershed management be implemented in order to enhance water quality and physical habitats, and hence the protection and recovery of the macroinvertebrate biodiversity.

Optimization of mycoremediation treatment for the chemical oxygen demand (COD) and ammonia nitrogen (AN) removal from domestic effluent using wild-Serbian Ganoderma lucidum (WSGL)

The fungi-based technology, wild-Serbian Ganoderma lucidum (WSGL) as myco-alternative to existing conventional microbial-based wastewater treatment is introduced in this study as a potential alternative treatment. The mycoremediation is highly persistent for its capability to oxidatively breakdown pollutant substrates and widely researched for its medicinal properties. Utilizing the nonhazardous properties and high degradation performance of WSGL, this research aims to optimize mycoremediation treatment design for chemical oxygen demand (COD) and ammonia nitrogen (AN) removal in domestic wastewater based on proposed Model 1 (temperature and treatment time) and Model 2 (volume of pellet and treatment time) via response surface methodology (RSM). Combined process variables were temperature (0C) (Model 1) and the volume of mycelial pellets (%) (Model 2) against treatment time (hour). Response variables for these two sets of central composite design (CCD) were the removal efficiencies of COD (%) and AN (%). The regression line fitted well with the data with R2 values of 0.9840 (Model 1-COD), 0.9477 (Model 1-AN), 0.9988 (Model 2-COD), and 0.9990 (Model 2-AN). The lack of fit test gives the highest value of sum of squares equal to 9494.91 (Model 1-COD), 9701.68 (Model 1-AN), 23786.55 (Model 2-COD), and 13357.02 (Model 2-AN), with probability F values less than 0.05 showing significant models. The optimized temperature for Model 1 was at 25 °C within 24 h of treatment time with 95.1% COD and 96.3% AN removals. The optimized condition (temperature) in Model 1 was further studied in Model 2. The optimized volume of pellet for Model 2 was 0.25% in 24-h treatment time with 76.0% COD and 78.4% AN removals. Overall, the ascended sequence of high volume of pellet considered in Model 2 will slow down the degradation process. The best fit volume of pellet with maximum degradation of COD and AN is equivalent to 0.1% at 25 °C in 24 h. The high performance achieved demonstrates that the mycoremediation of G. lucidum is highly potential as part of the wastewater treatment system in treating domestic wastewater of high organic loadings.