Introduction: The patronage of online pharmacies is rapidly growing, driven by the convenience and cheaper costs of purchasing prescription drugs electronically, especially under the lockdown situation. However, there are issues regarding the quality of the prescription drugs sold online and the legitimacy of online pharmacies. The use of prescription drugs without the supervision of a licensed health care practitioner may potentially harm consumers. Objectives: This systematic review was conducted to improve the body of knowledge on three main aspects of online pharmacies: (1) type and characteristics of the online pharmacies selling drugs; (2) the quality of pharmaceutical drugs purchased online; and (3) the characteristics of consumers of online pharmacies. Methods: Based on a pre-defined search strategy, PubMed and Scopus were utilised to search articles written in the English language published between January 2009 and February 2020. Studies focusing on the sale of prescription drugs were included. The terms used for the literature search were “online pharmacy”, “internet pharmacy”, “e-pharmacy”, “prescription”, “quality”, “medication safety”, and “counterfeit medicine”. These terms were used alone and in combination with Boolean operators. The institutional webpages including the World Health Organization (WHO) and the United States Food and Drug Administration (USFDA) were also examined for any additional studies. No methodological limitations in terms of study design were applied. A standardised data collection form was used to compile the data. Results: Based on the inclusion and exclusion criteria, a total of 46 articles were eligible and included in the final analysis. There were 27 articles on types and characteristic of online pharmacies, 13 articles on the quality of prescription drugs sold from online pharmacies, and 11 articles on consumers purchasing prescription drugs from online pharmacies. Readers should note that five articles discussed both the types and characteristics of online pharmacies, and the quality of the drugs sold from the outlets. The response rate (products received out of the number of orders) ranged from 20% to 100%, whereas the proportion of consumers buying prescription drugs online ranged from 2.3% to 13%. Reasons for online purchase of prescription drugs include the difficulty of obtaining a prescription for certain medications such as opioid analgesics, cheaper cost, since the costs associated with seeing a physician to obtain a prescription are reduced, and the need to obtain drugs such as opioid analgesics and benzodiazepine for misuse. Conclusions: Almost half of the online pharmacies are not properly regulated and fraudulent issues were uncovered. To address this issue, stricter regulation by World Health Organization and implementation should be carried out together with frequent monitoring of the licensure system and pharmacy verification on every online pharmacy, this would reduce the number of illegal or illegitimate online pharmacy.

Background: A great deal of research has been carried out on the assessment of the eudaimonic perspective of psychological well-being and the hedonic perspective of subjective well-being. The Flourishing Scale (FS) has been extensively used in research and practice, as it assesses the fundamental aspects of social psychological functioning. Nevertheless, the psychometric properties of Urdu versions of eudaimonic measures, such as the FS, have not yet been ascertained. The translation and validation of the FS in the Urdu language was not available, and hence this study was planned with the aim to validate the Urdu version of the FS.Methods: We assessed the psychometric properties of the FS in a sample of adults aged 18 years and above in Pakistan (N = 130) using exploratory factor analysis based on principal component analysis with varimax rotation and confirmatory factor analysis.Results: The exploratory factor analysis confirmed the unidimensional nature of the 8-item FS. We assessed that the Urdu version of the FS showed a high internal consistency reliability (α = 0.914) with a significant intraclass correlation coefficient (ICC), p < 0.001). In our study, the Kaiser–Mayer–Olkin value was 0.915 with a chi-square test value (χ2) of 637.687, and Bartlett's test of sphericity was significant (df = 28, p < 0.001). The intraclass correlation coefficients (ICCs) at test–retest for all domains were statistically significant (p < 0.001) and showed excellent agreement for all the items. The revised confirmatory factor analysis revealed a good-fit model, but with item 8—“People respect me”—removed due to its lower factor loading.Conclusions: The findings suggest that the FS is a psychometrically sound instrument for assessing social psychological functioning among adults in Pakistan. Therefore, the validated Urdu version of the FS may be used in future studies of well-being in clinical psychology and positive psychology.

Background Blockchain technology is a part of Industry 4.0’s new Internet of Things applications: decentralized systems, distributed ledgers, and immutable and cryptographically secure technology. This technology entails a series of transaction lists with identical copies shared and retained by different groups or parties. One field where blockchain technology has tremendous potential is health care, due to the more patient-centric approach to the health care system as well as blockchain’s ability to connect disparate systems and increase the accuracy of electronic health records. Objective The aim of this study was to systematically review studies on the use of blockchain technology in health care and to analyze the characteristics of the studies that have implemented blockchain technology. Methods This study used a systematic review methodology to find literature related to the implementation aspect of blockchain technology in health care. Relevant papers were searched for using PubMed, SpringerLink, IEEE Xplore, Embase, Scopus, and EBSCOhost. A quality assessment of literature was performed on the 22 selected papers by assessing their trustworthiness and relevance. Results After full screening, 22 papers were included. A table of evidence was constructed, and the results of the selected papers were interpreted. The results of scoring for measuring the quality of the publications were obtained and interpreted. Out of 22 papers, a total of 3 (14%) high-quality papers, 9 (41%) moderate-quality papers, and 10 (45%) low-quality papers were identified. Conclusions Blockchain technology was found to be useful in real health care environments, including for the management of electronic medical records, biomedical research and education, remote patient monitoring, pharmaceutical supply chains, health insurance claims, health data analytics, and other potential areas. The main reasons for the implementation of blockchain technology in the health care sector were identified as data integrity, access control, data logging, data versioning, and nonrepudiation. The findings could help the scientific community to understand the implementation aspect of blockchain technology. The results from this study help in recognizing the accessibility and use of blockchain technology in the health care sector.

Purpose The term “Mental health literacy” is defined as knowledge and beliefs about mental disorders which aid their recognition, management or prevention. The importance of health literacy for physical health is widely studied; however, the area of mental health literacy in Pakistan has been comparatively neglected. The purpose of this paper is to address the knowledge about mental health in people living in Pakistan. Design/methodology/approach Relevant literature relating to mental health literacy was identified through various database searches. The databases searched included: PubMed, Cochrane database of Systemic Reviews, PsycINFO using the terms mental health, mental health literacy, mental health education, Pakistan. Findings Literature suggests that there is dearth of knowledge about mental illnesses and their treatment among public. This review also highlights the importance of mental health literacy among professionals working in the field of health care. In Pakistan, due to low literacy rate, a high percentage of poverty and dearth of trained professionals warrants an emendation in approaches established for attaining the goal of public health and psychiatric care. Practical implications Findings have implications for practitioners in the field of mental health care as well as designing targeted interventions for enhancing mental health literacy and help-seeking behavior in the future. Originality/value A limited understanding and lack of improvement in mental health literacy may interfere with society’s acceptance of evidence-based mental health care which may hamper the delivery of adequate mental health services to the needy.

Background: This study explored the knowledge of attitudes to and perception of consumption of antibiotics, and understanding of antibiotic resistance among students and general population across South and East Asia region. Method: A systematic review was performed through PubMed, Scopus, EBSCOhost (Medline) and EMBASE scientific databases. Cross-sectional studies aimed to investigate the knowledge of, attitude to and perception of antibiotic use as well as studies concerning the demand of antibiotics, antibiotic resistance were evaluated. Other inclusion criteria were: studies published in English prior to July 2016; survey that examined one of the 7 topics proposed by Gualano et al. (2015) in their systematic review on knowledge and attitudes about antibiotics. Results: A total of 9 studies were selected for systematic review. A lack of knowledge about antibiotics was identified. Approximately 50% of the sample mistakenly believed that antibiotics could treat viral infections which are commonly responsible for the common cold, sore throat and cough. The majority (above 60%) of the sample were compliant with completing a full course of antibiotics but unfortunately 40% of the sample still selfadministered antibiotics without prescription. Conclusion: Knowledge of, attitudes to and perceptions of antibiotic use are found to be inappropriate among the student and general public in the South and East Asia region. Although antibiotic resistance is a global issue, every country in the South and East Asia region is encouraged to take their own initiative to curb antibiotic resistance.