@mastersthesis{mmedsc-2023-kong, title = {Development and Usability Testing of a Mobile Diet Application and Assessment of Diet Quality among Malaysian Adults.}, author = {Nadine Kong}, year = {2023}, date = {2023-12-20}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya}, abstract = {Diet monitoring has been linked to improved eating habits and positive health outcomes. However, traditional methods place a high burden on both participants and researchers through pen and paper recordings, and manual nutrient coding respectively. The digitalization of dietary monitoring has greatly reduced these barriers. This study aims to develop and test the usability of a diet application with novel food recognition system and assess diet quality among adults in a public university setting. The study was conducted in four phases. The first three phases focused on gathering information, planning and determining features, and development of MyDietCam. Phase 4a involved the participation of 31 individuals, who engaged in real-world food recognition testing, evaluating the AI’s accuracy. In Phase 4b, 65 participants from another local university utilised MyDietCam for three days to assess the usability of the app while their diet quality scores were calculated using the Malaysian Healthy Eating Index (M-HEI). The final iteration of MyDietCam incorporates three primary components: food logging, goal setting, and nutrient analyses. The AI revealed a 72% recognition accuracy in real world scenarios. Usability testing yielded a score of 5.15 out of a possible 7, signifying acceptable usability. However, the M-HEI scores indicated poor diet quality, with an average score of 42.54. The development of MyDietCam demonstrated its usability and potential for facilitating dietary monitoring. Future work should focus on addressing the issues raised before testing the effectiveness of prolonged app usage on improving diet quality and other health outcomes.}, type = {masterthesis}, note = {Master of Medical Science (Research) Dissertation}, keywords = {}, pubstate = {published}, tppubtype = {mastersthesis} } @phdthesis{drph-2023-abhishek, title = {The Effect of Community-Based Intervention on Dengue Awareness and Prevention Among Urban Poor Community in Delhi, India}, author = {Abhishek Shivanand Lachyan Rafdzah Ahmad Zaki Nasrin Aghamohammadi Bratati Banerjee}, year = {2023}, date = {2023-07-10}, urldate = {2023-07-10}, abstract = {Dengue contributes significantly to the disease burden of vector-borne diseases worldwide. Vector control is considered the most common approach to controlling dengue. Nevertheless, this can be successful with community participation, and increasing community awareness through engagement will positively impact the number of incidents. Hence, it becomes essential to investigate the community’s perception of disease and control approaches. This study aims to see how well an intervention program for preventing dengue fever in India’s poor urban communities works with the housing index. This research is based on the Health Belief Model (HBM), a theoretical framework for preventing problems and coming up with ways to help people with problems. This study is almost an experiment, and 314 people from New Delhi’s Sanjay Colony are participating. There are two groups in the study. Among the 314 participants, 157 were assigned to the control group, and 157 were given to the intervention group of the Sanjay colony. This study was conducted for 12 months, from August 2020 to September 2021. A pre-tested questionnaire was used to get baseline information from both the control and interventional groups. The outcomes were changes in house index (HI) from baseline to post-intervention 1 \& 2, a three-month final follow-up, and a comparison between the two groups. The intervention group got a program to prevent dengue fever that taught them about the disease, how to take care of their health, and how to take care of their environment twice, one month apart. Post-intervention data-1 and post-intervention data-2 were collected after completing both intervention programs. The outcomes were changes in house index (HI) from baseline to post-intervention and three-month follow-up, along with a comparison between the two groups. We collected final follow-up data from both groups three months after the baseline. Overall, there was a statistically significant difference seen in the values between the groups (p \<0.01) for Total Score for Disease caused by mosquitoes, with higher values in the intervention group at baseline to final follow-up (3 months) and Total Score (TS) knowledge, with higher values in the intervention group (p\<0.001). Total score (TS) attitude had higher values in the interventional group (p \<0.001), as did total score (TS) practices (p \<0.001). There were significant changes in how people knew what caused dengue, how they understood the symptoms, and how mosquitoes behaved regarding breeding and biting. Compared to the regular program, there was a rise in the number of participants who participated in the intervention program. Both for post-intervention Data-2 and the final follow-up, the House Index (HI) decreased for the intervention group (p \<0.05). The impact of the intervention on Knowledge, Attitude, and Practice showed crucial significance in the prevention of dengue fever. The Health Belief Model-based Dengue Prevention Program effectively lowers HI and improves people’s Knowledge and preventive actions in New Delhi’s poor urban neighbourhoods.}, note = {The thesis was part of Dr Abhishek Shivanand Lachyan Doctor of Public Health project. He was supervised by Assoc. Prof. Dr Rafdzah Ahmad Zaki and Associate Prof Dr Nasrin Aghamohammadi from the Department, and Professor Dr Bratati Banerjee from the Department of Community Medicine, Maulana Azad Medical College, New Delhi.}, keywords = {Community-Based, Dengue, Housing, Intervention, Prevention}, pubstate = {published}, tppubtype = {phdthesis} } @phdthesis{Abuobieda-DrPH, title = {The Effect of Framedtext-messaging on vaccination uptake among healthcare personnel in Primary Health Care in Saudi Arabia: Randomised Control Trial}, author = {Abuobieda Khogali Abdalla Abdalrouf}, year = {2022}, date = {2022-03-09}, urldate = {2022-03-09}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {Background: Suboptimal vaccination coverage of healthcare personnel (HCP) is a global issue. This study was intended to estimate the vaccination coverage and its association with the perceived threat of vaccine-preventable diseases (VPDs) and vaccination effectiveness among HCP in the primary care setting. It was also intended to assess the effectiveness of framed Short Messages Service (SMS) to improve vaccination uptake among HCP. Methodology: The study was conducted in two sequential phases in the Prince Sultan Military Medical City, Riyadh, Saudi Arabia. Phase-I, a cross-sectional study, was based on the constructs of the Health Beliefs Model (HBM). The data were collected from 469 HCP using self-administered validated questionnaires. The randomised control trial (RCT) phase was conducted between October 2018 and March 2019. Three hundred and forty-three unvaccinated HCP were randomised into three arms: HCP receiving a loss framed-SMS, HCP receiving a gain framed-SMS, and control group. The vaccination uptake after receiving a loss or gain framed-SMS was estimated. Results: Only 5.8% of the HCP had completed their vaccinations. The mean perceived VPDs threat score and vaccination effectiveness score of HCP-influenced by vaccine-promoting cues were significantly higher by 3.06 (95% Confidence Interval (95%CI): 1.46, 4.66), and 3.05 (95%CI: 1.39, 4.7), respectively. Vaccine-promoting cues were independently associated with the perceived vaccination effectiveness with an adjusted mean difference of 1.61 (95%CI: 0.23, 3.00; P=0.022). The mean of perceived VPDs threat score and vaccination effectiveness of HCP who completed vaccination against bloodborne and airborne VPDs significantly exceeded that of unvaccinated ones by 5.85 (95%CI: 3.86, 7.85) and 5.29 (95%CI: 3.38, 7.20), respectively. Vaccination completeness was independently associated with perceived threat (Odds Ratio}, note = {DrPH Thesis}, keywords = {Health Beliefs Model, Healthcare Personnel, Short Message Service, Vaccination, Vaccine-Preventable Diseases}, pubstate = {published}, tppubtype = {phdthesis} } @article{RN386, title = {The Effectiveness of Educational Intervention in Improving Primary Health-Care Service Providers' Knowledge, Identification, and Management of Elder Abuse and Neglect: A Systematic Review}, author = {F. H. M. Mydin and C. W. Yuen and S. Othman}, doi = {10.1177/1524838019889359}, issn = {1524-8380}, year = {2021}, date = {2021-01-01}, journal = {Trauma Violence Abuse}, volume = {22}, number = {4}, pages = {944-960}, abstract = {Elder abuse and neglect (EAN) occurrence is expected to increase in many countries due to rapidly aging populations, yet it is still unrecognized and underreported. Gaps were identified in the knowledge and skills to intervene EAN among health-care service providers. It is still unclear whether educating health-care service providers on EAN improve the identification and management of EAN cases. A systematic review was conducted on the effectiveness of educational intervention designed to improve primary health-care service providers' (PHSPs) knowledge, attitude, and practice in managing EAN cases. We performed a comprehensive and systematic search for original studies in the following major electronic databases (ScienceDirect, PubMed, EMBASE, and CINAHL) and specialist registers (Cochrane Central Controlled Trials Register) with a set of search terms. Studies included were randomized controlled trials (RCTs) and observational studies on EAN education intervention that aimed to improve knowledge, attitude, and management skills of the PHSPs. There were no publication period restrictions until June 2018 and written in English. Overall, three RCTs and 10 observational studies were selected. These studies were grouped based on the type of the study, methodological quality (six moderate risk of bias and seven serious risk of bias), and the type of educational intervention (seven face-to-face educational intervention, two educational videos, two simulation-based training, and two online educational training). The education programs in the selected studies range from brief didactic to experiential learning. EAN educational intervention among primary care service providers potentially result in increasing awareness and knowledge on EAN. However, there is a lack of evidence on the changes of attitude and practice.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN245, title = {Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight}, author = {NCD Risk Factor Collaboration (NCD-RisC)}, doi = {10.7554/eLife.60060}, issn = {2050-084x}, year = {2021}, date = {2021-01-01}, journal = {Elife}, volume = {10}, abstract = {From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN244, title = {Insights on emotional distress following cancer, sources of support and the unmet needs in a setting with limited supportive care services for people living with cancer}, author = {H. D. A. Rajah and C. M. H. Chan and Y. C. Kong and L. P. Wong and R. S. Bustaman and G. F. Ho and K. M. Lai and C. H. Yip and N. Bhoo-Pathy}, doi = {10.1007/s00520-021-06148-2}, issn = {0941-4355}, year = {2021}, date = {2021-01-01}, journal = {Support Care Cancer}, volume = {29}, number = {10}, pages = {5811-5819}, abstract = {INTRODUCTION: Delivery of supportive cancer care is often deemed a low priority in resource-limited settings. We aimed to explore the sources of emotional distress, the related support and the unmet needs of cancer survivors in Malaysia, where cancer survivorship services are presently limited. METHOD: Twenty focus group discussions were conducted with 102 cancer patients from diverse ethnic and socioeconomic backgrounds. Thematic analyses were performed. RESULTS: Patient narratives suggested that emotional distress arose from direct and indirect stressors. Direct stressors comprised physical and cognitive side effects of cancer surgery and therapies, and fear of recurrence. Indirect stressors included worry over dependent family members, financial distress following cancer, working with cancer and lack of practical support at home. Distress from altered physical appearances, fear of recurrence and lack of practical support were mainly raised by women, implying that men and women may have disproportionate emotional needs. Emotional support largely came from informal sources including self, family, friends and religion. While formal emotional support from professional counsellors and cancer support groups was acknowledged as important, it appeared to be largely lacking. Unmet needs in coping with fear of recurrence, financial distress, workplace discrimination and household chores were particularly highlighted. CONCLUSION: The unmet needs revealed in this study provide insights to initiate actionable changes to improve the emotional wellbeing of people living with cancer in settings where cancer survivorship services are still in its infancy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN166, title = {The epidemiology of COVID-19 in ten Southeast Asian countries}, author = {S. Rampal and L. Rampal and V. J. Jayaraj and A. Pramanick and M. Choolani and B. S. Liew and A. Gosavi and S. Arj-Ong Vallibhakara}, issn = {0300-5283 (Print) 0300-5283}, year = {2021}, date = {2021-01-01}, journal = {Med J Malaysia}, volume = {76}, number = {6}, pages = {783-791}, abstract = {INTRODUCTION: Periodic benchmarking of the epidemiology of COVID-19 in the Association of Southeast Asian Nations (ASEAN) countries is critical for the continuous understanding of the transmission and control of COVID-19 in the region. The incidence, mortality, testing and vaccination rates within the ASEAN region from 1 January 2020 to 15 October 2021 is analysed in this paper. METHODS: COVID-19 data on cases, deaths, testing, and vaccinations were extracted from the Our World in Data (OWID) COVID-19 data repository for all the ten ASEAN countries. Comparative time-trends of the epidemiology of COVID-19 using the incidence rate, cumulative case fatality rate (CFR), delay-adjusted case fatality rate, cumulative mortality rate (MR), test positivity rate (TPR), cumulative testing rate (TR) and vaccination rate was carried out. RESULTS: Over the study period, a total of 12,720,661 cases and 271,475 deaths was reported within the ASEAN region. Trends of daily per capita cases were observed to peak between July and September 2021 for the ASEAN region. The cumulative case fatality rate (CFR) in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, was of 0.9% (N=68), 2.2% (N=2,610), 3.5% (N=142,889), 0.1% (N=36), 1.2% (N=27,700), 4.0% (N=18,297), 1.6% (N=40,424), 0.1% (N=215), 1.7% (N=18,123), and 2.6% (N=21,043), respectively. CFR was consistently highest between January-June 2020. The cumulative mortality rate (MR) was 9.5, 13.7, 51.4, 0.2, 80.3, 32.4, 34.5, 1.6, 23.9 and 19.7 per 100,000 population, respectively. The cumulative test positivity rate (TPR) was 8.4%, 16.9%, 4.6%, 7.5%, 11.1%, 12.9%, 0.5%, 11.7%, and 3.6%, with the cumulative testing rate (TR) at 25.0, 90.1, 27.4, 917.7, 75.8, 177.8, 3303.3, 195.2, and 224.9 tests per 1,000 population in Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, respectively. The percentage of population that completed vaccinations (VR) was 44.5%, 65.3%, 18.5%, 28.2%, 61.8%, 6.8%, 19.2%, 76.8%, 22.7%, and 10% in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, respectively. CONCLUSION: In 2020, most countries in ASEAN had higher case fatality rates but lower mortalities per population when compared to the third quarter of 2021 where higher mortalities per population were observed. Low testing rates have been one of the factors leading to high test positivity rates. Slow initiation of vaccination programs was found to be the key factor leading to high incidence and case fatality rate in most countries in ASEAN. Effective public health measures were able to interrupt the transmission of this novel virus to some extent. Increasing preparedness capacity within the ASEAN region is critical to ensure that any future similar outbreaks can be dealt with collectively.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN203, title = {Economic Burden of Stroke Disease: A Systematic Review}, author = {T. N. Rochmah and I. T. Rahmawati and M. Dahlui and W. Budiarto and N. Bilqis}, doi = {10.3390/ijerph18147552}, issn = {1661-7827 (Print) 1660-4601}, year = {2021}, date = {2021-01-01}, journal = {Int J Environ Res Public Health}, volume = {18}, number = {14}, abstract = {Globally, one of the main causes of non-communicable disease as a cause of death every year is stroke. The objective of this study was to analyze the burden in consequence of stroke. This research used a systematic review method. Furthermore, a search for articles was carried out in June-July 2020. Four databases were used to search articles from 2015 to 2020. Eligible studies were identified, analyzed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were prospective cost studies, retrospective cost studies, database analysis, mathematical models, surveys, and COI studies that assess burden of stroke in primary and referral healthcare (hospital-based). The results showed that from four databases, 9270 articles were obtained, and 13 articles were qualified. A total of 9270 articles had the identified search keywords, but only 13 articles met the set criteria for inclusion. The criteria for inclusion were stroke patients, the economic burden of stroke disease based on cost of illness method, which is approximately equal to USD 1809.51-325,108.84 (direct costs 86.2%, and indirect costs 13.8%). Those that used the health expenditure method did not present the total cost; instead, only either direct or indirect cost of health expenditure were reported. For most hospital admissions due to stroke, LOS (length of stay) was the dominant cost. The high economic burden to manage stroke justifies the promotion and preventive efforts by the policymakers and motivates the practice of healthy lifestyles by the people.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN223, title = {Workplace Bullying Among Junior Doctors in Malaysia: A Multicentre Cross-Sectional Study}, author = {E. Z. Samsudin and M. Isahak and S. Rampal and I. Rosnah and M. I. Zakaria}, doi = {10.21315/mjms2021.28.2.13}, issn = {1394-195X (Print) 1394-195x}, year = {2021}, date = {2021-01-01}, journal = {Malays J Med Sci}, volume = {28}, number = {2}, pages = {142-156}, abstract = {BACKGROUND: Research suggests that junior doctors often experience workplace bullying, which may have adverse impacts on medical training and delivery of quality healthcare. However, evidence among local population has not been established. The present study aims to examine the prevalence of workplace bullying among Malaysian junior doctors and explore its associated sociodemographic and employment factors. METHODS: A multicentre cross-sectional study was conducted in 12 government hospitals accredited for housemanship training within the central zone of Malaysia. The study included a total of 1,074 house officers who had been working for at least 6 months in various housemanship rotations. The Negative Acts Questionnaire-Revised (NAQ-R) was used to examine workplace bullying. RESULTS: The 6-month prevalence of workplace bullying among study participants was 13%. Work-related bullying such as 'being ordered to do work below your level of competence', person-related bullying such as 'being humiliated or ridiculed in connection with your work', and physically intimidating bullying such as 'being shouted at or being the target of spontaneous anger' were commonly reported by study participants. Medical officers were reported to be the commonest perpetrators of negative actions at the workplace. Study participants who graduated from Eastern European medical schools (adjusted odds ratio [AOR] 2.27; 95% confidence interval [CI]: 1.27, 4.07) and worked in surgical-based rotation (AOR 1.83; 95% CI: 1.13, 2.97) had higher odds of bullying compared to those who graduated from local medical schools and worked in medical-based rotation, whereas study participants with good English proficiency (AOR 0.14; 95% CI: 0.02, 0.94) had lower odds of bullying compared to those with poor English proficiency. CONCLUSION: The present study shows that workplace bullying is prevalent among Malaysian junior doctors. Considering the gravity of its consequences, impactful strategies should be developed and implemented promptly in order to tackle this serious occupational hazard.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN151, title = {Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019}, author = {J. M. Kocarnik and K. Compton and F. E. Dean and W. Fu and B. L. Gaw and J. D. Harvey and H. J. Henrikson and D. Lu and A. Pennini and R. Xu and E. Ababneh and M. Abbasi-Kangevari and H. Abbastabar and S. M. Abd-Elsalam and A. Abdoli and A. Abedi and H. Abidi and H. Abolhassani and I. A. Adedeji and Q. E. S. Adnani and S. M. Advani and M. S. Afzal and M. Aghaali and B. O. Ahinkorah and S. Ahmad and T. Ahmad and A. Ahmadi and S. Ahmadi and T. Ahmed Rashid and Y. Ahmed Salih and G. T. Akalu and A. Aklilu and T. Akram and C. J. Akunna and H. Al Hamad and F. Alahdab and Z. Al-Aly and S. Ali and Y. Alimohamadi and V. Alipour and S. M. Aljunid and M. Alkhayyat and A. Almasi-Hashiani and N. A. Almasri and S. A. A. Al-Maweri and S. Almustanyir and N. Alonso and N. Alvis-Guzman and H. Amu and E. W. Anbesu and R. Ancuceanu and F. Ansari and A. Ansari-Moghaddam and M. H. Antwi and D. Anvari and A. E. Anyasodor and M. Aqeel and J. Arabloo and M. Arab-Zozani and O. Aremu and H. Ariffin and T. Aripov and M. Arshad and A. Artaman and J. Arulappan and Z. Asemi and M. Asghari Jafarabadi and T. Ashraf and P. Atorkey and A. Aujayeb and M. Ausloos and A. F. Awedew and B. P. Ayala Quintanilla and T. Ayenew and M. A. Azab and S. Azadnajafabad and A. Azari Jafari and G. Azarian and A. Y. Azzam and A. D. Badiye and S. Bahadory and A. A. Baig and J. L. Baker and S. Balakrishnan and M. Banach and T. W. B\"{a}rnighausen and F. Barone-Adesi and F. Barra and A. Barrow and M. Behzadifar and U. I. Belgaumi and W. M. M. Bezabhe and Y. M. Bezabih and D. S. Bhagat and A. S. Bhagavathula and N. Bhardwaj and P. Bhardwaj and S. Bhaskar and K. Bhattacharyya and V. S. Bhojaraja and others}, doi = {10.1001/jamaoncol.2021.6987}, issn = {2374-2437}, year = {2021}, date = {2021-01-01}, journal = {JAMA Oncol}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {IMPORTANCE: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN197, title = {Psychosocial stress, sleep deprivation, and its impact on type II diabetes mellitus: Policies, guidelines, and initiatives from Malaysia}, author = {A. L. Samy and N. N. Hairi and W. Y. Low}, doi = {10.1096/fba.2020-00115}, issn = {2573-9832}, year = {2021}, date = {2021-01-01}, journal = {FASEB Bioadv}, volume = {3}, number = {8}, pages = {593-600}, abstract = {Type II Diabetes Mellitus (T2DM) is a serious public health issue, affecting the global population, particularly those living in low- and middle-income countries. Worldwide, the prevalence of T2DM ranges between 10.4% and 13.5%, depending on the domiciliary. T2DM negatively affects individuals' quality of life and causes high economic burden due to the increasing cost of treatment and management of the disease. Risk factors associated with T2DMs include aging, lifestyle or behavior, genetics, and important biopsychological aspects, which are psychological stress and sleep deprivation. By understanding the associations of psychological stress and sleep deprivation, which contribute to pathophysiology of T2DM, policies, programs, and guidelines were developed in Malaysia to combat the issue among population at large. This narrative review examines 19 national public health policies, programs, and guidelines from the past 20 years in Malaysia that aimed to mitigate the negative health effects of psychological stress, sleep deprivation, and T2DM, both from the government and non-governmental organizations. Both psychological stress and sleep deprivation works independently or as combined effects in the pathophysiology of T2DM. Besides, in Malaysia, the government, in collaboration with non-governmental organizations, have been developing and implementing policies, programs, and guidelines to combat mental health and T2DM issues, targeted to population at large. Integration of digital technology, such as usage of social media for health promotion and dissemination of public health messages to the community and good governance from government were deemed important in the effective implementation of health policies and guidelines, resulting in better health outcome.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN267, title = {Anticipated delay in help-seeking for cancer symptoms: Findings from a nationwide study of Malaysian adults}, author = {D. Schliemann and R. Ismail and M. Donnelly and T. T. Su}, doi = {10.1016/j.canep.2020.101882}, issn = {1877-7821}, year = {2021}, date = {2021-01-01}, journal = {Cancer Epidemiol}, volume = {71}, number = {Pt A}, pages = {101882}, abstract = {BACKGROUND: To investigate the relationship between anticipated delay in help-seeking and cancer symptom recognition and the extent to which this relationship varied according to socio-demographic and health-related characteristics. METHODS: A cross-sectional telephone survey was conducted of 1895 adults aged ≥40 years who were randomly selected across Malaysia and interviewed using the Awareness and Beliefs about Cancer questionnaire, which was previously validated and culturally adapted by the research team. Logistic regression analysis was used to test the associations between anticipated delay for help seeking \>2 weeks and socio-demographic and health-related variables. RESULTS: Anticipated delay in help-seeking was reported for persistent cough (19.3 %), rectal bleeding (6.1 %) and breast changes (2.5 %). Difficulty in accessing a doctor was associated with anticipated delayed help-seeking for breast changes and rectal bleeding (adjusted ORs 7.58; 95 % CI 1.98, 28.94 and 2.37; 95 % CI 1.21, 4.66, respectively); not recognising the symptom 'unexplained bleeding' as a colorectal cancer warning sign was associated with anticipated delayed help-seeking for rectal bleeding (adjusted OR 1.54; 95 % CI 1.03, 2.31); and ethnicity was associated with anticipated delay for rectal bleeding and persistent cough. CONCLUSIONS: Generally, anticipated delay to help-seeking for cancer symptoms in Malaysia (a middle-income country) appeared to be a less significant problem compared to other countries including high-income countries. There appeared to be a significant association between social variation indicators in Malaysia and anticipated delay in help-seeking.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN238, title = {Traditional and Novel Adiposity Indicators and Pancreatic Cancer Risk: Findings from the UK Women's Cohort Study}, author = {S. Shyam and D. Greenwood and C. W. Mai and S. S. Tan and B. N. Mohd Yusof and F. M. Moy and J. Cade}, doi = {10.3390/cancers13051036}, issn = {2072-6694 (Print) 2072-6694}, year = {2021}, date = {2021-01-01}, journal = {Cancers (Basel)}, volume = {13}, number = {5}, abstract = {(1) Background: We studied the association of both conventional (BMI, waist and hip circumference and waist-hip ratio) and novel (UK clothing sizes) obesity indices with pancreatic cancer risk in the UK women's cohort study (UKWCS). (2) Methods: The UKWCS recruited 35,792 women from England, Wales and Scotland from 1995 to 1998. Cancer diagnosis and death information were obtained from the National Health Service (NHS) Central Register. Cox's proportional hazards regression was used to evaluate the association between baseline obesity indicators and pancreatic cancer risk. (3) Results: This analysis included 35,364 participants with a median follow-up of 19.3 years. During the 654,566 person-years follow up, there were 136 incident pancreatic cancer cases. After adjustments for age, smoking, education and physical activity, each centimetre increase in hip circumference (HR: 1.03, 95% CI: 1.01-1.05}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN23, title = {A comprehensive bibliometrics of 'walkability' research landscape: visualization of the scientific progress and future prospects}, author = {L. Ramakreshnan and N. Aghamohammadi and C. S. Fong and N. M. Sulaiman}, doi = {10.1007/s11356-020-11305-x}, issn = {0944-1344}, year = {2021}, date = {2021-01-01}, urldate = {2021-01-01}, journal = {Environ Sci Pollut Res Int}, volume = {28}, number = {2}, pages = {1357-1369}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {This study quantitatively investigated the scientific progress of walkability research landscape and its future prospects using bibliometric indicators to highlight the research hotspots. The results accentuated multifaceted nature of walkability research landscape with a strong association towards public health disciplines. Keyword co-occurrence analysis emphasized that majority of the walkability studies centred on the interactions between walking and other three main factors such as built environment attributes, transportation and obesity. Based on the identified research hotspots, a brief state-of-the-art review of walkability studies was presented. Future prospects based on the unexplored research gaps within the hotspots were also discussed. High correlation (r = 0.99, p \< 0.05) between annual publications and citation counts demonstrated the significance of walkability studies to the contemporary scientific community. Being one of the comprehensive studies to evaluate the historic trajectory of walkability research landscape, the findings were expected to accelerate a comprehensive understanding of the walkability research domain that will assist future research direction.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN257, title = {Obstructive sleep apnoea syndrome (OSAS) as a risk factor for secondary osteoporosis in children}, author = {N. S. Sies and A. A. Zaini and J. A. Bruyne and M. Y. Jalaludin and A. M. Nathan and N. Y. Han and S. Thavagnanam}, doi = {10.1038/s41598-021-82605-6}, issn = {2045-2322}, year = {2021}, date = {2021-01-01}, journal = {Sci Rep}, volume = {11}, number = {1}, pages = {3193}, abstract = {Repetitive hypoxia seen in obstructive sleep apnoea syndrome (OSAS) may affect bone metabolism increasing the risk for secondary osteoporosis. This study investigates the association between OSAS in children and secondary osteoporosis. This cross-sectional study included 150 children aged 10-17 years: 86 with OSAS and 64 with no OSAS. OSAS was confirmed by polysomnography. Quantitative ultrasound (QUS) of calcaneum measuring speed of sound (SoS) and broadband ultrasound attenuation (BUA) were collected. Other parameters collected including bone profile, vitamin D levels, physical activity scoring and dietary calcium intake. Majority were male and Malay ethnicity. OSAS children were mostly obese (84%) and 57% had moderate to severe OSAS. Most had lower physical activities scores. Mean (SD) phosphate and Alkaline phosphatase were lower in OSA children compared to controls: PO(4)}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN162, title = {Pre-diagnostic alterations in circulating bile acid profiles in the development of hepatocellular carcinoma}, author = {M. Stepien and M. Lopez-Nogueroles and A. Lahoz and T. K\"{u}hn and G. Perlemuter and C. Voican and D. Ciocan and M. C. Boutron-Ruault and E. Jansen and V. Viallon and M. Leitzmann and A. Tj\onneland and G. Severi and F. R. Mancini and C. Dong and R. Kaaks and R. T. Fortner and M. M. Bergmann and H. Boeing and A. Trichopoulou and A. Karakatsani and E. Peppa and D. Palli and V. Krogh and R. Tumino and C. Sacerdote and S. Panico and H. B. Bueno-de-Mesquita and G. Skeie and S. Merino and R. Z. Ros and M. J. S\'{a}nchez and P. Amiano and J. M. Huerta and A. Barricarte and K. Sj\"{o}berg and B. Ohlsson and H. Nystr\"{o}m and M. Werner and A. Perez-Cornago and J. A. Schmidt and H. Freisling and A. Scalbert and E. Weiderpass and S. Christakoudi and M. J. Gunter and M. Jenab}, doi = {10.1002/ijc.33885}, issn = {0020-7136}, year = {2021}, date = {2021-01-01}, journal = {Int J Cancer}, abstract = {Bile acids (BA) play different roles in cancer development. Some are carcinogenic and BA signaling is also involved in various metabolic, inflammatory, and immune-related processes. The liver is the primary site of BA synthesis. Liver dysfunction and microbiome compositional changes, such as during hepatocellular carcinoma (HCC) development, may modulate BA metabolism increasing concentration of carcinogenic BAs. Observations from prospective cohorts are sparse. We conducted a study (233 HCC case-control pairs) nested within a large observational prospective cohort with blood samples taken at recruitment when healthy with follow-up over time for later cancer development. A targeted metabolomics method was used to quantify 17 BAs (primary/secondary/tertiary; conjugated/un-conjugated) in pre-diagnostic plasma. Odd ratios (OR) for HCC risk associations were calculated by multivariable conditional logistic regression models. Positive HCC risk associations were observed for the molar sum of all BAs (OR(doubling) = 2.30, 95%CI = 1.76-3.00) and choline- and taurine-conjugated BAs. Relative concentrations of BAs showed positive HCC risk associations for glycoholic acid and most taurine-conjugated BAs. We observe an association between increased HCC risk and higher levels of major circulating BAs, from several years prior to tumor diagnosis and after multivariable adjustment for confounders and liver functionality. Increased in BA concentration is accompanied by a shift in BA profile towards higher proportions of taurine-conjugated BAs, indicating early alterations of BA metabolism with HCC development. Future studies are needed to assess BA profiles for improved stratification of patients at high HCC risk and to determine whether supplementation with certain BAs may ameliorate liver dysfunction. This article is protected by copyright. All rights reserved.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN168, title = {WTO must ban harmful fisheries subsidies}, author = {U. R. Sumaila and D. J. Skerritt and A. Schuhbauer and S. Villasante and A. M. Cisneros-Montemayor and H. Sinan and D. Burnside and P. R. Abdallah and K. Abe and K. A. Addo and J. Adelsheim and I. J. Adewumi and O. K. Adeyemo and N. Adger and J. Adotey and S. Advani and Z. Afrin and D. Aheto and S. L. Akintola and W. Akpalu and L. Alam and J. J. Alava and E. H. Allison and D. J. Amon and J. M. Anderies and C. M. Anderson and E. Andrews and R. Angelini and Z. Anna and W. Antweiler and E. K. Arizi and D. Armitage and R. I. Arthur and N. Asare and F. Asche and B. Asiedu and F. Asuquo and L. Badmus and M. Bailey and N. Ban and E. B. Barbier and S. Barley and C. Barnes and S. Barrett and X. Basurto and D. Belhabib and E. Bennett and N. J. Bennett and D. Benzaken and R. Blasiak and J. J. Bohorquez and C. Bordehore and V. Bornarel and D. R. Boyd and D. Breitburg and C. Brooks and L. Brotz and D. Campbell and S. Cannon and L. Cao and J. C. Cardenas Campo and S. Carpenter and G. Carpenter and R. T. Carson and A. R. Carvalho and M. Castrej\'{o}n and A. J. Caveen and M. N. Chabi and K. M. A. Chan and F. S. Chapin and T. Charles and W. Cheung and V. Christensen and E. O. Chuku and T. Church and C. Clark and T. M. Clarke and A. L. Cojocaru and B. Copeland and B. Crawford and A. S. Cr\'{e}pin and L. B. Crowder and P. Cury and A. N. Cutting and G. C. Daily and J. M. Da-Rocha and A. Das and S. Puente and A. Zeeuw and S. K. S. Deikumah and M. Deith and B. Dewitte and N. Doubleday and C. M. Duarte and N. K. Dulvy and T. Eddy and M. Efford and P. R. Ehrlich and L. G. Elsler and K. A. Fakoya and others}, doi = {10.1126/science.abm1680}, issn = {0036-8075}, year = {2021}, date = {2021-01-01}, journal = {Science}, volume = {374}, number = {6567}, pages = {544}, abstract = {[Figure: see text].}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN201, title = {Mental health crisis in healthcare providers in the COVID-19 pandemic: a cross-sectional facility-based survey}, author = {C. W. Sung and C. H. Chen and C. Y. Fan and J. H. Chang and C. C. Hung and C. M. Fu and L. P. Wong and E. P. Huang and T. S. Lee}, doi = {10.1136/bmjopen-2021-052184}, issn = {2044-6055}, year = {2021}, date = {2021-01-01}, journal = {BMJ Open}, volume = {11}, number = {7}, pages = {e052184}, abstract = {OBJECTIVES: During a pandemic, healthcare providers experience increased mental and physical burden. Burnout can lead to treatment errors, patient mortality, increased suicidal ideation and substance abuse as well as medical malpractice suits among medical staff. This study aimed to investigate the occurrence of burnout, acute stress disorder, anxiety disorder and depressive disorder among healthcare providers at the third month of the COVID-19 pandemic. DESIGN: A cross-sectional facility-based survey. SETTING: Hospitals around the country with different levels of care. PARTICIPANTS: A total of 1795 respondents, including 360 men and 1435 women who participated in the survey. PRIMARY OUTCOME MEASURES: Burnout was assessed using the Physician Work Life Study. A score of ≥3 implied burnout. RESULTS: Of the 1795 respondents, 723 (40.3%) reported burnout, and 669 (37.3%) cared for patients with COVID-19. Anxiety levels were mild in 185 (10.3%) respondents, moderate in 209 (11.6%) and severe in 1401 (78.1%). The mean Center for Epidemiologic Studies Depression Scale-10 score was 9.5±6.3, and 817 (45.5%) respondents were classified as having depression. Factors associated with burnout were working in acute and critical care (ACC) divisions (adjusted OR (aOR)=1.84, 95% CI 1.20 to 3.39}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN208, title = {The authors reply}, author = {P. C. Tah and Z. Y. Lee and B. K. Poh and H. Abdul Majid and V. R. Hakumat-Rai and M. B. Mat Nor and C. C. Kee and M. Kamarul Zaman and M. S. Hasan}, doi = {10.1097/ccm.0000000000005082}, issn = {0090-3493}, year = {2021}, date = {2021-01-01}, journal = {Crit Care Med}, volume = {49}, number = {8}, pages = {e804-e805}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN155, title = {A journey of a thousand miles begins with a single step: Applying evidence-based medicine to answer clinical questions}, author = {P. S. K. Tok}, doi = {10.51866/lte1336}, issn = {1985-207X (Print) 1985-2274}, year = {2021}, date = {2021-01-01}, journal = {Malays Fam Physician}, volume = {16}, number = {3}, pages = {132}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN167, title = {Effect of COVID-19 on tuberculosis notification in Johor Bahru, Malaysia}, author = {P. S. K. Tok and N. Kamarudin and M. Jamaludin and M. F. Ab Razak and M. A. S. Ahmad and F. A. Abu Bakar and N. Rosli and H. R. Toha}, doi = {10.1080/23744235.2021.2000636}, issn = {2374-4243}, year = {2021}, date = {2021-01-01}, journal = {Infect Dis (Lond)}, pages = {1-3}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN232, title = {COVID-19 Impact on Healthcare and Supportive Services for People Who Use Drugs (PWUDs) in Malaysia}, author = {B. Vicknasingam and N. A. Mohd Salleh and W. T. Chooi and D. Singh and N. Mohd Zaharim and A. Kamarulzaman and M. C. Chawarski}, doi = {10.3389/fpsyt.2021.630730}, issn = {1664-0640 (Print) 1664-0640}, year = {2021}, date = {2021-01-01}, journal = {Front Psychiatry}, volume = {12}, pages = {630730}, abstract = {Background: Restrictive orders and temporary programmatic or ad hoc changes within healthcare and other supportive systems that were implemented in response to the COVID-19 epidemic in Malaysia may have created hindrances to accessing healthcare and/or receiving other supportive services for people who use drugs (PWUDs). Design: A primarily qualitative study has been conducted to evaluate how service providers and recipients were adapting and coping during the initial periods of the COVID-19 response. Settings: The study engaged several healthcare and non-governmental organizations (NGOs) in the peninsular states of Penang, Kelantan, Selangor, and Melaka. Participants: Medical personnel of methadone maintenance treatment (MMT) programs (n = 2) and HIV clinics (n = 3), staff of NGO services (n = 4), and MMT patients (n = 9) were interviewed using a semi-structured format. Results: Interviewed participants reported significant organizational, programmatic, and treatment protocols related changes implemented within the healthcare and support services in addition to nationally imposed Movement Control Orders (MCOs). Changes aimed to reduce patient flow and concentration at the on-site services locations, including less frequent in-person visits, increased use of telemedicine resources, and greater reliance on telecommunication methods to maintain contacts with patients and clients; changes in medication dispensing protocols, including increased take-home doses and relaxed rules for obtaining them, or delivery of medications to patients' homes or locations near their homes were reported by the majority of study participants. No significant rates of COVID-19 infections among PWUDs, including among those with HIV have been reported at the study sites. Conclusions: Although the reported changes presented new challenges for both services providers and recipients and resulted in some degree of initial disruption, generally, all participants reported successful implementation and high levels of compliance with the newly introduced restrictions, regulations, and protocols, resulting in relatively low rates of treatment disruption or discontinuation at the study sites.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN243, title = {Predictors of glycosylated haemoglobin A1C trend among type 2 diabetes patients in a multi-ethnic country}, author = {K. S. Wan and N. N. Hairi and F. I. Mustapha and K. Mohd Yusof and Z. Mohd Ali and F. M. Moy}, doi = {10.1038/s41598-021-86277-0}, issn = {2045-2322}, year = {2021}, date = {2021-01-01}, journal = {Sci Rep}, volume = {11}, number = {1}, pages = {6803}, abstract = {Good control of glycosylated haemoglobin A1C in diabetes patients prevents cardiovascular complications. We aim to describe the A1C trend and determine the predictors of the trend among type 2 diabetes patients in Malaysia. Longitudinal data in the National Diabetes Registry from 2013 to 2017 were analysed using linear mixed-effects modelling. Among 17,592 patients, 56.3% were females, 64.9% Malays, and the baseline mean age was 59.1 years. The U-shaped A1C trend changed marginally from 7.89% in 2013 to 8.07% in 2017. The A1C excess of 1.07% as reported in 2017 represented about 22% higher risk of diabetes-related death, myocardial infarction, and stroke, which are potentially preventable. The predictors for higher baseline A1C were non-Chinese ethnicity, younger age groups, longer diabetes duration, patients on insulin treatment, polypharmacy use, patients without hypertension, and patients who were not on antihypertensive agents. Younger age groups predicted a linear increase in the A1C trend, whereas patients on insulin treatment predicted a linear decrease in the A1C trend. Specifically, the younger adults and patients of Indian and Malay ethnicities had the poorest A1C trends. Targeted interventions should be directed at these high-risk groups to improve their A1C control.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN153, title = {Associations of Health Literacy with Blood Pressure and Dietary Salt Intake among Adults: A Systematic Review}, author = {D. Mohd Isa and S. Shahar and F. J. He and H. A. Majid}, doi = {10.3390/nu13124534}, issn = {2072-6643}, year = {2021}, date = {2021-01-01}, journal = {Nutrients}, volume = {13}, number = {12}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Health literacy has been recognized as a significant social determinant of health, defined as the ability to access, understand, appraise, and apply health-related information across healthcare, disease prevention, and health promotion. This systematic review aims to understand the relationship between health literacy, blood pressure, and dietary salt intake. A web-based search of PubMed, Web of Science, CINAHL, ProQuest, Scopus, Cochrane Library, and Prospero was performed using specified search/MESH terms and keywords. Two reviewers independently performed the data extraction and analysis, cross-checked, reviewed, and resolved any discrepancies by the third reviewer. Twenty out of twenty-two studies met the inclusion criteria and were rated as good quality papers and used in the final analysis. Higher health literacy had shown to have better blood pressure or hypertension knowledge. However, the relationship between health literacy with dietary salt intake has shown mixed and inconsistent findings. Studies looking into the main four domains of health literacy are still limited. More research exploring the links between health literacy, blood pressure, and dietary salt intake in the community is warranted. Using appropriate and consistent health literacy tools to evaluate the effectiveness of salt reduction as health promotion programs is required.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN214, title = {Changes in body mass index, glycosylated hemoglobin A1C, blood pressure, and LDL-cholesterol among type 2 diabetes patients in Malaysia: A population-based longitudinal study}, author = {K. S. Wan and F. M. Moy and F. I. Mustapha and M. Ismail and N. N. Hairi}, doi = {10.1111/1753-0407.13206}, issn = {1753-0407}, year = {2021}, date = {2021-01-01}, journal = {J Diabetes}, volume = {13}, number = {11}, pages = {915-929}, abstract = {BACKGROUND: This study aimed to describe changes in body mass index, glycosylated hemoglobin A1C, blood pressure, and low-density lipoprotein (LDL)-cholesterol among type 2 diabetes patients in Malaysia. METHODS: A five-year retrospective cohort study was conducted using data from the National Diabetes Registry. Type 2 diabetes patients aged ≥18 years and had ≥2 clinical audits between 2013 and 2017 were included in the analysis. The first audit information formed the baseline characteristics, and the last audit information was used for comparison. Individualized A1C, blood pressure, and LDL-cholesterol goals were adapted from Malaysian Clinical Practice Guidelines on Type 2 Diabetes Management 2020, American Diabetes Association 2020, and European Association for the Study of Diabetes 2019. RESULTS: Of the 18 341 patients, 55.8% were female and 64.9% Malay ethnicity. The baseline mean age was 59.3 ± 10.6 years. During an average of 2.5 person-years of follow-up, the mean body mass index dropped by 0.16 kg/m(2) to 27.9 kg/m(2) , A1C increased by 0.16% to 8.0%, systolic blood pressure increased by 1.4 mm Hg to 136.2 mm Hg, diastolic blood pressure decreased by 1.0 mm Hg to 77.3 mm Hg and LDL-cholesterol reduced by 0.12 mmol/L to 2.79 mmol/L, P \< 0.001 for all. Out of eight categories of individualized goals, most patients achieved the A1C goal of ≤8.0%. The new LDL-cholesterol goal of \<1.4 mmol/L was least likely to be achieved. CONCLUSIONS: The body mass index, A1C, blood pressure, and LDL-cholesterol performance remained suboptimal. Standards of care for these clinical parameters remain to be achieved by the majority of diabetes patients.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN233, title = {Implementation of a COVID-19 surveillance programme for healthcare workers in a teaching hospital in an upper-middle-income country}, author = {K. S. Wan and P. S. K. Tok and K. K. Yoga Ratnam and N. Aziz and M. Isahak and R. Ahmad Zaki and N. D. Nik Farid and N. N. Hairi and S. Rampal and C. W. Ng and M. F. Samsudin and V. Venugopal and M. Asyraf and N. H. Damanhuri and S. Doraimuthu and C. T. Arumugam and T. Marthammuthu and F. A. Nawawi and F. Baharudin and D. W. Q. Chong and V. J. Jayaraj and V. Magarita and S. Ponnampalavanar and N. Hasnan and A. Kamarulzaman and M. A. Said}, doi = {10.1371/journal.pone.0249394}, issn = {1932-6203}, year = {2021}, date = {2021-01-01}, journal = {PLoS One}, volume = {16}, number = {4}, pages = {e0249394}, abstract = {INTRODUCTION: The reporting of Coronavirus Disease 19 (COVID-19) mortality among healthcare workers highlights their vulnerability in managing the COVID-19 pandemic. Some low- and middle-income countries have highlighted the challenges with COVID-19 testing, such as inadequate capacity, untrained laboratory personnel, and inadequate funding. This article describes the components and implementation of a healthcare worker surveillance programme in a designated COVID-19 teaching hospital in Malaysia. In addition, the distribution and characteristics of healthcare workers placed under surveillance are described. MATERIAL AND METHODS: A COVID-19 healthcare worker surveillance programme was implemented in University Malaya Medical Centre. The programme involved four teams: contact tracing, risk assessment, surveillance and outbreak investigation. Daily symptom surveillance was conducted over fourteen days for healthcare workers who were assessed to have low-, moderate- and high-risk of contracting COVID-19. A cross-sectional analysis was conducted for data collected over 24 weeks, from the 6th of March 2020 to the 20th of August 2020. RESULTS: A total of 1,174 healthcare workers were placed under surveillance. The majority were females (71.6%), aged between 25 and 34 years old (64.7%), were nursing staff (46.9%) and had no comorbidities (88.8%). A total of 70.9% were categorised as low-risk, 25.7% were moderate-risk, and 3.4% were at high risk of contracting COVID-19. One-third (35.2%) were symptomatic, with the sore throat (23.6%), cough (19.8%) and fever (5.0%) being the most commonly reported symptoms. A total of 17 healthcare workers tested positive for COVID-19, with a prevalence of 0.3% among all the healthcare workers. Risk category and presence of symptoms were associated with a positive COVID-19 test (p\<0.001). Fever (p\<0.001), cough (p = 0.003), shortness of breath (p = 0.015) and sore throat (p = 0.002) were associated with case positivity. CONCLUSION: COVID-19 symptom surveillance and risk-based assessment have merits to be included in a healthcare worker surveillance programme to safeguard the health of the workforce.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN172, title = {Malay version of the modified Conflict Tactics Scale of elder abuse and neglect (MMCTS-EAN): Validation and methodological challenges}, author = {S. W. Wazid and R. M. Yunus and N. N. Mohd Hairi and W. Y. Choo}, doi = {10.1080/08946566.2021.1990815}, issn = {0894-6566}, year = {2021}, date = {2021-01-01}, journal = {J Elder Abuse Negl}, volume = {33}, number = {5}, pages = {368-384}, abstract = {Among the challenges in systematic inquiry into elder abuse and neglect (EAN) is the lack of standardized tool of measurement. Existing literature demonstrates diverse tools being used, with the Conflict Tactics Scale (CTS) and its versions being the most common. The Malaysian Elder Mistreatment Project (MAESTRO) utilized the Modified CTS developed and used by the National Study of Elder Abuse and Neglect in Ireland (NSEA-I). This article aimed to validate this Malay version of the modified CTS for use in the Malaysian context and by Malay-speaking populations across Southeast Asia while highlighting the various practical and methodological challenges encountered along the process. Data were collected from 1927 older respondents who lived in Kuala Pilah district. Preliminary data screening led to the dropping of 10 items due to 0 variance. Further four items were deleted during CFA due to low loading. The indicators of neglect factor were made into a composite factor due to high collinearity. The final scale had acceptable reliability and validity. This tool is likely to assist in assessing and detecting EAN more quickly and conveniently. It will also assist future researches of EAN in taking into account the issues that arise in the measurement of EAN.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN113, title = {The role of occupational-participation, meaningful-activity and quality-of-life of colorectal cancer survivors: findings from path-modelling}, author = {S. Y. Loh and M. Sapihis and M. Danaee and Y. P. Chua}, doi = {10.1080/09638288.2020.1715492}, issn = {0963-8288}, year = {2021}, date = {2021-01-01}, journal = {Disabil Rehabil}, volume = {43}, number = {19}, pages = {2729-2738}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: This novel study aims to explore the relationship between occupational participation, meaningful activity, and the health-related quality of life of people living with a diagnosis of colorectal cancer. METHODS: A cross-sectional study design with 113 colorectal cancer survivors (from two large public hospitals in Malaysia) was conducted. Data collection tools included the Occupational Participation Questionnaire, Engagement in Meaningful-activities, and the European Organization for Research and Treatment in Cancer Quality of Life (QOL) Questionnaire. Data analyses were conducted using SmartPLS to examine path analyses between the three measures. RESULTS: There were independent significant relationships between (1) occupational participation, and (2) meaningful activity engagements on the dependent variable of QOL in this cohort of cancer survivors. More importantly, the result showed that "meaningful-activity" positively and significantly mediates the path between occupational participation and quality of life [β = 0.250 (0.46*0.59), ρ \< 0.001(t = 3.91)]. CONCLUSIONS: Engagement in meaningful activity mediates the occupational participation of a cohort of colorectal survivors, and produces an impact on their quality of life. This study demonstrates that "occupational participation" (an important construct in occupational therapy), has the potential to improve colorectal cancer survivors' quality of lives. Therefore, the role of occupational therapists must be optimized within the oncology team, to improve occupational participation and patients' abilities to engage in meaningful activities for better quality of life.Implications for RehabilitationOccupational therapy intervention addresses the needs of people of all ages, who encountered limitations in their daily occupational participations.Cancer can have significant impact on occupational performance, and occupational therapy can improve these limitations to improve their Quality of Life.Occupational therapy should be a vital part in the cancer survivorship treatment plan for it can significantly improve occupational performance and quality of life of cancer survivors.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN242, title = {Escalating progression of mental health disorders during the COVID-19 pandemic: Evidence from a nationwide survey}, author = {L. P. Wong and H. Alias and A. A. Md Fuzi and I. S. Omar and A. Mohamad Nor and M. P. Tan and D. L. Baranovich and C. Z. Saari and S. H. Hamzah and K. W. Cheong and C. H. Poon and V. Ramoo and C. C. Che and K. Myint and S. Zainuddin and I. Chung}, doi = {10.1371/journal.pone.0248916}, issn = {1932-6203}, year = {2021}, date = {2021-01-01}, journal = {PLoS One}, volume = {16}, number = {3}, pages = {e0248916}, abstract = {Since the first nationwide movement control order was implemented on 18 March 2020 in Malaysia to contain the coronavirus disease 2019 (COVID-19) outbreak, to what extent the uncertainty and continuous containment measures have imposed psychological burdens on the population is unknown. This study aimed to measure the level of mental health of the Malaysian public approximately 2 months after the pandemic's onset. Between 12 May and 5 September 2020, an anonymous online survey was conducted. The target group included all members of the Malaysian population aged 18 years and above. The Depression Anxiety Stress Scale (DASS-21) was used to assess mental health. There were increased depressive, anxiety and stress symptoms throughout the study period, with the depression rates showing the greatest increase. During the end of the data collection period (4 August-5 September 2020), there were high percentages of reported depressive (59.2%) and anxiety (55.1%) symptoms compared with stress (30.6%) symptoms. Perceived health status was the strongest significant predictor for depressive and anxiety symptoms. Individuals with a poorer health perception had higher odds of developing depression (odds ratio [OR] = 5.68; 95% confidence interval [CI] 3.81-8.47) and anxiety (OR = 3.50; 95%CI 2.37-5.17) compared with those with a higher health perception. By demographics, young people-particularly students, females and people with poor financial conditions-were more vulnerable to mental health symptoms. These findings provide an urgent call for increased attention to detect and provide intervention strategies to combat the increasing rate of mental health problems in the ongoing COVID-19 pandemic.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN161, title = {Older people and responses to COVID-19: A cross-sectional study of prevention practices and vaccination intention}, author = {L. P. Wong and H. Alias and Y. R. Tan and K. M. Tan}, doi = {10.1111/opn.12436}, issn = {1748-3735}, year = {2021}, date = {2021-01-01}, journal = {Int J Older People Nurs}, pages = {e12436}, abstract = {BACKGROUND: COVID-19 is a threat to everyone's health and can be especially devastating to older individuals. AIM: This study examined the behavioural prevention practices against SARS-CoV-2 infection and the intention to vaccinate among older people when the COVID-19 vaccine is on the verge of becoming available. METHOD: A cross-sectional, online survey was conducted between 14th July and 8th October 2020 among the older people in Malaysia. A questionnaire was designed to assess the practice towards measures preventing SARS-CoV-2 infection, and COVID-19 vaccination attitudes and intention. Socio-demographic characteristics, constructs of a health belief model (HBM), the 6-item state version of the State-Trait Anxiety Inventory (STAI-6) were correlates of the main outcomes. FINDINGS: The mean score of total preventive measures scores was 13.4 ± 1.7 out of a maximum score of 15, indicating very good prevention practices. By demographics, females, having a tertiary education exhibited higher prevention practices in the univariable analyses. Components of the HBM and being female remain significant correlates of higher prevention practices in multivariable logistic regression analysis (MLRA). A total of 657 (87.1%) participants responded and intend to receive the COVID-19 vaccination. Provider recommendations may improve vaccination uptake (91.6%). MLRA revealed that having a positive vaccination attitude was 16 times more likely to accept the COVID-19 vaccination (OR = 16.10; 95% CI 8.97-28.91). Hearing of someone they know who has COVID-19 serves as a cue to action and significantly influences vaccination (OR = 4.25; 95% CI 1.80-10.03). Participants below 70 years old expressed higher vaccination intention (OR = 2.07; 95% CI 1.19-3.58). CONCLUSION: The results provide the first evidence for public authorities to target older people vulnerable to compliance with recommended preventive measures against SARS-CoV-2 infections.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN239, title = {Psychological distress among cancer survivors during implementation of a nationwide Movement Control Order over the COVID-19 pandemic}, author = {L. P. Wong and L. L. Lai and M. H. See and H. Alias and M. Danaee and C. Y. Ting and P. S. K. Tok}, doi = {10.1007/s00520-021-06182-0}, issn = {0941-4355 (Print) 0941-4355}, year = {2021}, date = {2021-01-01}, journal = {Support Care Cancer}, volume = {29}, number = {10}, pages = {6087-6097}, abstract = {OBJECTIVES: This study aimed to investigate the psychological distress and its associated factors among cancer survivors in Malaysia during the COVID-19 pandemic. METHODS: An anonymous Internet-based study was conducted between 23 April and 26 June 2020. During the study period, the country underwent phase 3 and phase 4 of the Movement Control Order (MCO), Conditional Movement Control Order (CMCO), and Recovery Movement Control Order (RMCO). Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS), which is a 14-item self-assessment scale for measuring distress (total HADS score; HADS-T) with two subscales, namely, anxiety (HADS-A) and depression (HADS-D). Perceived threat of infection was measured based on the health belief model. RESULTS: From a total of 631 responses received, the proportion of participants with anxiety and depression symptoms (above threshold score of 8 on HADS-A and HADS-D) was 29.0 and 20.9%, respectively. Psychological distress (HADS-T \> 16) was reported in 22.3% of the respondents. A total of 16.5% had combined anxiety and depression symptoms. The highest HADS-A (6.10; 95% CI 5.64-6.56), HADS-D (5.61; 95% CI 5.14-6.08), and HADS-T (11.71; 95% CI 10.84-12.58) scores were reported among respondents during phase 4 of the MCO. Partial least square-based structural equation modelling (PLS-SEM) revealed that self-perceived health status, perceived susceptibility, and severity of COVID-19 have the greatest effect, leading to higher HADS-A, HADS-D, and HADS-T scores. CONCLUSION: Heightened psychological distress was evident in cancer survivors particularly during the enforcement of the MCO over COVID-19. Providing support to address cancer survivors' psychological and emotional needs during the COVID-19 pandemic is essential.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN230, title = {The Risk of Transfusion-Transmitted Hepatitis E Virus: Evidence from Seroprevalence Screening of Blood Donations}, author = {L. P. Wong and H. Y. Lee and C. S. Khor and J. Abdul-Jamil and H. Alias and N. Abu-Amin and M. Mat-Radzi and N. A. Rohimi and H. N. Mokhtardin and S. AbuBakar and Z. Zheng and T. Wu and Q. Zhao and N. Xia}, doi = {10.1007/s12288-021-01428-7}, issn = {0971-4502 (Print) 0971-4502}, year = {2021}, date = {2021-01-01}, journal = {Indian J Hematol Blood Transfus}, pages = {1-8}, abstract = {Throughout the world, there has been growing concern over the risk of hepatitis E virus (HEV) transmission via blood transfusion. The present study screened blood donor samples for anti-HEV immunoglobulin M (IgM) and immunoglobulin G (IgG). The prevalence of HEV infection was assessed on a total of 1,003 archived serum samples obtained from the National Blood Centre, Malaysia. The samples were collected from healthy blood donor from Klang Valley between 2017 and 2018. All samples were tested for IgM and IgG antibodies to HEV using enzyme-linked immunosorbent assays (ELISA). HEV-specific IgG antibodies were detected in 31/1003 (3.1%; 95% confidence interval [CI] 2.1%-4.4%) and IgM in 9/1003 (0.9%; 95% CI 0.4%-1.7%) samples. In bivariate analysis, there was no significant difference in the prevalence of anti-HEV IgG with respect to gender and district of origin. Although not statistically significant, males had higher odds of having anti-HEV IgG than females (odds ratio [OR] = 2.86; 95% CI 0.95-8.64). All anti-HEV IgG positive individuals were people of Chinese descent. Anti-HEV IgG increased significantly with age, from 0.6% (95% CI 0.1%-2.6%) of 18-30-year-old donors to 7.4% (95% CI 2.7%-17.0%) of donors older than 50 years and was highest among non-professional workers (5.3%; 95% CI 2.5%-10.5%). Increasing age and a non-professional occupation remained significant predictors for anti-HEV IgG in the multivariable analysis. Screening of blood donations for HEV in Malaysia is important to safeguard the health of transfusion recipients. The higher rates of HEV infection in blood from older donors and donors who are non-professional workers may provide insights into targeted groups for blood screening.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN235, title = {Psychological Consequences of the Delay in the Silent Mentor Programme During the COVID-19 Pandemic: Perspectives From Family Members of Silent Mentors}, author = {L. P. Wong and S. L. Tan and H. Alias and T. E. Sia and A. Saw}, doi = {10.1177/00302228211000952}, issn = {0030-2228}, year = {2021}, date = {2021-01-01}, journal = {Omega (Westport)}, pages = {302228211000952}, abstract = {The COVID-19 pandemic has put a hold on the Silent Mentor Programme (SMP); this pause has not only caused unprecedented challenges for the delivery of medical education but has forced changes in the programme ceremony sessions. We aimed to describe the psychological impact and experiences of family members of silent mentors during the COVID-19 pandemic using qualitative interviews. Many expressed feelings of remorse and unrest about the unprecedented delay of the SMP. The delay increased negative emotions particularly among some elderly family members; however, there was no prominent negative effect on their functional health and well-being. Several participants relayed the belief that the soul cannot rest until the body receives a proper burial while some worried about the deterioration of the physical condition of the mentors. In conclusion, findings provide insights into the importance of not overlooking the mental health implications of delaying the SMP in future outbreaks or crises.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN224, title = {The role of institutional trust in preventive practices and treatment-seeking intention during the coronavirus disease 2019 outbreak among residents in Hubei, China}, author = {L. P. Wong and Q. Wu and Y. Hao and X. Chen and Z. Chen and H. Alias and M. Shen and J. Hu and S. Duan and J. Zhang and L. Han}, doi = {10.1093/inthealth/ihab023}, issn = {1876-3413 (Print) 1876-3405}, year = {2021}, date = {2021-01-01}, journal = {Int Health}, abstract = {BACKGROUND: We aimed to investigate the association between institution trust and public responses to the coronavirus disease 2019 (COVID-19) outbreak. METHODS: An Internet-based, cross-sectional survey was administered on 29 January 2020. A total of 4393 adults ≥18 y of age and residing or working in the province of Hubei, central China were included in the study. RESULTS: The majority of the participants expressed a great degree of trust in the information and preventive instructions provided by the central government compared with the local government. Being under quarantine (adjusted odds ratio [OR] 2.35 [95% confidence interval CI 1.80 to 3.08]) and having a high institutional trust score (OR 2.23 [95% CI 1.96 to 2.53]) were both strong and significant determinants of higher preventive practices scores. The majority of study participants (n=3640 [85.7%]) reported that they would seek hospital treatment if they suspected themselves to have been infected with COVID-19. Few of the participants from Wuhan (n=475 [16.6%]) and those participants who were under quarantine (n=550 [13.8%]) expressed an unwillingness to seek hospital treatment. CONCLUSIONS: Institutional trust is an important factor influencing adequate preventive behaviour and seeking formal medical care during an outbreak.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN254, title = {Hepatitis C virus core antigen as alternative diagnostic algorithm for active hepatitis C virus infection among haemodialysis population: Cost implications}, author = {X. Z. Wong and A. Amirah and C. C. Gan and S. Fatiha and D. Maznah and R. Yahya and S. Ganapathy and S. S. Tan and R. Mohamed and S. K. Lim}, doi = {10.1111/nep.13862}, issn = {1320-5358}, year = {2021}, date = {2021-01-01}, journal = {Nephrology (Carlton)}, volume = {26}, number = {5}, pages = {463-470}, abstract = {AIMS: In Malaysia, majority anti-HCV positive haemodialysis patients do not undergo hepatitis C confirmation due to the high cost of HCV RNA. HCV Core Antigen might be a cost-effective diagnostic test to identify HD patients who have active HCV infection eligible for Direct Acting Anti-viral therapy. METHODS: A cross-sectional study was conducted to assess the correlation between HCV Ag and HCV RNA and the cost implications of different diagnostic algorithms to diagnose active HCV infection using Anti-HCV, HCV Ag, and HCV RNA. Pre-dialysis blood was tested for both HCV Ag and HCV RNA. HCV Ag was tested with Abbott ARCHITECT HCV Ag test. RESULTS: Two-hundred twenty-seven haemodialysis patients were recruited from 20 centres with mean age of 57.68 ± 12.48 years, and male constitutes 56.8% (129) of the study population. HCV Ag correlated well with HCV RNA (Spearman test coefficient 0.943, p \< .001) with sensitivity of 93.9%, specificity 99.3%, and the accuracy was 97.36%. Cost analysis indicated that a sequential test involving Anti-HCV antibody as initial screening, followed by HCV Ag on Anti-HCV positive and HCV RNA on HCV Ag negative cases translated to a modest cost-saving algorithm compared to standard diagnostic algorithm. CONCLUSION: HCV Ag correlated well with HCV RNA and can potentially be fused in an alternative diagnostic algorithm to generate cost savings methods to diagnose active HCV infection among haemodialysis patients. This alternative algorithm is especially relevant in low to middle-income countries such as Malaysia to optimize the use of the healthcare resource and gains in clinical outcomes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN246, title = {Accelerating action on cervical screening in lower- and middle-income countries (LMICs) post COVID-19 era}, author = {Y. L. Woo and P. Gravitt and S. K. Khor and C. W. Ng and M. Saville}, doi = {10.1016/j.ypmed.2020.106294}, issn = {0091-7435 (Print) 0091-7435}, year = {2021}, date = {2021-01-01}, journal = {Prev Med}, volume = {144}, pages = {106294}, abstract = {Cervical cancer remains the fourth most common cancer in women, with 85% of deaths occurring in LMICs. Despite the existence of effective vaccine and screening tools, efforts to reduce the burden of cervical cancer must be considered in the context of the social structures within the health systems of LMICs. Compounding this existing challenge is the global COVID-19 pandemic, declared in March 2020. While it is too soon to tell how health systems priorities will change as a result of COVID-19 and its impact on the cervical cancer elimination agenda, there are opportunities to strengthen cervical screening by leveraging on several trends. Many LMICs maximized the strengths of their long established community-based primary care and public health systems with expansion of surveillance systems which incorporated mobile technologies. LMICs can harness the momentum of the measures taken against COVID-19 to consolidate the efforts against cervical cancer. Self-sampling, molecular human papillomavirus (HPV) testing and digital health will shift health systems towards stronger public health and primary care networks and away from expensive hospital-based care investments. While COVID-19 will change health systems priorities in LMICs in ways that may de-prioritize cervical cancer screening, there are significant opportunities for integration into longer-term trends towards universal health coverage, self-care and digital health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN260, title = {Assessing the impact of non-pharmaceutical interventions on the transmissibility and severity of COVID-19 during the first five months in the Western Pacific Region}, author = {E. K. Yeoh and K. C. Chong and C. J. Chiew and V. J. Lee and C. W. Ng and H. Hashimoto and S. Kwon and W. Wang and N. N. S. Chau and C. H. K. Yam and T. Y. Chow and C. T. Hung}, doi = {10.1016/j.onehlt.2021.100213}, issn = {2352-7714 (Print) 2352-7714}, year = {2021}, date = {2021-01-01}, journal = {One Health}, volume = {12}, pages = {100213}, abstract = {While most countries in the Western Pacific Region (WPR) had similar trajectories of COVID-19 from January to May, their implementations of non-pharmaceutical interventions (NPIs) differed by transmission stages. To offer a better understanding for an implementation of multidisciplinary policies in COVID-19 control, we compared the impact of NPIs by assessing the transmissibility and severity of COVID-19 in different phases of the epidemic during the first five months in WPR. In this study, we estimated the piecewise instantaneous reproduction number (R (t) ) and the reporting delay-adjusted case-fatality ratio (dCFR) of COVID-19 in seven WPR jurisdictions: Hong Kong Special Administrative Region, Japan, Malaysia, Shanghai, Singapore, South Korea, and Taiwan. According to the results, implementing NPIs was associated with an apparent reduction of the piecewise R (t) in two epidemic waves in general. However, large cluster outbreaks raised the piecewise R (t) to a high level. We also observed relaxing the NPIs could result in an increase of R (t) . The estimated dCFR ranged from 0.09% to 1.59% among the jurisdictions, except in Japan where an estimate of 5.31% might be due to low testing efforts. To conclude, in conjunction with border control measures to reduce influx of imported cases which might cause local outbreaks, other NPIs including social distancing measures along with case finding by rapid tests are also necessary to prevent potential large cluster outbreaks and transmissions from undetected cases. A comparatively lower CFR may reflect the health system capacity of these jurisdictions. In order to keep track of sustained disease transmission due to resumption of economic activities, a close monitoring of disease transmissibility is recommended in the relaxation phase. The report of transmission of SARS CoV-2 to pets in Hong Kong and to mink in farm outbreaks highlight for the control of COVID-19 and emerging infectious disease, the One Health approach is critical in understanding and accounting for how human, animals and environment health are intricately connected.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN299, title = {Nursing practice environment, resilience, and intention to leave among critical care nurses}, author = {L. Y. Ying and V. Ramoo and L. W. Ling and S. T. Nahasaram and C. P. Lei and L. K. Leong and M. Danaee}, doi = {10.1111/nicc.12551}, issn = {1362-1017}, year = {2021}, date = {2021-01-01}, journal = {Nurs Crit Care}, volume = {26}, number = {6}, pages = {432-440}, abstract = {BACKGROUND: Retaining experienced critical care nurses (CCNs) remains a challenge for health care organizations. Nursing practice environment and resilience are both seen as modifiable factors in ameliorating the impact on CCNs' intention to leave and have not yet been explored in Malaysia. AIMS AND OBJECTIVES: To assess the association between perceived nursing practice environment, resilience, and intention to leave among CCNs and to determine the effect of resilience on intention to leave after controlling for other independent variables. DESIGN: This was a cross-sectional survey. METHODS: The universal sampling method was used to recruit nurses from adult and paediatric (including neonatal) critical care units of a large public university hospital in Malaysia. Descriptive analysis and χ(2) and hierarchical logistic regression tests were used to analyse the data. RESULTS: A total of 229 CCNs completed the self-administrated questionnaire. Of the nurses, 76.4% perceived their practice environment as being favourable, 54.1% were moderately resilient, and only 20% were intending to leave. The logistic regression model explained 13.1% of variance in intention to leave and suggested that being single, an unfavourable practice environment, and increasing resilience were significant predictors of nurses' intention to leave. CONCLUSION: This study found that an unfavourable practice environment is a strong predictor of intention to leave; however, further exploration is needed to explain the higher likelihood of expressing intention to leave among CCNs when their resilience level increases. RELEVANCE TO CLINICAL PRACTICE: Looking into staff allocation and equality of workload assignments may improve the perception of the work environment and help minimize intention to leave among nurses.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN253, title = {Is there any association between body mass index and severity of dengue infection?}, author = {M. S. Zulkipli and S. Rampal and A. Bulgiba and D. Peramalah and N. Jamil and L. L. C. See and R. A. Zaki and S. F. S. Omar and M. Dahlui}, doi = {10.1093/trstmh/trab021}, issn = {0035-9203}, year = {2021}, date = {2021-01-01}, journal = {Trans R Soc Trop Med Hyg}, volume = {115}, number = {7}, pages = {764-771}, abstract = {BACKGROUND: Dengue, an acute infectious disease caused by a flavivirus, is a threat to global health. There is sparse evidence exploring obesity and the development of more severe dengue cases in adults. With increasing prevalence of obesity in areas with a high risk of dengue infection, obesity may increase the burden and mortality related to dengue infection. Our study aimed to determine the association between obesity and the development of more severe dengue infection in primary healthcare settings and whether these associations were modified by dengue fever phase. METHODS: A cohort study was conducted among laboratory-confirmed dengue patients aged \>18 y in the central region of Peninsular Malaysia from May 2016 to November 2017. We collected demographic, clinical history, physical examination and laboratory examination information using a standardized form. Dengue severity (DS) was defined as either dengue with warning signs or severe dengue. Participants underwent daily follow-up, during which we recorded their vital signs, warning signs and full blood count results. Incidence of DS was modeled using mixed-effects logistic regression. Changes in platelet count and hematocrit were modeled using mixed-effects linear regression. The final multivariable models were adjusted for age, gender, ethnicity and previous dengue infection. RESULTS: A total of 173 patients were enrolled and followed up. The mean body mass index (BMI) was 37.4±13.75 kg/m2. The majority of patients were Malay (65.9%), followed by Chinese (17.3%), Indian (12.7%) and other ethnic groups (4.1%). A total of 90 patients (52.0%) were male while 36 patients (20.8%) had a previous history of dengue infection. BMI was significantly associated with DS (adjusted OR=1.17; 95% CI 1.04 to 1.34) and hematocrit (%) (aβ=0.09; 95% CI 0.01 to 0.16), but not with platelet count (x103/µL) (aβ=-0.01; 95% CI -0.84 to 0.81). In the dose response analysis, we found that as BMI increases, the odds of DS, hematocrit levels and platelet levels increase during the first phase of dengue fever. CONCLUSION: Higher BMI and higher hematocrit levels were associated with higher odds of DS. Among those with high BMI, the development of DS was observed during phase one of dengue fever instead of during phase two. These novel results could be used by clinicians to help them risk-stratify dengue patients for closer monitoring and subsequent prevention of severe dengue complications.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN154, title = {The Importance of Sociocultural Context When Choosing to Eat Healthier}, author = {J. Dai and N. F. Zulkefli and F. M. Moy and D. L. Humphries}, doi = {10.1016/j.jneb.2021.08.019}, issn = {1499-4046}, year = {2021}, date = {2021-01-01}, journal = {J Nutr Educ Behav}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVE: To explore how working women in metropolitan Malaysia make food decisions. DESIGN: A grounded theory approach and semistructured interviews. SETTING: A large university in metropolitan Malaysia. PARTICIPANTS: Twenty-four female employees purposively recruited to vary in ethnicity, body mass index, age, and marital status via convenience sampling. PHENOMENON OF INTEREST: Perceptions of sociocultural influences on healthy eating behavior among working women. ANALYSIS: Researchers audio-recorded interviews and analyzed verbatim transcripts. RESULTS: Working women shared a desire to eat a healthier, more balanced diet by reducing processed food consumption through home-cooked meals. Participants described aspects of their living situations and cultural values about food that made it seem impossible to change their diets. Living with other people limited their ability to cook the food they wanted to eat. In addition, unspoken rules about communal eating in Malaysia, such as not refusing food and not wasting food, prevented working women from practicing healthy eating. CONCLUSIONS AND IMPLICATIONS: In this population of working women in metropolitan Malaysia, experiences of time scarcity and limited sociocultural support for behavior change were major barriers to healthy eating. Interventions could prioritize leveraging these realities about food to facilitate environments in which women feel like they have control of their own food intake.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN152, title = {Maternal diet during pregnancy and infant respiratory morbidity: A prospective study}, author = {K. N. Chong and H. C. E and R. A. Zaki and S. H. Mohd and H. A. Majid and A. K. Ng and K. P. Eg and S. Y. Hng and C. S. J. Teh and N. Razali and A. M. Nathan and J. A. Bruyne}, doi = {10.6133/apjcn.202112_30(4).0010}, issn = {0964-7058}, year = {2021}, date = {2021-01-01}, journal = {Asia Pac J Clin Nutr}, volume = {30}, number = {4}, pages = {632-642}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND AND OBJECTIVES: Maternal diet during pregnancy may impact infant respiratory morbidity. The aim was to determine the association between antenatal maternal diet and respiratory morbidity of their infants during their first 6 months of life. METHODS AND STUDY DESIGN: This prospective cohort study included healthy motherinfant pairs. Maternal diet during the last trimester was determined with a validated food frequency questionnaire. Infant respiratory morbidity was solicited at 1, 3 and 6 months. RESULTS: Three hundred mother-baby pairs were recruited. Maternal consumption of milk and dairy products was associated with reduced respiratory symptoms at 1 month (aOR 0.29 [95% CI: 0.10, 0.86]}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN44, title = {Perceptions of eating practices and physical activity among Malaysian adolescents in secondary schools: a qualitative study with multi-stakeholders}, author = {S. Mohammadi and T. T. Su and A. Papadaki and M. Y. Jalaludin and M. Dahlui and M. N. A. Mohamed and R. Jago and Z. Toumpakari and L. Johnson and H. A. Majid}, doi = {10.1017/s1368980020002293}, issn = {1368-9800}, year = {2021}, date = {2021-01-01}, journal = {Public Health Nutr}, volume = {24}, number = {8}, pages = {2273-2285}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVE: To conduct formative research using qualitative methods among stakeholders of secondary schools to explore their perceptions, barriers and facilitators related to healthy eating and physical activity (PA) among Malaysian adolescents. DESIGN: A qualitative study involving eight focus groups and twelve in-depth interviews. Focus groups and interviews were recorded and transcribed verbatim. An inductive thematic analysis approach was used to analyse the data. SETTING: Four secondary schools in Perak and Selangor states (two urban and two rural schools) in Malaysia. PARTICIPANTS: Focus groups were conducted with seventy-six adolescents aged 13-14 years, and in-depth interviews were conducted with four headmasters, four PA education teachers and four food canteen operators. RESULTS: Stakeholders thought that adolescents' misperceptions, limited availability of healthy options, unhealthy food preferences and affordability were important challenges preventing healthy eating at school. Low-quality physical education (PE) classes, limited adolescent participation and teachers' commitment during lessons were perceived as barriers to adolescents being active at school. Affordability was the main challenge for adolescents from rural schools. Stakeholders perceived that a future school-based intervention should improve the availability and subsidies for healthy foods, provide health education/training for both adolescents and PE teachers, enhance active adolescent participation in PE and develop social support mechanisms to facilitate engagement with PA. CONCLUSIONS: These findings provide important insights into developing school-based lifestyle interventions to improve healthy eating and strengthening PA of Malaysian adolescents.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN39, title = {Treatment abandonment in children with cancer: Does a sex difference exist? A systematic review and meta-analysis of evidence from low- and middle-income countries}, author = {A. Palagyi and C. Balane and J. Shanthosh and M. Jun and N. Bhoo-Pathy and T. Gadsden and K. Canfell and S. Jan}, doi = {10.1002/ijc.33279}, issn = {0020-7136}, year = {2021}, date = {2021-01-01}, journal = {Int J Cancer}, volume = {148}, number = {4}, pages = {895-904}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {In this systematic review and meta-analyses, we sought to determine sex-disparities in treatment abandonment in children with cancer in low- and middle-income countries (LMICs) and identify the characteristics of children and their families most disadvantaged by such abandonment. Sex-disaggregated data on treatment abandonment were collated from the available literature and a random-effects meta-analysis was conducted to compare the rates in girls with those in boys. Subgroup analyses were conducted in which studies were stratified by design, cancer type and the Gender Inequality Index of the country of study. Eighteen studies were included in the systematic review and of these studies, 16 qualified for the meta-analysis, representing 10 754 children. The pooled rate of treatment abandonment overall was 30%. We observed no difference in the proportion of treatment abandonment in girls relative to estimates observed in boys (rate ratio [RR] 0.95, 95% CI: 0.79-1.15; P = .61). There was significant heterogeneity across the included studies and in the pooled estimate of RR for girls vs boys (both I(2) \> 98%). Subgroup analyses did not reveal any effect on abandonment risk. Risk factors for abandonment observed fell into three main categories: socio-demographic; geographic; and travel-related. In conclusion, a high rate of treatment abandonment (30%) was observed overall for children with cancer in included studies in LMICs, although this was variable and context specific. No evidence of gender bias in childhood cancer treatment abandonment rates across LMICs was found. Given that the risk factors for abandonment are context specific, in-depth country-level analyses may provide further insights into the role of a child's gender in treatment abandonment decisions.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN22, title = {Methadone maintenance therapy service components linked to improvements in HIV care cascade outcomes: A systematic review of trials and observational studies}, author = {N. A. Mohd Salleh and P. Voon and M. Karamouzian and M. J. Milloy and L. Richardson}, doi = {10.1016/j.drugalcdep.2020.108342}, issn = {0376-8716 (Print) 0376-8716}, year = {2021}, date = {2021-01-01}, journal = {Drug Alcohol Depend}, volume = {218}, pages = {108342}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: The beneficial links between engagement in methadone maintenance therapy (MMT) and HIV treatment outcomes have been extensively described. Nevertheless, people who use drugs (PWUD) continue to experience suboptimal HIV treatment outcomes. In this systematic review, we sought to identify components of MMT service provision that are associated with improvements in HIV care outcomes across the HIV care cascade. METHODS: We searched for peer-reviewed studies in online databases. To be eligible for inclusion in this review, studies must have involved a population or sub-population of PWUD engaged in MMT; report improved uptake of HIV testing, exposure to ART, or HIV-1 RNA plasma viral load suppression; provide details on MMT services; and be published in English between 1 January 2006 until 31 December 2018. RESULTS: Out of the 5594 identified records, 22 studies were eligible for this systematic review. Components of MMT services associated with HIV care cascade outcomes described in the studies were classified in three categories of care models: 1) standard MMT care with adequate doses, 2) standard MMT care and alongside additional medical component(s), and 3) standard MMT care, additional medical component(s) as well as informational or instrumental social support. CONCLUSION: The few studies identified reflect a scarcity of evidence on the role of social support to increase the benefits of MMT for PWUD who are living with HIV. Further research is needed to assess the role of medical and social service components in MMT care delivery in advancing PWUD along the HIV care cascade.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN20, title = {What Do Students in Pharmacy and Medicine Think About Pharmacogenomics and Personalized Medicine Education? Awareness, Attitudes, and Perceptions in Malaysian Health Sciences}, author = {S. Siamoglou and M. Koromina and F. M. Moy and C. Mitropoulou and G. P. Patrinos and K. Vasileiou}, doi = {10.1089/omi.2020.0178}, issn = {1536-2310}, year = {2021}, date = {2021-01-01}, journal = {Omics}, volume = {25}, number = {1}, pages = {52-59}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {This study reports on the attitudes and perceptions toward pharmacogenomics (PGx) and personalized medicine (PM) education among pharmacy and medical students in Malaysian health sciences. Importantly, the survey was developed through a codesign approach, with field pretesting/design with users before the actual survey, and based on collaboration between institutions in Greece and Malaysia. The study addressed eight key areas of interest to education in health sciences: (1) General awareness about genetics and PGx, (2) Attitude toward genetic testing usefulness, (3) Benefits of direct-to-consumer personal genome testing as a "diagnostic" tool, (4) Concerns (risks) about genetics, (5) Effectiveness of genetic testing in PM, (6) Benefits of PGx on disease management, (7) Benefits of PGx on drug management, and (8) Attitudes toward genetic testing public endorsement. We observed that Malaysian students appear aware of the term PGx, but there are areas of critical knowledge gap such as the need for greater familiarity with the concept of PGx implementation science, and the availability of genetic testing in clinical practice. This is one of the first studies on perceptions and attitudes toward PGx testing in Southeast Asia. The present findings provide a map of the views and perspectives of medicine and pharmacy students regarding PGx and implementation of PM in Malaysia and should assist toward facilitating the integration of genomics into the medical decision-making process. To this end, it is necessary to enhance collaboration between universities, health care institutions, and governing bodies to incorporate further training and additional education topics related to PGx and genetic testing. This is the first study that assesses the level of PGx and genomics knowledge of pharmacy and medicine students in Southeast Asia, Malaysia in particular, and thus paves the way to guide future global PGx implementation science.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN24, title = {Working after cancer: in-depth perspectives from a setting with limited employment protection policies}, author = {Y. C. Kong and N. Rauf and S. Subramaniam and R. S. Bustamam and L. P. Wong and G. F. Ho and H. Zaharah and M. Mellor and C. H. Yip and N. Bhoo-Pathy}, doi = {10.1007/s11764-020-00962-z}, issn = {1932-2259}, year = {2021}, date = {2021-01-01}, journal = {J Cancer Surviv}, volume = {15}, number = {5}, pages = {706-712}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: A considerable proportion of individuals who are diagnosed with cancer are at a working age. We aimed to gain an in-depth understanding of the challenges, and arising needs related to working after cancer in a setting with limited employment protection policies. METHODS: Focus group discussions were conducted with cancer patients who were diagnosed at least 1 year prior to recruitment, and either had paid work, were self-employed, currently unemployed, or currently retired (N = 66). RESULTS: Three main themes were identified: (1) loss of income: While some participants were entitled for a 1-year cancer-specific sick leave, many other participants recounted having insufficient paid sick leave, forcing them to take prolonged unpaid leave to complete treatment; (2) dealing with side effects of cancer and its treatment: The need for workplace accommodations was highlighted including flexible working hours, lighter workloads, and dedicated rest areas to enable patients to cope better; (3) Discrimination and stigma at workplace: Some participants mentioned being passed over on a promotion, getting demoted, or being forced to resign once their cancer diagnosis was disclosed, highlighting an urgent need to destigmatize cancer in the workplace. CONCLUSION: In settings with limited employment protection policies, a cancer diagnosis severely impacts the working experiences of patients, leading to financial loss. Urgent interventions and legislative reforms are needed in these settings to address the unmet employment needs of cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: This study may facilitate planning of local solutions to fulfill the unmet employment needs following cancer, such as return-to-work navigation services.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN43, title = {Temporal changes in psychobehavioural responses during the early phase of the COVID-19 pandemic in Malaysia}, author = {L. P. Wong and H. Alias}, doi = {10.1007/s10865-020-00172-z}, issn = {0160-7715 (Print) 0160-7715}, year = {2021}, date = {2021-01-01}, journal = {J Behav Med}, volume = {44}, number = {1}, pages = {18-28}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Monitoring public psychological and behavioural responses during the early phase of the coronavirus disease 2019 (COVID-19) outbreak is important for the management and control of infection. This study aims to investigate the temporal trend in (1) avoidance and protective behaviors, (2) fear, (3) socio-economic impact, and (4) anxiety levels during the early phase of the COVID-19 pandemic. As a high level of anxiety may have a detrimental impact during an infectious disease outbreak, factors associated with anxiety were also explored. The survey was carried out for 10 weeks and the responses were divided into three periods of around 3 weeks: 25 January-21 February, 22 February-17 March and 18 March-3 April (the period the Malaysian Government issued Movement Control Order). Findings revealed that most of the pyschobehavioural variables showed small increases during first (25 January-21 February) and second (22 February-17 March) periods, and high psychobehavioral responses were reported during the third period. A total of 72.1% (95%CI = 69.2-75.0) reported moderate to severe anxiety as measured by the State-Trait Anxiety Inventory. Factor influencing moderate to severe anxiety is a high perception of severity (OR = 2.09; 95%CI = 1.48-2.94), high perceived susceptibility (OR = 1.71; 95%CI = 1.17-2.50), high impact score (OR = 1.63; 95%CI = 1.17-2.26) and high fear score (OR = 1.47; 95%CI = 1.01-2.14). In conclusion, the psychological and behavioural responses were found to increase with the progression of the outbreak. High anxiety levels found in this study warrant provision of mental health intervention during the early phase of COVID-19 outbreak.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN191, title = {Analyzing Predictors of Control Measures and Psychosocial Problems Associated with COVID-19 Pandemic: Evidence from Eight Countries}, author = {S. S. R. Jony and U. Haque and N. J. Webb and E. Spence and M. S. Rahman and N. Aghamohammadi and Y. Lie and A. Angulo-Molina and S. Ananth and X. Ren and N. Kawachi and H. Ito and O. Ulvi and J. Lubinda and A. Karamehic-Muratovic and W. Maher and P. Ali and M. S. Rahman}, doi = {10.3390/bs11080106}, issn = {2076-328X (Print) 2076-328x}, year = {2021}, date = {2021-01-01}, journal = {Behav Sci (Basel)}, volume = {11}, number = {8}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {COVID-19 has harshly impacted communities globally. This study provides relevant information for creating equitable policy interventions to combat the spread of COVID-19. This study aims to predict the knowledge, attitude, and practice (KAP) of the COVID-19 pandemic at a global level to determine control measures and psychosocial problems. A cross-sectional survey was conducted from July to October 2020 using an online questionnaire. Questionnaires were initially distributed to academicians worldwide. These participants distributed the survey among their social, professional, and personal groups. Responses were collected and analyzed from 67 countries, with a sample size of 3031. Finally, based on the number of respondents, eight countries, including Bangladesh, China, Japan, Malaysia, Mexico, Pakistan, the United States, and Zambia were rigorously analyzed. Specifically, questionnaire responses related to COVID-19 accessibility, behavior, knowledge, opinion, psychological health, and susceptibility were collected and analyzed. As per our analysis, age groups were found to be a primary determinant of behavior, knowledge, opinion, psychological health, and susceptibility scores. Gender was the second most influential determinant for all metrics except information about COVID-19 accessibility, for which education was the second most important determinant. Respondent profession was the third most important metric for all scores. Our findings suggest that health authorities must promote health educations, implement related policies to disseminate COVID-19-awareness that can prevent and control the spread of COVID-19 infection.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN178, title = {Factors associated with prevention and control practices against Zika virus infection among pregnant women in Malaysia, a dengue-endemic country}, author = {L. P. Wong and H. Alias and J. Hassan and S. AbuBakar}, doi = {10.7883/yoken.JJID.2021.342}, issn = {1344-6304}, year = {2021}, date = {2021-01-01}, journal = {Jpn J Infect Dis}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {This study aimed to determine the prevention and control practices of ZIKV infection among pregnant women in Malaysia. A cross-sectional study was conducted among pregnant women who attended antenatal care. Only 7.8% reported that they abstain from sex or use barrier methods during sexual intercourse to prevent ZIKV transmission. The odd of abstaining from sex or using barrier methods was significantly higher among the Chinese ethnic group than the Malay ethnic group (OR=4.569; 95% CI: 2.696-7.743). Having a total ZIKV knowledge score of 12-24 was also significantly associated with higher odds of abstaining from sex or using barrier methods than a score of 0-11 (OR=2.819; 95% CI 1.682-4.725). In total, 38.6% recorded a higher mean total score for all the current mosquito control practices than before hearing of ZIKV. Participants living in bungalows or village houses (OR=2.006; 95% CI 1.023-3.936) and low-rise houses (OR=1.566; 95% CI 1.109-2.212) were more likely to have a higher mean total score of current mosquito control practices than control practices before hearing of ZIKV compared to those in high-rise houses. The deficit in ZIKV knowledge and control practices provides insight for the development of health education for pregnant women during antenatal care visits.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN192, title = {Assessment of Knowledge, Attitudes, and Practices Regarding Dengue among Physicians: A Web-Based Cross-Sectional Survey}, author = {K. S. Koonisetty and N. Aghamohammadi and T. Urmi and S\.{I} Yava\c{s}oglu and M. S. Rahman and R. Nandy and U. Haque}, doi = {10.3390/bs11080105}, issn = {2076-328X (Print) 2076-328x}, year = {2021}, date = {2021-01-01}, journal = {Behav Sci (Basel)}, volume = {11}, number = {8}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {Dengue fever is one of the most important viral infections transmitted by Aedes mosquitoes and a major cause of morbidity and mortality globally. Accurate identification of cases and treatment of dengue patients at the early stages can reduce medical complications and dengue mortality rate. This survey aims to determine the knowledge, attitude, and practices (KAP) among physicians in dengue diagnosis and treatment. This study was conducted among physicians in Turkey as one nonendemic country and Bangladesh, India, and Malaysia as three dengue-endemic countries. The dosing frequencies, maximum doses, and contraindications in dengue fever were examined. The results found that physicians from Bangladesh, India, and Malaysia have higher KAP scores in dengue diagnosis and treatment compared to physicians in Turkey. This may be due to a lack of physician's exposure to a dengue patient as Turkey is considered a nonendemic country. This assessment may help establish a guideline for intervention strategies among physicians to have successful treatment outcomes and reduce dengue mortality.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN188, title = {Longitudinal Follow-Up of Death Anxiety and Psychophysical-Symptom Experience of Participants in the Silent Mentor Program}, author = {L. P. Wong and S. L. Tan and H. Alias and T. E. Sia and A. Saw}, doi = {10.1177/00302228211043613}, issn = {0030-2228}, year = {2021}, date = {2021-01-01}, journal = {Omega (Westport)}, pages = {302228211043613}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {This study assessed death anxiety (Death Anxiety Questionnaire, DAQ) and psychophysical- (psychological and physical) symptom experience following cadaveric dissection among the Silent Mentor Program (SMP) participants before thawing (T1), after the suturing, dressing and coffining session (T2), and one month post-program (T3). There was a significant decline in the total DAQ score comparing T1 and T2 (t = 7.69, p \< 0.001) and T2 and T3 (t = 5.00, p \< 0.001) and T1 and T3 (t = 10.80, p \< 0.001). There was a significant reduction in total psychological-symptom score comparing T1 and T2 (t = 4.92, p \< 0.001) and between T1 and T3 (t = 4.85, p \< 0.001). However, for the physical-symptom experience, a significant increase in the physical-symptom score between T1 and T2 (t = -3.25}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN180, title = {Facilitators and Barriers to Implementing Healthy School Canteen Intervention among Malaysian Adolescents: A Qualitative Study}, author = {N. A. Azizan and A. Papadaki and T. T. Su and M. Y. Jalaludin and S. Mohammadi and M. Dahlui and M. Nahar Azmi Mohamed and H. A. Majid}, doi = {10.3390/nu13093078}, issn = {2072-6643}, year = {2021}, date = {2021-01-01}, journal = {Nutrients}, volume = {13}, number = {9}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {This study evaluated implementing a school-based intervention to promote healthier dietary habits in the school environment among Malaysian adolescents using qualitative methods. This qualitative study was conducted in four secondary schools in Perak and Selangor (two urban and two rural schools) that received the intervention (either training or training and food subsidy). A total of eight focus groups (68 students aged 15 years old) and 16 in-depth interviews were conducted with canteen operators, school convenience shop operators, school teachers and school principals in each school. Thematic analysis was used to analyse the qualitative data to identify suitable themes. We found several initiatives and changes by the schools' stakeholders to change to a healthy school canteen programme. The stakeholders also noticed the students' food preferences that influence healthy food intake in canteens and convenience shops. The food vendors and school administrators also found that subsidising healthy meals might encourage healthy eating. Among barriers to implementing healthy school initiatives were the student's perception of healthy food and their eating habits, which also affect the food vendors' profit if they want to implement a healthy canteen. The school-based intervention has the potential to promotes healthier eating among school adolescents. Continuous training and monitoring of canteen operators and convenience shops are needed, including building partnerships and educating the students on healthy eating to cultivate healthy eating habits.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN175, title = {COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries}, author = {L. P. Wong and H. Alias and M. Danaee and J. Ahmed and A. Lachyan and C. Z. Cai and Y. Lin and Z. Hu and S. Y. Tan and Y. Lu and G. Cai and D. K. Nguyen and F. N. Seheli and F. Alhammadi and M. D. Madhale and M. Atapattu and T. Quazi-Bodhanya and S. Mohajer and G. D. Zimet and Q. Zhao}, doi = {10.1186/s40249-021-00900-w}, issn = {2095-5162 (Print) 2049-9957}, year = {2021}, date = {2021-01-01}, journal = {Infect Dis Poverty}, volume = {10}, number = {1}, pages = {122}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. METHODS: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. RESULTS: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4). CONCLUSIONS: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN165, title = {COVID-19 Vaccine Hesitancy and Emerging Variants: Evidence from Six Countries}, author = {S. Mangla and F. T. Zohra Makkia and A. K. Pathak and R. Robinson and N. Sultana and K. S. Koonisetty and A. Karamehic-Muratovic and U. D. T. Nguyen and A. J. Rodriguez-Morales and J. A. Sanchez-Duque and P. T. Zamba and N. Aghamohammadi and F. Cs and U. Haque}, doi = {10.3390/bs11110148}, issn = {2076-328X (Print) 2076-328x}, year = {2021}, date = {2021-01-01}, journal = {Behav Sci (Basel)}, volume = {11}, number = {11}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {As the world tries to cope with the devastating effects of the COVID-19 pandemic and emerging variants of the virus, COVID-19 vaccination has become an even more critical tool toward normalcy. The effectiveness of the vaccination program and specifically vaccine uptake and coverage, however, is a function of an individual's knowledge and individual opinion about the disease and available vaccines. This study investigated the knowledge, attitudes, and resulting community practice(s) associated with the new COVID-19 variants and vaccines in Bangladesh, Colombia, India, Malaysia, Zimbabwe, and the USA. A cross-sectional web-based Knowledge, Attitudes, and Practices (KAP) survey was administered to respondents living in six different countries using a structured and multi-item questionnaire. Survey questions were translated into English, Spanish, and Malay to accommodate the local language in each country. Associations between KAP and a range of explanatory variables were assessed using univariate and multiple logistic regression. A total of 781 responses were included in the final analysis. The Knowledge score mean was 24 (out of 46), Attitude score 28.9 (out of 55), and Practice score 7.3 (out of 11). Almost 65% of the respondents reported being knowledgeable about COVID-19 variants and vaccination, 55% reported a positive attitude toward available COVID-19 vaccines, and 85% reported engaging in practices that supported COVID-19 vaccination. From the multiple logistic models, we found post-graduate education (AOR = 1.83, 95% CI: 1.23-2.74) and an age range 45-54 years (AOR = 5.81, 95% CI: 2.30-14.69) to be significantly associated with reported COVID-19 knowledge. In addition, positive Attitude scores were associated with respondents living in Zimbabwe (AOR = 4.49, 95% CI: 2.04-9.90) and positive Practice scores were found to be associated with people from India (AOR = 3.68, 95% CI: 1.15-11.74) and high school education (AOR = 2.16, 95% CI: 1.07-4.38). This study contributes to the identification of socio-demographic factors associated with poor knowledge, attitudes, and practices relating to COVID-19 variants and vaccines. It presents an opportunity for collaboration with diverse communities to address COVID-19 misinformation and common sources of vaccine hesitancy (i.e., knowledge, attitudes, and practices).}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN184, title = {Outcomes after mastectomy with immediate breast reconstruction for breast cancer in a multiethnic, middle-income Asian setting}, author = {M. H. See and S. Sinnadurai and L. L. Lai and K. L. Tan and M. S. Teh and L. Y. Teoh and S. Jamaris and R. Abdul Malik and N. Bhoo-Pathy}, doi = {10.1016/j.surg.2021.08.001}, issn = {0039-6060}, year = {2021}, date = {2021-01-01}, journal = {Surgery}, volume = {170}, number = {6}, pages = {1604-1609}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Although immediate breast reconstruction is increasingly becoming popular worldwide, evidence from resource-limited settings is scarce. We investigated factors associated with immediate breast reconstruction in a multiethnic, middle-income Asian setting. Short-term surgical complications, timing of initiation of chemotherapy, and survival outcomes were compared between women undergoing mastectomy alone and their counterparts receiving immediate breast reconstruction. METHODS: This historical cohort study included women who underwent mastectomy after diagnosis with stage 0 to stage IIIa breast cancer from 2011 to 2015 in a tertiary hospital. Multivariable regression analyses were used to assess factors associated with immediate breast reconstruction and to measure clinical outcomes. RESULT: Out of 790 patients with early breast cancer who had undergone mastectomy, only 68 (8.6%) received immediate breast reconstruction. Immediate breast reconstruction was independently associated with younger age at diagnosis, recent calendar years, Chinese ethnicity, higher education level, and invasive ductal carcinomas. Although immediate breast reconstruction was associated with a higher risk of short-term local surgical complications (adjusted odds ratio: 3.58 [95% confidence interval 1.75-7.30]), there were no significant differences in terms of delay in initiation of chemotherapy, 5-year disease-free survival, and 5-year overall survival between both groups in the multivariable analyses. CONCLUSION: Although associated with short-term surgical complications, immediate breast reconstruction after mastectomy does not appear to be associated with delays in initiation of chemotherapy, recurrence, or mortality after breast cancer. These findings are valuable in facilitating shared surgical decision-making, improving access to immediate breast reconstruction, and setting priorities for surgical trainings in middle-income settings.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN181, title = {A Qualitative Investigation on the Roles of Social Support on Physical Activity Behaviour among the Rural-Dwelling Older Women in Malaysia}, author = {T. Marthammuthu and F. M. Hairi and W. Y. Choo and N. A. M. Salleh and N. N. Hairi}, doi = {10.3390/ijerph18189609}, issn = {1661-7827 (Print) 1660-4601}, year = {2021}, date = {2021-01-01}, journal = {Int J Environ Res Public Health}, volume = {18}, number = {18}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {Despite many health benefits of physical activities, both physically and mentally, the majority of the older women in the rural areas of Malaysia are showing a low prevalence of physical activities. Understanding the roles of social support to improve physical activities is imperative to promote active and healthy ageing among the rural-dwelling older women in Malaysia. Hence, this qualitative study adopted an inductive design using 17 in-depth interviews to understand the role of social support on physical activity behaviour among the rural community-dwelling older woman in Kuala Pilah District, Negeri Sembilan, Malaysia from December 2019 to January 2020. Three categories of themes were identified in this study. Firstly, adaptive social support in terms of informational, companionship and emotional supports reported enhancing physical activity levels among older women. Secondly, the absence of help and assistance from the social network asserts independence and triggers the older women to perform the activities by themselves, thus engage in physically active lifestyles. Thirdly, lacking social support demotivate older women to be engaged in physical activities. In particular, loss of companionship support, poor acceptance or appraisal support, logistic issues to attend exercise programmes and neighbourhood safety and security issues were among the main barriers of physical activities reported by the older women. The main findings of this study shed some light on the exigency of strengthening social support from the social network to engage the older women in physical activities. The roles of social media, effective patient-doctor communication and interventions targeting the spouses and family members must be strengthened to create a supportive atmosphere to enhance physical activity levels among older women.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN193, title = {Practice of New Normal Lifestyles, Economic and Social Disruption, and Level of Happiness Among General Public in China in the Post-COVID-19 Era}, author = {X. Lin and Y. Lin and Z. Hu and H. Alias and L. P. Wong}, doi = {10.2147/rmhp.S320448}, issn = {1179-1594 (Print) 1179-1594}, year = {2021}, date = {2021-01-01}, journal = {Risk Manag Healthc Policy}, volume = {14}, pages = {3383-3393}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: This study aimed to investigate the impact of the COVID-19 pandemic on the practice of 'new normal' lifestyles, economic and social distribution, and individuals' well-being of people in China after the country ease the lockdown restriction. METHODS: A cross-sectional, self-administered online survey was carried out between 3 September and 15 October 2020. RESULTS: A total of 8393 complete responses were received from a nationwide sample. Poor sustainability in the practice of "new norm" was reported. Noteworthy disparities were observed in willingness to carry out "new normal" practices by gender, urban-rural locality, non-Han and Han Chinese and educational attainment. There was evidence of economic and social disruption associated with COVID-19 or "new normal" practices. The current mean (±standard deviation [SD]) happiness score (110.45 ± 17.55) was slightly lower than the mean happiness score before (111.12 ± 17.83) the COVID-19 pandemic (t= -9.01, p\<0.001). Lower socioeconomic status and greater economic and social disruptions were associated with lower current happiness scores. Moreover, greater willingness to adapt to "new normal" practices was associated with higher levels of happiness. CONCLUSION: There is a need to encourage sustainable practice of new norm post-pandemic. Segments of the public continue to experience significant economic and social effects and the post-pandemic 'new norms' remain at risk of leading to psychological consequences.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN163, title = {COVID-19 Anti-Vaccine Sentiments: Analyses of Comments from Social Media}, author = {L. P. Wong and Y. Lin and H. Alias and S. A. Bakar and Q. Zhao and Z. Hu}, doi = {10.3390/healthcare9111530}, issn = {2227-9032 (Print) 2227-9032}, year = {2021}, date = {2021-01-01}, journal = {Healthcare (Basel)}, volume = {9}, number = {11}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: This study analyzed the insights and sentiments of COVID-19 anti-vaccine comments from Instagram feeds and Facebook postings. The sentiments related to the acceptance and effectiveness of the vaccines that were on the verge of being made available to the public. PATIENTS AND METHODS: The qualitative software QSR-NVivo 10 was used to manage, code, and analyse the data. RESULTS: The analyses uncovered several major issues concerning COVID-19 vaccine hesitancy. The production of the COVID-19 vaccine at an unprecedented speed evoked the fear of skipping steps that would compromise vaccine safety. The unknown long-term effects and duration of protection erode confidence in taking the vaccines. There were also persistent concerns with regard to vaccine compositions that could be harmful or contain aborted foetal cells. The rate of COVID-19 death was viewed as low. Many interpreted the 95% effectiveness of the COVID-19 vaccine as insufficient. Preference for immunity gains from having an infection was viewed as more effective. Peer-reviewed publication-based data were favoured as a source of trust in vaccination decision-making. CONCLUSIONS: The anti-COVID-19 vaccine sentiments found in this study provide important insights for the formulation of public health messages to instill confidence in the vaccines.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN179, title = {Longitudinal assessment between lifestyle-related risk factors and a composite cardiovascular disease (CVD) risk index among adolescents in Malaysia}, author = {N. Thangiah and T. T. Su and K. Chinna and M. Y. Jalaludin and M. N. A. Mohamed and H. A. Majid}, doi = {10.1038/s41598-021-98127-0}, issn = {2045-2322}, year = {2021}, date = {2021-01-01}, journal = {Sci Rep}, volume = {11}, number = {1}, pages = {19135}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {The study aims to create a composite risk index of CVD among adolescents and examine the influence of demographic, socioeconomic and lifestyle-related risk factors on the composite risk index of biological CVD risk factors among adolescents in Malaysia. A Malaysian adolescent cohort of 1320 adolescents were assessed at 13, 15 and 17 years. Seven biological CVD risk factors with moderate correlation were identified, standardized and averaged to form a composite CVD risk index. Generalised estimating equation using longitudinal linear regression was used to examine the effects of changes in adolescent lifestyle-related risk factors on the composite CVD risk index over time. From the ages 13 to 17 years, physical fitness (β = - 0.001, 90% CI = - 0.003, 0.00002) and BMI (β = 0.051, 95% CI = 0.042, 0.060) were significant predictors of attaining high scores of CVD risk. Female (β = 0.118, 95% CI = 0.040, 0.197), Chinese (β = 0.122, 95% CI = 0.006, 0.239), Indians (β = - 0.114, 95% CI = - 0.216, - 0.012) and adolescents from rural schools (β = 0.066, 95% CI = - 0.005, 0.136) were also found to be considerably significant. A more robust and gender-specific intervention programme focusing on healthy lifestyle (including achieving ideal BMI and improving physical fitness) need to be implemented among school-going adolescents.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN183, title = {A preliminary study of the original TIBSIT and its cultural adaptation in Malaysia}, author = {S. D. Kevin and R. Govindaraju and M. Danaee and T. A. Shahrizal and N. Prepageran}, issn = {0300-5283 (Print) 0300-5283}, year = {2021}, date = {2021-01-01}, journal = {Med J Malaysia}, volume = {76}, number = {Suppl 4}, pages = {3-8}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: A simple and self-administered 'scratch \& sniff' test kit like the TIBSIT smell kit based on the Taiwan Smell Identification Test (TWSIT), provides a safe and quick assessment of olfaction. The original TIBSIT has been validated for use in Taiwan with age specific scores for different age groups and diagnosis. The main aim of this study is to examine if TIBSIT can be applicable for the Malaysian population and perform cultural adaptation as necessary to allow a more accurate assessment using this tool. METHOD AND MATERIAL: A preliminary study of the original TIBSIT (Phase 1) followed by cultural adaption (Phase 2) were carried out on volunteers from various neighbourhoods in Klang Valley, Malaysia comprising of age group 16-80 years. A total of 150 test subjects and 50 test subjects were recruited for Phase 1 and Phase 2 respectively. Cultural adaptation was done with changes to the distractors that were found to be confusing. In addition, modifications included added language translation and visual reinforcement with images of the odour's substance of origin. RESULTS: 109 out of the 150 responses were accepted for Phase 1. A detection rate of less than 75% was found in three of the odours with the remaining showing an average rate of 87.2% to 97.7%. These three odours were culturally adapted for Phase 2. All 50 responses for Phase 2 were accepted; two of the odours' detection rates improved to 98% but the plum odour was only detected 53% of the time. CONCLUSION: TIBSIT provides a quick office-based olfaction testing. The culturally adapted test kit is a potentially useful screening test for the Malaysian population. It is also safe and excludes the need of the clinician to carry out the test. This becomes especially useful in testing any dysosmia (hyposmia/anosmia) cases suspected of SARS-COV-2 virus infection (COVID-19).}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN164, title = {Baseline cardiovascular comorbidities, and the influence on cancer treatment decision-making in women with breast cancer}, author = {S. Subramaniam and Y. C. Kong and H. Zaharah and Cspm Uiterwaal and A. Richard and N. A. Taib and A. Deniel and K. H. Chee and R. S. Bustamam and M. H. See and A. Fong and C. H. Yip and N. Bhoo-Pathy}, doi = {10.3332/ecancer.2021.1293}, issn = {1754-6605 (Print) 1754-6605}, year = {2021}, date = {2021-01-01}, journal = {Ecancermedicalscience}, volume = {15}, pages = {1293}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: To measure the baseline prevalence of cardiovascular disease (CVD), its modifiable and non-modifiable risk factors in breast cancer patients, and determine their association with adjuvant treatment decision-making. METHOD: From 2016 to 2017, 2,127 women newly-diagnosed with breast cancer were prospectively recruited. Participants' cardiovascular biomarkers were measured prior to adjuvant treatment decision-making. Clinical data and medical histories were obtained from hospital records. Adjuvant treatment decisions were collated 6-8 months after recruitment. A priori risk of cardiotoxicity was predicted using the Cardiotoxicity Risk Score. RESULTS: Mean age was 54 years. Eighty-five patients had pre-existing cardiac diseases and 30 had prior stroke. Baseline prevalence of hypertension was 47.8%. Close to 20% had diabetes mellitus, or were obese. Dyslipidaemia was present in 65.3%. The proportion of women presenting with ≥2 modifiable CVD risk factors at initial cancer diagnosis was substantial, irrespective of age. Significant ethnic variations were observed. Multivariable analyses showed that pre-existing CVD was consistently associated with lower administration of adjuvant breast cancer therapies (odds ratio for chemotherapy: 0.32, 95% confidence interval: 0.17-0.58). However, presence of multiple risk factors of CVD did not appear to influence adjuvant treatment decision-making. In this study, 63.6% of patients were predicted to have high risks of developing cardiotoxicities attributed to a high baseline burden of CVD risk factors and anthracycline administration. CONCLUSION: While recent guidelines recommend routine assessment of cardiovascular comorbidities in cancer patients prior to initiation of anticancer therapies, this study highlights the prevailing gap in knowledge on how such data may be used to optimise cancer treatment decision-making.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN170, title = {Correction to: Do we need different predictive equations for the acute and late phases of critical illness? A prospective observational study with repeated indirect calorimetry measurements}, author = {P. C. Tah and B. K. Poh and C. C. Kee and Z. Y. Lee and V. R. Hakumat-Rai and M. B. Mat Nor and M. Kamarul Zaman and H. A. Majid and M. S. Hasan}, doi = {10.1038/s41430-021-01011-3}, issn = {0954-3007}, year = {2021}, date = {2021-01-01}, journal = {Eur J Clin Nutr}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {Seemingly unrelated events such as parity, age of mother, prior obstetrical complications, antepartum complications, etc., have been noted by workers such as Prechtl (1967) and Goodwin et al. (1963) as having a cumulative effect on the ultimate foetal risk. Also, multivariate analysis of the findings of the British Perinatal Mortality Survey of 1958 have singled out factors such as social and biological characteristics of the mother, the obstetrical history, the course of gestation and the birth of the baby as having a major influence on perinatal mortality (W.H.O. Public Health Papers No. 42). Based on these and other such statistical analyses various workers have attempted scoring systems for the identification of the foetus at risk. The objective of this study was to design a similar form for the identification of the foetus at risk, modified for local use and needs. In a developing country like Malaysia, with its limited financial and trained manpower resources, obstetrical care is still being provided by auxiliaries to the rural population, which accounts for 70% of the total population. Hospital and specialist obstetric services are available in major towns. From the foregoing, it was considered that it would be of great advantage if a simple scoring system for the identification of high risk pregnancies for use by auxiliaries in rural areas be formulated. For the purpose of designing a risk scoring form (study/ designed form) for this study, 4 scoring systems viz those used by Nesbitt et al. (1969), Goodwin et al. (1969), Wilson, et al. (1973) and Coopland et al. (1977) were considered in conjunction with the antenatal recording card which is currently being used for recording the examination findings in an antenatal mother attending any rural health clinic in Malaysia. Selection of factors for use in the assessment of the foetal risk, in the study/designed form, was based on the following criteria: (i) that the factors should be those for which particulars are routinely obtained from antenatal mothers attending any rural health clinic. (ii) that the recognition of the factor should be within the technical capabilities of the auxiliary. The decision for the scoring system that could be used as an index for designing the study form was based on the following criteria: (i) the scoring system should be easy to understand. (ii) the scoring system which could be adapted with the minimum of modifications. Having thus designed the form, it was evaluated by using the form to score 2 groups of mothers, one prospectively, and the other retrospectively. The only difference between the 2 groups being that in the former the outcome was not known prior to scoring and in the latter, the outcome was already known before scoring. The former group consisted of a group of 100 mothers selected randomly from those mothers whose last menstrual period was in March 1978 and who were attending rural health clinics in Kuala Pilah, and the latter group consisted of all the mothers in the same district who had a perinatal death during the whole of 1978. Altogether 135 mothers were scored, 96 in the prospective group and 39 in the retrospective group. This resulted in 137 births because there were 2 twin deliveries. Among these, there were a total of 43 perinatal and 96 surviving infants. The lowest score recorded was 0 and the highest score recorded was 10. When the 137 births were tabulated according to the risk score it was shown in the group with risk score 0 the percentage perinatal deaths was 9.5 and in the group with risk score 1 it was 16.2. Between risk score 2 to 7 the percentage perinatal deaths was higher than in the group with risk score 1. However a steady rise in percentage perinatal deaths with increasing score was not apparent probably because of the small numbers in each group. For the risk scores 9 and 10, the percentage perinatal death was 100%. A test of significance using the chi-square test gave a p value of \< 0.001, hence suggesting highly significant results. The sensitivity and specificity of the risk scoring form was found to be 60.5% and 77.7% respectively. By relating the risk scores and outcome of pregnancy to place of delivery and birth attendant it seemed to indicate that whatever the place of delivery the percentage perinatal death increases with increasing risk scores. It was apparently shown that percentage perinatal loss was high even in the low risk group where the delivery was conducted by untrained personnel. When the risk scores and outcome of pregnancy were related to period of gestation at delivery it seemed to show that prematurity was a major factor in the perinatal death irrespective of risk score. It also showed that with increasing risk score the percentage of pregnancies reaching 37 weeks gestation or more prior to delivery decreased from 92.4% in the risk score group 0 to 1 to 40% in the group with risk score of more than or equal to 6. In conclusion, this form seems to have a potential for use in detecting the foetus at risk. However, further widescale tests need to be carried out to confirm the validity of the scoring system.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN185, title = {The longitudinal relationship between nutritional status and anaemia among Malaysian adolescents}, author = {V. Krishnan and R. A. Zaki and A. M. Nahar and M. Y. Jalaludin and H. A. Majid}, doi = {10.1016/j.lanwpc.2021.100228}, issn = {2666-6065}, year = {2021}, date = {2021-01-01}, journal = {Lancet Reg Health West Pac}, volume = {15}, pages = {100228}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {INTRODUCTION: The triple burden of malnutrition characterised by stunting and wasting, overweight/obesity, and anaemia experienced by Malaysians causes severe and long-lasting damage during the period of development and rapid growth, particularly in adolescence. This study aimed to demonstrate the trend of anaemia prevalence and to determine its longitudinal association with nutritional status and lifestyle among Malaysian adolescents. METHOD: The study involved secondary data analysis from the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study. A closed cohort secondary data analysis was performed from the dynamic cohort of 528 adolescents (male = 151; female = 377) aged 13 years attending secondary school who were followed up at 15 and 17 years. Anaemia status was determined by haemoglobin level \< 12g/dL based on FBC, and iron deficiency anaemia (IDA) was determined when the Mentzer Index \< 13. A generalised estimating equation (GEE) was constructed to investigate the longitudinal relationship between nutritional status and lifestyle on anaemia status over five years. RESULTS: The trend of anaemia prevalence increased significantly across the age group (7•9%; 95% CI: 2•3-11•1, 13•9%; 95% CI: 10•8-15•7 and 15•8%; 95% CI: 3•8-23•1) at 13, 15 and 17 years, respectively, especially among females. The trend of anaemia prevalence among females, also increased significantly across the age group (11.1%;95% CI:6.7-17.8, 15.7%;95% CI:11.4-21.3, 23.1%;95% CI:16.8-31.0). A similar trend was noted for the prevalence of IDA among those who were anaemic (66•5%; 95% CI: 40•4-85•3, 72•2%;95% CI: 54•8-85•4, 76•3%; 95% CI: 59•2-87•7). A longitudinal analysis using GEE revealed that adolescents who did not meet the Recommended Nutrient Intake (RNI) for total iron intake per day were significantly associated with anaemia (RR=1•517;95% CI: 1•012-2•275; p=0•044) and IDA (RR=1•776;95% CI: 1•225-2•57; p= 0•002). CONCLUSION: The overall trend of anaemia among adolescents is in increasing trend and anaemia is prevalent among female adolescents in this study. It is crucial to understand that the current fortification strategy may need to be revisited, and robust intervention programmes are necessary and should be sex specific.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN187, title = {Preventing Re-Emergence of COVID-19: A National Survey of Public Risk Perceptions and Behavioural Intentions Concerning Travel Plan Among Taiwanese}, author = {L. P. Wong and C. J. Chiu and H. Alias and T. S. Lee and Z. Hu and Y. Lin}, doi = {10.3389/fpubh.2021.710508}, issn = {2296-2565}, year = {2021}, date = {2021-01-01}, journal = {Front Public Health}, volume = {9}, pages = {710508}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {Background: The objectives of this study were to investigate risk perceptions and travel intention among the general public in Taiwan during the COVID-19 outbreak. Methods: This study used a cross-sectional online survey to collect data. The questionnaire was disseminated via the social media platform (LINE and Facebook) to the general public. Results: A total of 3,237 complete responses were received, of whom 5.8% (95% CI 5.1-6.7) of the participants reported intent to travel to overseas countries with an apparent community spread and 5.5% (95% CI 4.7-6.3) reported intent to travel to other overseas countries in the next 1 month. A relatively higher proportion (46.5%; 95% CI 44.7-48.2) reported intention for domestic travelling. Participants who viewed travelling to only be risky for older adults or those with medical conditions (OR = 2.19; 95% CI 1.38-3.47) and who perceived that one will not get infected if one takes recommended precautionary measures (OR = 3.12; 95% CI 1.85-5.27) reported higher travelling intention to overseas countries with an apparent community spread. Conclusions: Overall, the findings suggest that risk perceptions were depicted as a strong influence of travel intentions.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN190, title = {Do we need different predictive equations for the acute and late phases of critical illness? A prospective observational study with repeated indirect calorimetry measurements}, author = {P. C. Tah and B. K. Poh and C. C. Kee and Z. Y. Lee and V. R. Hakumat-Rai and M. B. Mat Nor and M. Kamarul Zaman and H. A. Majid and M. S. Hasan}, doi = {10.1038/s41430-021-00999-y}, issn = {0954-3007 (Print) 0954-3007}, year = {2021}, date = {2021-01-01}, journal = {Eur J Clin Nutr}, pages = {1-8}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Predictive equations (PEs) for estimating resting energy expenditure (REE) that have been developed from acute phase data may not be applicable in the late phase and vice versa. This study aimed to assess whether separate PEs are needed for acute and late phases of critical illness and to develop and validate PE(s) based on the results of this assessment. METHODS: Using indirect calorimetry, REE was measured at acute (≤5 days; n = 294) and late (≥6 days; n = 180) phases of intensive care unit admission. PEs were developed by multiple linear regression. A multi-fold cross-validation approach was used to validate the PEs. The best PEs were selected based on the highest coefficient of determination (R(2)), the lowest root mean square error (RMSE) and the lowest standard error of estimate (SEE). Two PEs developed from paired 168-patient data were compared with measured REE using mean absolute percentage difference. RESULTS: Mean absolute percentage difference between predicted and measured REE was \<20%, which is not clinically significant. Thus, a single PE was developed and validated from data of the larger sample size measured in the acute phase. The best PE for REE (kcal/day) was 891.6(Height) + 9.0(Weight) + 39.7(Minute Ventilation)-5.6(Age) - 354, with R(2) = 0.442}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN173, title = {Factors influencing inappropriate use of antibiotics: Findings from a nationwide survey of the general public in Malaysia}, author = {L. P. Wong and H. Alias and S. A. Husin and Z. B. Ali and B. Sim and S. S. S. Ponnampalavanar}, doi = {10.1371/journal.pone.0258698}, issn = {1932-6203}, year = {2021}, date = {2021-01-01}, journal = {PLoS One}, volume = {16}, number = {10}, pages = {e0258698}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {Antibiotic resistance is one of the biggest threats to global public health. Misuse of antibiotics has never been investigated on a nationwide scale among the general public in Malaysia. This study aimed to identify sociodemographic and knowledge factors associated with inappropriate use of antibiotics in the Malaysian context to inform the development of interventions to mitigate inappropriate antibiotic use. We conducted computer-assisted telephone interviews (CATI) between June 2019 and December 2019. The telephone numbers were randomly generated from the electronic residential telephone directory of all 13 states and 3 Federal Territories in Malaysia. The survey consisted of questions on demographics, knowledge about antibiotics and antibiotic resistance (53 items), and practices of antibiotic use (16 questions). A total of 864 complete responses were received. Pronounced erroneous beliefs that antibiotics are effective against infections caused by viruses and that antibiotics can speed up recovery from coughs and colds were evident. The proportions that were aware of the terms 'drug resistance', 'antimicrobial resistance', and 'superbugs' were low. The mean and standard deviation (SD) for the antibiotic knowledge score was 23.7 (SD ±9.25; range 0 to 50) out of a possible score of 52. Regarding antibiotic practices, a considerable proportion reported non-adherence to recommended doses. The mean and SD for the antibiotic practices score was 37.9 (SD ± 6.5; range 17 to 47) out of a possible score of 48. Participants who earned an average monthly household income of MYR1001-3000 (OR 1.61, 95% CI 1.04-2.50) were more likely to report higher antibiotic practice scores than those with \<MYR1000. Participants with tertiary education attainment reported higher antibiotic practice scores (OR 1.99; 95%CI 1.02-3.91) than those with primary school and below. High antibiotic knowledge scores (OR 3.94; 95% CI 2.71-5.73) were associated with higher antibiotic practice scores. Inappropriate antibiotic use is influenced by demographics and antibiotic knowledge. This study calls for education interventions focused on the lower socio-economic status population to increase awareness and to promote appropriate antibiotic use.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN176, title = {Francisella philomiragia bacteremia in an immunocompromised patient: a rare case report}, author = {H. S. Chua and Y. H. Soh and S. K. Loong and S. AbuBakar}, doi = {10.1186/s12941-021-00475-2}, issn = {1476-0711}, year = {2021}, date = {2021-01-01}, journal = {Ann Clin Microbiol Antimicrob}, volume = {20}, number = {1}, pages = {72}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Francisella philomiragia is a very rare opportunistic pathogen of humans which causes protean diseases such as pneumonia and other systemic infections. Subsequent failure of prompt treatment may result in poor prognosis with mortality among infected patients. CASE PRESENTATION: The present report describes a case of F. philomiragia bacteraemia first reported in Malaysia and Asian in a 60-year-old patient with underlying end-stage renal disease (ESRF) and diabetes mellitus. He presented with Acute Pulmonary Oedema with Non-ST-Elevation Myocardial Infarction (NSTEMI) in our hospital. He was intubated in view of persistent type I respiratory failure and persistent desaturation despite post haemodialysis. Blood investigation indicated the presence of ongoing infection and inflammation. The aerobic blood culture growth of F. philomiragia was identified using the matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (Score value: 2.16) and confirmed by 16S Ribosomal DNA (16S rDNA) sequencing. He was discharged well on day 26 of admission, after completing one week of piperacillin/tazobactam and two weeks of doxycycline. CONCLUSION: Clinical suspicion should be raised if patients with known risk factors are presenting with pneumonia or pulmonary nodules especially as these are the most common manifestations of F. philomiragia infection. Early diagnosis via accurate laboratory identification of the organism through MALDI-TOF mass spectrometry and molecular technique such as 16S rDNA sequencing are vital for prompt treatment that results in better outcomes for the afflicted patients.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN189, title = {The Impact of the COVID-19 Pandemic on Future Nursing Career Turnover Intention Among Nursing Students}, author = {Y. Lin and Z. Hu and M. Danaee and H. Alias and L. P. Wong}, doi = {10.2147/rmhp.S322764}, issn = {1179-1594 (Print) 1179-1594}, year = {2021}, date = {2021-01-01}, journal = {Risk Manag Healthc Policy}, volume = {14}, pages = {3605-3615}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {INTRODUCTION: A shortage of nurses has been a major global concern, particularly during pandemics. Nursing students turning away from the nursing profession upon graduation may exacerbate nursing workforce shortfalls. The main objective of this study was to assess perceived occupational turnover intention among nursing students and associated factors (fear of COVID-19 and life satisfaction). Students were also asked to provide suggestions that could enhance their intention to join the nursing profession. METHODS: An online survey was sent to all registered undergraduate nursing students at Fujian Medical University, China. The partial least squares structural equation model (PLS-SEM) was used to investigate key factors influencing turnover intention. RESULTS: A total of 1020 complete responses were received (response rate: 86.2%). Nearly half (49.1%) reported that they would choose not to be on a nursing course if given a choice, 45.4% often think of not going into the nursing profession in the future, and 23.7% would consider entering a healthcare industry that has zero contact with patients. The total turnover intention score range was 3 to 15, and the mean ± standard deviation (SD) was 9.2 (SD ± 2.5). PLS-SEM path analysis revealed that fear of COVID-19 (β = 0.226, p \< 0.001) had a positive effect on turnover intention. Satisfaction with life (β = -0.212, p \< 0.001) had a negative effect on turnover intention. Analysis of open-ended survey data on students' perspectives on how to encourage nursing students to enter the nursing workforce revealed five central themes: 1) professional role, respect, and recognition; 2) higher wages; 3) reduce workload; 4) enhance occupational health and safety; and 5) career advancement opportunities. CONCLUSION: Factors influencing turnover intention and suggestions to reduce students' apprehension towards joining the nursing profession found in this study should be seriously taken into consideration in initiatives to address the nurse shortages.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN174, title = {Determinants of smokeless tobacco use and prevalence among Sudanese adolescents}, author = {M. Othman and N. D. N. Farid and N. Aghamohammadi and M. Danaee}, doi = {10.1186/s13690-021-00699-w}, issn = {0778-7367 (Print) 0778-7367}, year = {2021}, date = {2021-01-01}, journal = {Arch Public Health}, volume = {79}, number = {1}, pages = {176}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Smokeless tobacco is a part of social and cultural life in Sudan. The affordability and availability of this kind of tobacco make it a fundamental issue in adolescents. The aim of this study is to investigate the extent of the use of smokeless tobacco in adolescents and its determinants. METHODS: A school-based cross-sectional study was conducted in Khartoum state in Sudan. The study targeted male and female adolescents in secondary schools. A total of 3387 students from public and private schools participated in the study. Multistage random sampling was used to select the participants. The Arabic version questionnaire from the Global Youth Tobacco Survey (GYTS) was utilised to collect the data from the participants. RESULTS: Among the participants, 57.3% were females and 42.7% were males. Students from private and public schools were 48.4 and 51.6%, respectively. The overall prevalence of those who had ever used smokeless tobacco was 7.6%, in which the prevalence among male students was 11.0% while among females was 5.0%. The determinant factors were male gender (OR 1.53 CI 95% 1.03-2.28), family structure (OR 1.52 CI 95% 1.03-2.23), exposure to second-hand smoke at home (OR 1.60 CI 95% 1.11-2.31), friends smoking cigarettes (OR 1.78 CI 95% 1.22-2.60), lack of restriction of selling tobacco to minors (OR 1.73 CI 95% 1.25-2.39), promotion of smokeless tobacco (OR 2.12 CI 95% 1.20-3.72) and low self-efficacy (OR 7.47 CI 95% 4.45-12.52). CONCLUSION: A comprehensive prevention programme that enforces the prohibition of the promotion of smokeless tobacco and the selling of smokeless tobacco to minors is crucial. Moreover, the prevention programme should enhance adolescents' self-efficacy.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN177, title = {The impact of organisational communication satisfaction on health care professionals' work engagement}, author = {H. J. Abu Dalal and V. Ramoo and M. C. Chong and M. Danaee and Y. I. Aljeesh}, doi = {10.1111/jonm.13476}, issn = {0966-0429}, year = {2021}, date = {2021-01-01}, journal = {J Nurs Manag}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {AIM: To assess the impact of organisational communication satisfaction (OCS) on the work engagement of health care professionals (HCPs). BACKGROUND: Organisational communication can influence employees' work engagement, which is an essential component of an organisation's effectiveness. However, these concepts have not been broadly investigated in health care organisations. METHODS: A cross-sectional survey was administered to 235 HCPs in the Gaza Strip, Palestine. The SPSS statistical software (version 25) and partial least squares structural equation modelling (PLS-SEM) were used to analyse the collected data. RESULTS: The HCPs reported a moderate level of OCS (M = 4.96}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN171, title = {A qualitative exploration: Dietary behaviour of Malaysian breast cancer survivors}, author = {S. J. Kiew and H. A. Majid and N. A. Mohd Taib}, doi = {10.1111/ecc.13530}, issn = {0961-5423}, year = {2021}, date = {2021-01-01}, journal = {Eur J Cancer Care (Engl)}, pages = {e13530}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVE: This study aimed to explore the dietary practices and factors affecting Malaysian breast cancer survivors' dietary behaviours. METHODS: We conducted an in-depth qualitative interview on 20 participants from a cohort study. An ecological framework was used to construct the semi-structured topic guide. The interviews were audio-recorded and transcribed verbatim. Thematic analysis with theoretical saturation was used in data analysis. RESULTS: The participants were found to have variable dietary practices that either followed or did not follow dietary recommendations. The social environment was critical as most women relied on family and friends for food choices; additionally, individuals in charge of food preparation had to prepare food based on their family member preferences. Furthermore, individuals had difficulty sustaining healthy dietary changes during the acute survivorship phase due to a lack of health consciousness and difficulty in healthy food access. Notably, there was a lack of dietary guidance from health care professionals, especially dietitians, in long-term survivorship care. CONCLUSION: This study highlights the lack of breast cancer survivors' healthy diet and lifestyle knowledge. A holistic multidisciplinary approach involving individual, social, physical, and macro-level environmental elements are crucial to influencing healthy eating behaviours.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN186, title = {Validation of the Champion Health Belief Model Scale for an Investigation of Breast Cancer Screening Behaviour in Malaysia}, author = {M. N. N. Htay and D. Schliemann and M. Dahlui and C. R. Cardwell and S. Y. Loh and Nsbi Tamin and S. Somasundaram and V. Champion and M. Donnelly and T. T. Su}, doi = {10.3390/ijerph18179311}, issn = {1661-7827 (Print) 1660-4601}, year = {2021}, date = {2021-01-01}, journal = {Int J Environ Res Public Health}, volume = {18}, number = {17}, school = {Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya}, abstract = {Breast cancer (BC) is the most common cancer among women globally, including in Malaysia. There is a need to assess women's beliefs about BC and screening in different cultural settings. This study aimed to translate and validate an adapted version of the United States (US) Champion Health Belief Model Scale (CHBMS) for an investigation of predictors of BC screening in Malaysia. The CHBMS was adapted, and forward and backward translated into the Malay language. The validity and reliability of the CHBMS-BC-M (M for Malay language) was investigated in a community sample of 251 multi-ethnic Malay-speaking women. Principal component analysis with varimax rotation indicated that the structure of the adapted CHBMS-BC-M comprised three subscales with 21 items, and an Item-Content Validity Index (I-CVI) of 0.83 and above for all items. The explanatory factor analysis (EFA) showed acceptable to high factor loadings on items. Cronbach's alpha for the subscales ranged from 0.59 to 0.87. The reproducibility of the scale was fair to high, with an Intraclass Correlation Coefficient (ICC) of 0.53 to 0.80 for the subscales. Overall, the analysis indicated that the translated CHBMS-BC-M is a valid and reliable scale to measure beliefs about BC and screening in the Malay-speaking ethnic population of Malaysia.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN213, title = {Prevalence and risk factors associated with alcohol consumption among indigenous people in Sabah Borneo Island}, author = {R. B. Abd Rashid and M. N. B. Mohd Daud and R. M. Guad and S. H. Gan and Waib Wan Husin and N. Giloi and M. Danaee and M. A. B. Said and C. L. S. Lin Mmed and R. Bulan and A. M. B. Manah and A. B. Hashim and T. Seghatoleslam and M. H. Habil}, doi = {10.1111/ajr.12732}, issn = {1038-5282}, year = {2021}, date = {2021-01-01}, journal = {Aust J Rural Health}, volume = {29}, number = {3}, pages = {464-472}, abstract = {OBJECTIVES: In this study, we aimed to determine the prevalence and risk factors of alcohol use among a cohort of population in Sabah. DESIGN: This is a prospective, cohort study involving rural community residents. SETTING: Rural community resident at Bingkor, Keningau, Sabah. PARTICIPANTS: 363 individuals aged 13 years old and above. INTERVENTION: Community-based participatory research to determine the prevalence and risk factors associated with alcohol use. MAIN OUTCOME MEASURES: Measurement of alcohol use using Alcohol Use Disorders Identification Test (AUDIT) and assessment of psychiatric morbidity using Mini International Neuropsychiatric Interview (MINI) questionnaires. RESULTS: Most alcohol drinkers aged between 36-45 years old, followed by 26-35 years old and 46-55 years old. Interestingly, there are almost similar female to male ratio. Most were Kadazan-Dusun ethnic, non-Muslims, and married. Although only less than a third of the participants received tertiary education, the majority were working. Based on the findings, being a male, non-Muslim and having an obsessive-compulsive disorder (OCD) (current) posed a significantly higher risk of alcohol consumption. CONCLUSION: A worryingly high prevalence of hazardous alcohol consumption among the locals is reported. There is a need for population-wide intervention towards preventive measures based on the identified risk factors for hazardous alcohol use.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN252, title = {Association between structural social support and quality of life among urban older Malaysians}, author = {A. Abu Hammattah and R. Mohd Yunus and A. Matthias M\"{u}ller and S. Bahyah Kamaruzzaman and N. Naqiah Hairi}, doi = {10.1111/ajag.12919}, issn = {1440-6381}, year = {2021}, date = {2021-01-01}, journal = {Australas J Ageing}, volume = {40}, number = {4}, pages = {390-396}, abstract = {OBJECTIVE: The aim of this study was to examine the association between structural social support and quality of life (QoL) among urban older people in Malaysia. METHODS: Cross-sectional data of 1484 participants from the first wave of the Malaysian Elders Longitudinal Research (MELoR) were analysed. QoL was measured with the Control, Autonomy, Self-realization, and Pleasure 12-item scale (CASP-12). Multivariate analyses were run using the generalised linear interactive model (GLIM) to determine the association between structural social support measures and QoL. RESULTS: The mean age of the sample was 70.1 (SD = 7.4) years. Being married (B = 0.05, 95%CI 0.02, 0.08), larger social networks (B = 0.01, 95%CI 0.01, 0.02) and social participation (B = 0.02, 95%CI 0.02, 0.09) were associated with higher QoL, while living alone (B= -0.04, 95%CI -0.06, -0.02) was associated with lower QoL. CONCLUSION: Structural social support plays an important role in the QoL of older people in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN234, title = {Environmental heat-related health symptoms among community in a tropical city}, author = {N. Aghamohammadi and C. S. Fong and M. H. M. Idrus and L. Ramakreshnan and N. M. Sulaiman}, doi = {10.1016/j.scitotenv.2021.146611}, issn = {0048-9697}, year = {2021}, date = {2021-01-01}, journal = {Sci Total Environ}, volume = {782}, pages = {146611}, abstract = {Due to the changing climate, more frequent and prolonged heatwaves are expected to have a catastrophic consequence on urban human settlement. In tropical cities such as Kuala Lumpur (KL), the quality of the urban environment is made worse by urban heat island (UHI) phenomena due to poor urban planning practices. The prolonged exposure to urban heat is hypothesized to influence human health and well-being, especially in tropical urban areas with high population density. Therefore, a study was conducted to understand the association of urban heat stress with physical, psychosomatic and psychological (PPP) health symptoms within a tropical urban setting. Continuous urban microclimate monitoring is conducted using an automated weather station to define the level of heat stress in the study area expressed as Physiological Equivalent Temperature (PET). A cross-sectional approach is used to identify heat-related health symptoms experienced by the urban population. Through exploratory factor analysis, a total of 38 PPP health symptoms are reduced into 8 heat-related health clusters which are sensory organ pain, heat-related illnesses, cardiopulmonary, pain, fatigue, anxiety, somatization, and depression-related symptoms. Heat stress was found to significantly affect psychosomatic pain (p = 0.016) as well as psychological anxiety (p = 0.022) and somatization (p = 0.041) related symptoms. Other health clusters were not significantly associated with heat stress. More studies are needed to unravel the influence of confounding factors and the long-term impact of urban heat on the health and well-being of the urban population in a tropical city.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN226, title = {Development of the Active Ageing Awareness Questionnaire in Malaysia}, author = {N. H. Ahmad Bahuri and H. Rizal and H. Abdul Majid and M. A. Said and T. T. Su}, doi = {10.3390/healthcare9050499}, issn = {2227-9032 (Print) 2227-9032}, year = {2021}, date = {2021-01-01}, journal = {Healthcare (Basel)}, volume = {9}, number = {5}, abstract = {The world's ageing population is associated with increased morbidity, disability, and social and financial insecurity, which may affect quality of life (QoL). Therefore, the World Health Organization (WHO) endorsed the Active Ageing Framework (AAF) in 2002 to enhance QoL as people age. However, little is known about the status of awareness of active ageing among the population, and there is no appropriate tool for assessment. Hence, the Awareness of Active Ageing Questionnaire (AAAQ) was developed. The content, linguistic and face validations together with test-retest reliability were conducted. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to test the structural validity of the AAAQ. A total of 110 participants (mean ± SD = 50.19 ± 5.52) were selected for the pilot, 81 participants (mean ± SD = 49.40 ± 5.70) for the test-retest, and 404 participants (mean ± SD = 49.90 ± 5.80) for CFA and EFA tests. The 16-item AAAQ Malay version showed satisfactory reliability and validity. The Cronbach's alpha was more than 0.7 and showed good fit: Cmin/df = 2.771}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN227, title = {Heavy metals drinking water contamination and health risk assessment among primary school children of Pakistan}, author = {J. Ahmed and L. P. Wong and Y. P. Chua and N. Channa and U. U. Memon and J. V. Garn and A. Yasmin and J. A. VanDerslice}, doi = {10.1080/10934529.2021.1915653}, issn = {1093-4529}, year = {2021}, date = {2021-01-01}, journal = {J Environ Sci Health A Tox Hazard Subst Environ Eng}, volume = {56}, number = {6}, pages = {667-679}, abstract = {The purpose of this study was to characterize the concentrations of lead (Pb), cadmium (Cd), manganese (Mn), and Fe (Fe) in drinking water sources in primary schools in Sindh Province, Pakistan and to quantify potential health risks among those school children. We conducted a representative, cross-sectional study among 425 primary schools in Sindh province of Pakistan. We used risk assessment models to estimate the metal index, pollution index, lifetime cancer risk, and hazard quotient index. Across the 425 sampled schools, the levels of heavy metals in the drinking water often exceeded the WHO permissible limits (67% of schools exceeded Pb limit, 17% for Cd, 15% for Fe). The average incremental lifetime cancer risk (ILCR) for Pb exceeded tolerable limits in all of the districts under study. The findings, particularly for Pb, are of concern, as Pb may negatively influence children's growth, development, school performance, and long-term health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN196, title = {Screen-based media and young children: Review and recommendations}, author = {C. T. Arumugam and M. A. Said and N. D. Nik Farid}, doi = {10.51866/rv1143}, issn = {1985-207X (Print) 1985-2274}, year = {2021}, date = {2021-01-01}, journal = {Malays Fam Physician}, volume = {16}, number = {2}, pages = {7-13}, abstract = {Early childhood development is influenced by a child's environmental experiences. The qualities of surrounding in which a child lives, grows up and learns are key for attaining their milestones. Increased availability of screen-based media in families leads to excessive screen time among young children, resulting in high chances of displacing parent-child interaction which is fundamental in a thriving child's process of learning and development. Numerous publications have investigated the potential health impacts of early exposure and excessive usage of screen-based media among children, with literature suggesting links between excessive screen time and behavioural difficulties, developmental delay and increased risk of obesity, among other issues. Existing guidelines from international bodies call for limiting screen time to an hour per day for children aged two to five years old and urge that children below the age of two should not be exposed to any screen time. To spark awareness among parents and caregivers concerning the potential health impacts of screen-based media usage among young children, child media habits are recommended to be incorporated as part of toddlers' developmental assessment in health clinics. A guideline for mindful usage of screen-based media focusing on children below the age of five tailored to a Malaysian context ought to be developed based on current evidence from research, theory and practice. A collaborative effort between concerned agencies is essential to ensuring a developmentally stimulating environment in which young children may grow up.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN204, title = {The association between elder abuse and childhood adversity: A study of older adults in Malaysia}, author = {M. Asyraf and M. P. Dunne and N. N. Hairi and F. Mohd Hairi and N. Radzali and C. Wan Yuen}, doi = {10.1371/journal.pone.0254717}, issn = {1932-6203}, year = {2021}, date = {2021-01-01}, journal = {PLoS One}, volume = {16}, number = {7}, pages = {e0254717}, abstract = {OBJECTIVES: Childhood adversity has been linked with later victimization of young and middle-aged adults, but few studies have shown persistence of this effect among elders, especially outside of North America. This research examined the association between adverse childhood experiences (ACEs) and elder abuse among older adults aged 60 years and over in Malaysia. DESIGN: Cross sectional data were collected via face-to-face interview from June to August 2019. SETTING: Eight government community health clinics in Kuala Pilah, a district in Negeri Sembilan state approximately 100km from Malaysian capital city Kuala Lumpur. PARTICIPANTS: Older adults aged 60 years and above (N = 1984; Mean age 69.2, range 60-93 years) attending all eight government health clinics in the district were recruited for a face-to-face interview about health and well-being. MEASUREMENT: The Adverse Childhood Experience International Questionnaire (ACE-IQ) and the Revised Conflict Tactics Scale (CTS) were utilized to estimate childhood adversity and elder abuse respectively. RESULTS: Multiple logistic regression analysis revealed a significant relationship between the number of cumulative ACEs and elder abuse. Compared to older adults with no self-reported adversity, those reporting three ACEs (OR 2.67, 95% CI 1.84,3.87) or four or more ACEs (OR 1.7, 95% CI 1.16, 2.48) had higher risk of any elder abuse occurrence since age 60 years. The effect was most prominent for financial and psychological elder abuse. The associations persisted in multivariate logistic regression models after adjusting for sociodemographic and health factors. CONCLUSION: Early life adversities were significantly associated with victimization of older adults. Social and emotional support to address elder abuse should recognize that, for some men and women, there is a possibility that vulnerability to maltreatment persisted throughout their life course.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN222, title = {Continuation of Screening Endoscopy for Colorectal Cancer in Older Adults}, author = {N. Bhoo-Pathy and N. N. Bujang and C. W. Ng}, doi = {10.1001/jamaoncol.2021.1119}, issn = {2374-2437}, year = {2021}, date = {2021-01-01}, journal = {JAMA Oncol}, volume = {7}, number = {7}, pages = {973-975}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN218, title = {Out-of-Pocket Costs of Complementary Medicine Following Cancer and the Financial Impact in a Setting With Universal Health Coverage: Findings From a Prospective Cohort Study}, author = {N. Bhoo-Pathy and S. Subramaniam and S. Khalil and M. Kimman and Y. C. Kong and C. W. Ng and R. S. Bustamam and C. H. Yip}, doi = {10.1200/op.20.01052}, issn = {2688-1527}, year = {2021}, date = {2021-01-01}, journal = {JCO Oncol Pract}, volume = {17}, number = {10}, pages = {e1592-e1602}, abstract = {PURPOSE: To determine household spending patterns on complementary medicine following cancer and the financial impact in a setting with universal health coverage. METHODS: Country-specific data from a multinational prospective cohort study, Association of Southeast Asian Nations Costs in Oncology Study, comprising 1,249 cancer survivors were included. Household costs of complementary medicine (healthcare practices or products that are not considered as part of conventional medicine) throughout the first year after cancer diagnosis were measured using cost diaries. Study outcomes comprised (1) shares of household expenditures on complementary medicine from total out-of-pocket costs and health costs that were respectively incurred in relation to cancer, (2) incidence of financial catastrophe (out-of-pocket costs related to cancer ≥ 30% of annual household income), and (3) economic hardship (inability to pay for essential household items or services). RESULTS: One third of patients reported out-of-pocket household expenditures on complementary medicine in the immediate year after cancer diagnosis, accounting to 20% of the total out-of-pocket costs and 35% of the health costs. Risk of financial catastrophe was higher in households reporting out-of-pocket expenditures on complementary medicine (adjusted odds ratio: 1.39 [95% CI, 1.05 to 1.86]). Corresponding odds ratio within patients from low-income households showed that they were substantially more vulnerable: 2.28 (95% CI, 1.41 to 3.68). Expenditures on complementary medicine were, however, not associated with economic hardship in the immediate year after cancer diagnosis. CONCLUSION: In settings with universal health coverage, integration of subsidized evidence-based complementary medicine into mainstream cancer care may alleviate catastrophic expenditures. However, this must go hand in hand with interventions to reduce the use of nonevidence-based complementary therapies following cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN262, title = {Climate Change, Food Supply, and Dietary Guidelines}, author = {C. W. Binns and M. K. Lee and B. Maycock and L. E. Torheim and K. Nanishi and D. T. T. Duong}, doi = {10.1146/annurev-publhealth-012420-105044}, issn = {0163-7525}, year = {2021}, date = {2021-01-01}, journal = {Annu Rev Public Health}, volume = {42}, pages = {233-255}, abstract = {Food production is affected by climate change, and, in turn, food production is responsible for 20-30% of greenhouse gases. The food system must increase output as the population increases and must meet nutrition and health needs while simultaneously assisting in achieving the Sustainable Development Goals. Good nutrition is important for combatting infection, reducing child mortality, and controlling obesity and chronic disease throughout the life course. Dietary guidelines provide advice for a healthy diet, and the main principles are now well established and compatible with sustainable development. Climate change will have a significant effect on food supply; however, with political commitment and substantial investment, projected improvements will be sufficient to provide food for the healthy diets needed to achieve the Sustainable Development Goals. Some changes will need to be made to food production, nutrient content will need monitoring, and more equitable distribution is required to meet the dietary guidelines. Increased breastfeeding rates will improve infant and adult health while helping to reduce greenhouse gases.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN202, title = {Developing a policy to reduce the salt content of food consumed outside the home in Malaysia: protocol of a qualitative study}, author = {M. K. Brown and S. Shahar and Y. X. You and V. Michael and H. A. Majid and Z. A. Manaf and H. Haron and N. S. Sukiman and Y. C. Chia and F. J. He and G. A. MacGregor}, doi = {10.1136/bmjopen-2020-044628}, issn = {2044-6055}, year = {2021}, date = {2021-01-01}, journal = {BMJ Open}, volume = {11}, number = {7}, pages = {e044628}, abstract = {INTRODUCTION: Current salt intake in Malaysia is high. The existing national salt reduction policy has faced slow progress and does not yet include measures to address the out of home sector. Dishes consumed in the out of home sector are a known leading contributor to daily salt intake. This study aims to develop a salt reduction strategy, tailored to the out of home sector in Malaysia. METHODS AND ANALYSIS: This study is a qualitative analysis of stakeholder views towards salt reduction. Participants will be recruited from five zones of Malaysia (Western, Northern, Eastern and Southern regions and East Malaysia), including policy-makers, non-governmental organisations, food industries, school canteen operators, street food vendors and consumers, to participate in focus group discussions or in-depth interviews. Interviews will be transcribed and analysed using thematic analysis. Barriers will be identified and used to develop a tailored salt reduction strategy. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Universiti Kebangsaan Malaysia Medical Research Ethics Committee (UKM PPI/1118/JEP-2020-524), the Malaysian National Medical Research Ethics Committee (NMRR-20-1387-55481 (IIR)) and Queen Mary University of London Research Ethics Committee (QMERC2020/37) . Results will be presented orally and in report form and made available to the relevant ministries for example, Ministry of Health, Ministry of Education and Ministry of Trade to encourage adoption of strategy as policy. The findings of this study will be disseminated through conference presentations, peer-reviewed publications and webinars.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN231, title = {Association of Pre-diagnostic Antibody Responses to Escherichia coli and Bacteroides fragilis Toxin Proteins with Colorectal Cancer in a European Cohort}, author = {J. Butt and M. Jenab and J. Werner and V. Fedirko and E. Weiderpass and C. C. Dahm and A. Tj\onneland and A. Olsen and M. C. Boutron-Ruault and J. A. Rothwell and G. Severi and R. Kaaks and R. Turzanski-Fortner and K. Aleksandrova and M. Schulze and D. Palli and V. Pala and S. Panico and R. Tumino and C. Sacerdote and B. Bueno-de-Mesquita and C. H. Van Gils and I. T. Gram and M. Lukic and N. Sala and M. J. S\'{a}nchez P\'{e}rez and E. Ardanaz and M. D. Chirlaque and R. Palmquist and T. L\"{o}wenmark and R. C. Travis and A. Heath and A. J. Cross and H. Freisling and S. Zouiouich and E. Aglago and T. Waterboer and D. J. Hughes}, doi = {10.1080/19490976.2021.1903825}, issn = {1949-0976 (Print) 1949-0976}, year = {2021}, date = {2021-01-01}, journal = {Gut Microbes}, volume = {13}, number = {1}, pages = {1-14}, abstract = {Experimental evidence has implicated genotoxic Escherichia coli (E. coli) and enterotoxigenic Bacteroides fragilis (ETBF) in the development of colorectal cancer (CRC). However, evidence from epidemiological studies is sparse. We therefore assessed the association of serological markers of E. coli and ETBF exposure with odds of developing CRC in the European Prospective Investigation into Nutrition and Cancer (EPIC) study.Serum samples of incident CRC cases and matched controls (n = 442 pairs) were analyzed for immunoglobulin (Ig) A and G antibody responses to seven E. coli proteins and two isoforms of the ETBF toxin via multiplex serology. Multivariable-adjusted conditional logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of sero-positivity to E. coli and ETBF with CRC.The IgA-positivity of any of the tested E. coli antigens was associated with higher odds of developing CRC (OR: 1.42; 95% CI: 1.05-1.91). Dual-positivity for both IgA and IgG to E. coli and ETBF was associated with \>1.7-fold higher odds of developing CRC, with a significant association only for IgG (OR: 1.75; 95% CI: 1.04, 2.94). This association was more pronounced when restricted to the proximal colon cancers (OR: 2.62; 95% CI: 1.09, 6.29) compared to those of the distal colon (OR: 1.24; 95% CI: 0.51, 3.00) (p(heterogeneity) = 0.095). Sero-positivity to E. coli and ETBF was associated with CRC development, suggesting that co-infection of these bacterial species may contribute to colorectal carcinogenesis. These findings warrant further exploration in larger prospective studies and within different population groups.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN219, title = {Effect of the COVID-19 Pandemic on Medical Student Career Perceptions: Perspectives from Medical Students in China}, author = {C. Z. Cai and Y. Lin and H. Alias and Z. Hu and L. P. Wong}, doi = {10.3390/ijerph18105071}, issn = {1661-7827 (Print) 1660-4601}, year = {2021}, date = {2021-01-01}, journal = {Int J Environ Res Public Health}, volume = {18}, number = {10}, abstract = {Our aim was to examine perceived occupational turnover intentions among medical students and the associated factors. A cross-sectional study using a Web-based survey was conducted. A total of 2922 completed responses were received (response rate 55.7%). A total of 58.4% (95% CI 56.6-60.2) reported high turnover intention (score of 7-15). The odds of higher total turnover score among the fifth-year students was nearly four times that of first-year students (OR = 3.88, 95% CI 2.62-5.73). Perception of the medical profession as not being of high social status and reputation significantly influenced high turnover intention scores (OR = 2.26, 95% CI 1.90-2.68). All three dimensions of the multidimensional scale of perceived social support (MSPSS) significantly predict turnover intention. Lower scores in the support from Significant Other (OR = 1.47, 95% CI 1.17-1.84), Family (OR = 1.47, 95% CI 1.18-1.83) and Friend (OR = 1.42, 95% CI 1.14-1.77) subscales were associated with higher turnover intention. Low score in the Brief Resilience Scale (BRS) was also associated with higher turnover intention (OR = 1.44, 95% CI 1.17-1.77). The findings shed light on the importance of changing public attitudes towards respecting the medical profession and improving the implementation of policies to protect the well-being of people in the medical profession.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN200, title = {Psychological and mental health impacts of COVID-19 pandemic on healthcare workers in China: A review}, author = {C. Z. Cai and Y. L. Lin and Z. J. Hu and L. P. Wong}, doi = {10.5498/wjp.v11.i7.337}, issn = {2220-3206 (Print) 2220-3206}, year = {2021}, date = {2021-01-01}, journal = {World J Psychiatry}, volume = {11}, number = {7}, pages = {337-346}, abstract = {The coronavirus disease-19 (COVID-19) pandemic has put healthcare workers in an unprecedented situation, increasing their psychological and mental health distress. Much research has focused on the issues surrounding anxiety, depression, and stress among healthcare workers. The consequences of mental health problems on healthcare workers' physical health, health-compromising behaviours, suicide ideation, family relationships, and job satisfaction during the COVID-19 pandemic are not well studied. Enhanced psychological stress has known effects on an individual's physical health. In healthcare workers with pre-existing comorbidities, psychological stressors may exacerbate their current health problems. Healthcare professionals are known to have a high risk of substance use, hence they may be at risk of development of substance use addiction or vulnerable to addiction relapse. Frontline COVID-19 healthcare workers are being pushed above and beyond their limits, possibly resulting in suicidal tendencies. Furthermore, the burden of high workload and burnout may also have serious manifestations in relationships with family and an intention to quit their jobs. Future studies should explore the above-mentioned deleterious consequences to provide insight into the development of mental healthcare strategies to combat the psychological impact of COVID-19 on healthcare workers during the COVID-19 emergency. It is imperative to employ strategies to care for and policies to protect the psychological well-being of healthcare workers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN250, title = {Behavioural responses and anxiety symptoms during the coronavirus disease 2019 (COVID-19) pandemic in Japan: A large scale cross-sectional study}, author = {G. Cai and Y. Lin and Y. Lu and F. He and K. Morita and T. Yamamoto and K. Aoyagi and T. Taguri and Z. Hu and H. Alias and M. Danaee and L. P. Wong}, doi = {10.1016/j.jpsychires.2021.02.008}, issn = {0022-3956 (Print) 0022-3956}, year = {2021}, date = {2021-01-01}, journal = {J Psychiatr Res}, volume = {136}, pages = {296-305}, abstract = {BACKGROUND: This study explored the behavioural responses and anxiety symptoms of the general adult population in Japan during the ongoing coronavirus disease 2019 (COVID-19) outbreak. METHODS: A web-based cross-sectional survey was conducted between 12th and May 13, 2020. Quota sampling was used to attain equal gender and age distributions representative of the Japanese population. RESULTS: A total of 4127 complete responses were analysed. Higher educational level (B = 0.045}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN206, title = {Prevalence of Insufficient Sleep and Its Associated Factors Among Working Adults in Malaysia}, author = {C. M. H. Chan and C. S. Siau and J. E. Wong and L. H. Wee and N. A. Jamil and V. C. W. Hoe}, doi = {10.2147/nss.S295537}, issn = {1179-1608 (Print) 1179-1608}, year = {2021}, date = {2021-01-01}, journal = {Nat Sci Sleep}, volume = {13}, pages = {1109-1116}, abstract = {INTRODUCTION: Given the scarcity of data on sleep insufficiency in developing countries and its emerging importance in public health, this study aims to provide the prevalence and factors associated with insufficient sleep among working Malaysian adults. MATERIALS AND METHODS: A total of 11,356 working adults (≥18 years) were recruited from a cross-sectional online health and work survey. Sleep duration was self-reported and was categorised as insufficient sleep (\<7 h) and sufficient sleep (≥7 h) based on the National Sleep Guidelines' daily sleep time recommendation for adults. The 10-item Kessler scale was used to assess psychological distress levels (cutoff score ≥20). Bivariate and multivariable regression analyses were performed to examine the factors associated with insufficient sleep. RESULTS: The mean age of the participants was 35.7 years (standard deviation, SD±9.2). There were more female (n=6613; 58.2%) respondents. The mean sleep duration was 6.49 h (SD±1.10). A total of 6212 individuals (54.7%) reported getting \<7 h of sleep daily. After adjusting for gender, marital status and educational attainment, older age (odds ratio}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN205, title = {Filtering Facepiece Respirators for Healthcare Workers Protection in the Time of COVID-19 Pandemic}, author = {C. T. Chang and P. Rajan and V. C. W. Hoe}, doi = {10.21315/mjms2021.28.3.14}, issn = {1394-195X (Print) 1394-195x}, year = {2021}, date = {2021-01-01}, journal = {Malays J Med Sci}, volume = {28}, number = {3}, pages = {151-154}, abstract = {Protecting healthcare workers (HCWs) who are in the frontline during the time of the COVID-19 pandemic is paramount. The filtering facepiece respirators (FFRs) or N95 respirator is one of the personal protective equipment (PPE) used to protect HCWs exposed to airborne pathogens in clinical practice or when performing aerosol generating procedures. The FFRs should be able to serve the intended purpose without causing additional health and safety hazards for the HCWs. The following commentary will provide some basic information on selecting correct FFRs and conducting fitness test.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN157, title = {Propagation of a hospital-associated cluster of COVID-19 in Malaysia}, author = {D. W. Chong and V. J. Jayaraj and C. W. Ng and I. C. Sam and M. A. Said and R. Ahmad Zaki and N. N. Hairi and N. D. Nik Farid and V. C. Hoe and M. Isahak and S. Ponnampalavanar and S. F. Syed Omar and S. B. Kamaruzzaman and H. C. Ong and K. Hasmukharay and N. Hasnan and A. Kamarulzaman and Y. F. Chan and Y. M. Chong and S. Rampal}, doi = {10.1186/s12879-021-06894-y}, issn = {1471-2334}, year = {2021}, date = {2021-01-01}, journal = {BMC Infect Dis}, volume = {21}, number = {1}, pages = {1238}, abstract = {BACKGROUND: Hospitals are vulnerable to COVID-19 outbreaks. Intrahospital transmission of the disease is a threat to the healthcare systems as it increases morbidity and mortality among patients. It is imperative to deepen our understanding of transmission events in hospital-associated cases of COVID-19 for timely implementation of infection prevention and control measures in the hospital in avoiding future outbreaks. We examined the use of epidemiological case investigation combined with whole genome sequencing of cases to investigate and manage a hospital-associated cluster of COVID-19 cases. METHODS: An epidemiological investigation was conducted in a University Hospital in Malaysia from 23 March to 22 April 2020. Contact tracing, risk assessment, testing, symptom surveillance, and outbreak management were conducted following the diagnosis of a healthcare worker with SARS-CoV-2 by real-time PCR. These findings were complemented by whole genome sequencing analysis of a subset of positive cases. RESULTS: The index case was symptomatic but did not fulfill the initial epidemiological criteria for routine screening. Contact tracing suggested epidemiological linkages of 38 cases with COVID-19. Phylogenetic analysis excluded four of these cases. This cluster included 34 cases comprising ten healthcare worker-cases, nine patient-cases, and 15 community-cases. The epidemic curve demonstrated initial intrahospital transmission that propagated into the community. The estimated median incubation period was 4.7 days (95% CI: 3.5-6.4), and the serial interval was 5.3 days (95% CI: 4.3-6.5). CONCLUSION: The study demonstrated the contribution of integrating epidemiological investigation and whole genome sequencing in understanding disease transmission in the hospital setting. Contact tracing, risk assessment, testing, and symptom surveillance remain imperative in resource-limited settings to identify and isolate cases, thereby controlling COVID-19 outbreaks. The use of whole genome sequencing complements field investigation findings in clarifying transmission networks. The safety of a hospital population during this COVID-19 pandemic may be secured with a multidisciplinary approach, good infection control measures, effective preparedness and response plan, and individual-level compliance among the hospital population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN169, title = {Preparing for and conducting the National Health and Morbidity Survey in Malaysia amid the COVID-19 pandemic: balancing risks and benefits to participants and society}, author = {Z. L. Chong and N. A. Lodz and M. H. A. Mutalip and Y. C. Lim and M. Mahjom and N. A. Ahmad}, doi = {10.5365/wpsar.2021.12.3.842}, issn = {2094-7321 (Print) 2094-7321}, year = {2021}, date = {2021-01-01}, journal = {Western Pac Surveill Response J}, volume = {12}, number = {3}, pages = {71-76}, abstract = {PROBLEM: The novel coronavirus disease 2019 (COVID-19) pandemic adversely affected the preparation of Malaysia's National Health and Morbidity Survey for 2020 because conducting it would expose data collectors and participants to an increased risk of infection. CONTEXT: The survey is nationally representative and community based and is conducted by the Institute for Public Health, part of the National Institutes of Health, to generate health-related evidence and to support the Malaysian Ministry of Health in policy-making. Its planned scope for 2020 was the seroprevalence of communicable diseases such as hepatitis B and C. ACTION: Additional components were added to the survey to increase its usefulness, including COVID-19 seroprevalence and facial anthropometric studies to ensure respirator fit. The survey's scale was reduced, and data collection was changed from including only face-to-face interviews to mainly self-administered and telephone interviews. The transmission risk to participants was reduced by screening data collectors before the survey and fortnightly thereafter, using standard droplet and contact precautions, ensuring proper training and monitoring of data collectors, and implementing other administrative infection prevention measures. OUTCOME: Data were collected from 7 August to 11 October 2020, with 5957 participants recruited. Only 4 out of 12 components of the survey were conducted via face-to-face interview. No COVID-19 cases were reported among data collectors and participants. All participants were given their hepatitis and COVID-19 laboratory test results; 73 participants with hepatitis B and 14 with hepatitis C who had been previously undiagnosed were referred for further case management. DISCUSSION: Preparing and conducting the National Health and Morbidity Survey during the COVID-19 pandemic required careful consideration of the risks and benefits, multiple infection prevention measures, strong leadership and strong stakeholder support to ensure there were no adverse events.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN264, title = {Religious Coping, Depression and Anxiety among Healthcare Workers during the COVID-19 Pandemic: A Malaysian Perspective}, author = {S. K. Chow and B. Francis and Y. H. Ng and N. Naim and H. C. Beh and M. A. A. Ariffin and M. H. M. Yusuf and J. W. Lee and A. H. Sulaiman}, doi = {10.3390/healthcare9010079}, issn = {2227-9032 (Print) 2227-9032}, year = {2021}, date = {2021-01-01}, journal = {Healthcare (Basel)}, volume = {9}, number = {1}, abstract = {Anxiety and depression have been prevalent among Healthcare Workers (HCWs) amidst the COVID-19 pandemic. This study aims to evaluate the prevalence of anxiety and depression among HCWs amid the pandemic and their association with religious coping. A cross-sectional study design was applied. The scales utilized were Malay versions of the Brief Religious Coping Scale (Brief RCOPE M) and Hospital Anxiety and Depression Scale (HADS M). In total, 200 HCWs were recruited. HCWs scored higher in positive religious coping (mean: 21.33) than negative religious coping (mean: 10.52). The prevalence of anxiety and depression was 36.5% and 29.5%. Both positive and negative religious coping were significantly associated with anxiety (p \< 0.01) and depression (p \< 0.05, p \< 0.01). Positive coping predicted reduction in anxiety (adjusted b = -0.15}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN263, title = {Publisher Correction: Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction}, author = {D. V. Conti and B. F. Darst and L. C. Moss and E. J. Saunders and X. Sheng and A. Chou and F. R. Schumacher and A. A. A. Olama and S. Benlloch and T. Dadaev and M. N. Brook and A. Sahimi and T. J. Hoffmann and A. Takahashi and K. Matsuda and Y. Momozawa and M. Fujita and K. Muir and A. Lophatananon and P. Wan and L. Le Marchand and L. R. Wilkens and V. L. Stevens and S. M. Gapstur and B. D. Carter and J. Schleutker and T. L. J. Tammela and C. Sipeky and A. Auvinen and G. G. Giles and M. C. Southey and R. J. MacInnis and C. Cybulski and D. Woko\lorczyk and J. Lubi\'{n}ski and D. E. Neal and J. L. Donovan and F. C. Hamdy and R. M. Martin and B. G. Nordestgaard and S. F. Nielsen and M. Weischer and S. E. Bojesen and M. A. R\oder and P. Iversen and J. Batra and S. Chambers and L. Moya and L. Horvath and J. A. Clements and W. Tilley and G. P. Risbridger and H. Gronberg and M. Aly and R. Szulkin and M. Eklund and T. Nordstr\"{o}m and N. Pashayan and A. M. Dunning and M. Ghoussaini and R. C. Travis and T. J. Key and E. Riboli and J. Y. Park and T. A. Sellers and H. Y. Lin and D. Albanes and S. J. Weinstein and L. A. Mucci and E. Giovannucci and S. Lindstrom and P. Kraft and D. J. Hunter and K. L. Penney and C. Turman and C. M. Tangen and P. J. Goodman and Jr. I. M. Thompson and R. J. Hamilton and N. E. Fleshner and A. Finelli and M\'{E} Parent and J. L. Stanford and E. A. Ostrander and M. S. Geybels and S. Koutros and L. E. B. Freeman and M. Stampfer and A. Wolk and N. Hr{a}kansson and G. L. Andriole and R. N. Hoover and M. J. Machiela and K. D. S\orensen and M. Borre and W. J. Blot and W. Zheng and E. D. Yeboah and J. E. Mensah and Y. J. Lu and others}, doi = {10.1038/s41588-021-00786-2}, issn = {1061-4036}, year = {2021}, date = {2021-01-01}, journal = {Nat Genet}, volume = {53}, number = {3}, pages = {413}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN270, title = {Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction}, author = {D. V. Conti and B. F. Darst and L. C. Moss and E. J. Saunders and X. Sheng and A. Chou and F. R. Schumacher and A. A. A. Olama and S. Benlloch and T. Dadaev and M. N. Brook and A. Sahimi and T. J. Hoffmann and A. Takahashi and K. Matsuda and Y. Momozawa and M. Fujita and K. Muir and A. Lophatananon and P. Wan and L. Le Marchand and L. R. Wilkens and V. L. Stevens and S. M. Gapstur and B. D. Carter and J. Schleutker and T. L. J. Tammela and C. Sipeky and A. Auvinen and G. G. Giles and M. C. Southey and R. J. MacInnis and C. Cybulski and D. Woko\lorczyk and J. Lubi\'{n}ski and D. E. Neal and J. L. Donovan and F. C. Hamdy and R. M. Martin and B. G. Nordestgaard and S. F. Nielsen and M. Weischer and S. E. Bojesen and M. A. R\oder and P. Iversen and J. Batra and S. Chambers and L. Moya and L. Horvath and J. A. Clements and W. Tilley and G. P. Risbridger and H. Gronberg and M. Aly and R. Szulkin and M. Eklund and T. Nordstr\"{o}m and N. Pashayan and A. M. Dunning and M. Ghoussaini and R. C. Travis and T. J. Key and E. Riboli and J. Y. Park and T. A. Sellers and H. Y. Lin and D. Albanes and S. J. Weinstein and L. A. Mucci and E. Giovannucci and S. Lindstrom and P. Kraft and D. J. Hunter and K. L. Penney and C. Turman and C. M. Tangen and P. J. Goodman and Jr. I. M. Thompson and R. J. Hamilton and N. E. Fleshner and A. Finelli and M\'{E} Parent and J. L. Stanford and E. A. Ostrander and M. S. Geybels and S. Koutros and L. E. B. Freeman and M. Stampfer and A. Wolk and N. Hr{a}kansson and G. L. Andriole and R. N. Hoover and M. J. Machiela and K. D. S\orensen and M. Borre and W. J. Blot and W. Zheng and E. D. Yeboah and J. E. Mensah and Y. J. Lu and others}, doi = {10.1038/s41588-020-00748-0}, issn = {1061-4036 (Print) 1061-4036}, year = {2021}, date = {2021-01-01}, journal = {Nat Genet}, volume = {53}, number = {1}, pages = {65-75}, abstract = {Prostate cancer is a highly heritable disease with large disparities in incidence rates across ancestry populations. We conducted a multiancestry meta-analysis of prostate cancer genome-wide association studies (107,247 cases and 127,006 controls) and identified 86 new genetic risk variants independently associated with prostate cancer risk, bringing the total to 269 known risk variants. The top genetic risk score (GRS) decile was associated with odds ratios that ranged from 5.06 (95% confidence interval (CI), 4.84-5.29) for men of European ancestry to 3.74 (95% CI, 3.36-4.17) for men of African ancestry. Men of African ancestry were estimated to have a mean GRS that was 2.18-times higher (95% CI, 2.14-2.22), and men of East Asian ancestry 0.73-times lower (95% CI, 0.71-0.76), than men of European ancestry. These findings support the role of germline variation contributing to population differences in prostate cancer risk, with the GRS offering an approach for personalized risk prediction.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN265, title = {Developing an evidence assessment framework and appraising the academic literature on migrant health in Malaysia: a scoping review}, author = {A. W. Smalen and Z. X. Chan and C. Abreu Lopes and M. Vanore and T. Loganathan and N. S. Pocock}, doi = {10.1136/bmjopen-2020-041379}, issn = {2044-6055}, year = {2021}, date = {2021-01-01}, journal = {BMJ Open}, volume = {11}, number = {1}, pages = {e041379}, abstract = {BACKGROUND: A large number of international migrants in Malaysia face challenges in obtaining good health, the extent of which is still relatively unknown. This study aims to map the existing academic literature on migrant health in Malaysia and to provide an overview of the topical coverage, quality and level of evidence of these scientific studies. METHODS: A scoping review was conducted using six databases, including Econlit, Embase, Global Health, Medline, PsycINFO and Social Policy and Practice. Studies were eligible for inclusion if they were conducted in Malaysia, peer-reviewed, focused on a health dimension according to the Bay Area Regional Health Inequities Initiative (BARHII) framework, and targeted the vulnerable international migrant population. Data were extracted by using the BARHII framework and a newly developed decision tree to identify the type of study design and corresponding level of evidence. Modified Joanna Briggs Institute checklists were used to assess study quality, and a multiple-correspondence analysis (MCA) was conducted to identify associations between different variables. RESULTS: 67 publications met the selection criteria and were included in the study. The majority (n=41) of studies included foreign workers. Over two-thirds (n=46) focused on disease and injury, and a similar number (n=46) had descriptive designs. The average quality of the papers was low, yet quality differed significantly among them. The MCA showed that high-quality studies were mostly qualitative designs that included refugees and focused on living conditions, while prevalence and analytical cross-sectional studies were mostly of low quality. CONCLUSION: This study provides an overview of the scientific literature on migrant health in Malaysia published between 1965 and 2019. In general, the quality of these studies is low, and various health dimensions have not been thoroughly researched. Therefore, researchers should address these issues to improve the evidence base to support policy-makers with high-quality evidence for decision-making.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN216, title = {Antibiotic usage and resistance in animal production in Vietnam: a review of existing literature}, author = {K. N. Di and D. T. Pham and T. S. Tee and Q. A. Binh and T. C. Nguyen}, doi = {10.1007/s11250-021-02780-6}, issn = {0049-4747}, year = {2021}, date = {2021-01-01}, journal = {Trop Anim Health Prod}, volume = {53}, number = {3}, pages = {340}, abstract = {Inappropriate use of antibiotics in animal production system is one of the major factors leading to the antibiotic resistance (ABR) development. In Vietnam, the ABR situation is crucial as antibiotics have been used indiscriminately for disease prevention and as growth promoters in animals. Thus, a thorough understanding on the ABR in veterinary settings would be beneficial to the Vietnam public health authority in formulating timely interventions. This review aimed to provide information on the current status of antibiotic usage in animal husbandry in Vietnam, identified gaps in research, and suggested possible solutions to tackle ABR. To this end, data on ABR in animals were extracted from 3 major electronic databases (PubMed, Web of Science, and ScienceDirect) in the period of January 2013-December 2020. The review findings were reported according to PRISMA, which highlighted the emergence and persistence of ABR in bacterial isolates, including Escherichia coli, Enterococcus spp., and Salmonella species, obtained from pigs and poultry. The lack of awareness of Vietnamese farmers on the antibiotic utilization guidelines was one of the main causes driving the animal ABR. Hence, this paper calls for interventions to restrict antibiotics use in food-producing animals by national action plan and antibiotics control programs. Additionally, studies to evaluate knowledge, attitude, and practice (KAP) of the community are required to promote rational use of antibiotics in all sectors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN266, title = {Prevalence study of epilepsy in Malaysia}, author = {S. L. Fong and K. S. Lim and L. Tan and N. H. Zainuddin and J. H. Ho and Z. J. Chia and W. Y. Choo and S. D. Puvanarajah and S. Chinnasami and S. K. Tee and A. A. Raymond and W. C. Law and C. T. Tan}, doi = {10.1016/j.eplepsyres.2021.106551}, issn = {0920-1211}, year = {2021}, date = {2021-01-01}, journal = {Epilepsy Res}, volume = {170}, pages = {106551}, abstract = {INTRODUCTION: The lifetime prevalence of epilepsy varies greatly from 1.5-14.0 per 1000 persons among the Asian countries. We aim to study the prevalence of epilepsy in Malaysia to have a better insight into the burden of disease in the country. METHODS: A population-based door-to-door survey was carried out throughout the country, using questionnaire for brief screening in ascertainment of epilepsy, using a questionnaire and its validated multilingual versions. Respondents who were screened positive underwent second-stage diagnostic phone interview by neurologists/ research assistants. RESULTS: A total 16, 686 respondents participated in the survey and 646 (3.8 %) respondents were screened positive during the first stage interview. A total of 185 consented for second stage diagnostic interview and 118 (63.8 %) respondents were contacted successfully for the second stage diagnostic phone interview, of which 17 (14.4 %) respondents were diagnosed to have epilepsy. An additional 68 (57.6 %) respondents had febrile seizures only. After applying a weighting factor to each respondent to adjust for non-response and for the varying probabilities of selection, the adjusted lifetime epilepsy prevalence was 7.8 in 1000 population, and the adjusted prevalence for active epilepsy was 4.2 in 1000 population in Malaysia. CONCLUSION: The prevalence of lifetime epilepsy in Malaysia is 7.8 per 1000 persons.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN221, title = {HIV treatment outcomes among people who acquired HIV via injecting drug use in the Asia-Pacific region: a longitudinal cohort study}, author = {W. M. Han and A. Jiamsakul and N. A. M. Salleh and J. Y. Choi and B. V. Huy and E. Yunihastuti and C. D. Do and T. P. Merati and Y. M. Gani and S. Kiertiburanakul and F. Zhang and Y. J. Chan and M. P. Lee and R. Chaiwarith and O. T. Ng and S. Khusuwan and R. Ditangco and N. Kumarasamy and S. Sangle and J. Ross and A. Avihingsanon}, doi = {10.1002/jia2.25736}, issn = {1758-2652}, year = {2021}, date = {2021-01-01}, journal = {J Int AIDS Soc}, volume = {24}, number = {5}, pages = {e25736}, abstract = {INTRODUCTION: Data on HIV treatment outcomes in people who inject drugs (PWID) in the Asia-Pacific are sparse despite the high burden of drug use. We assessed immunological and virological responses, AIDS-defining events and mortality among PWID receiving antiretroviral therapy (ART). METHODS: We investigated HIV treatment outcomes among people who acquired HIV via injecting drug use in the TREAT Asia HIV Observational Database (TAHOD) between January 2003 and March 2019. Trends in CD4 count and viral suppression (VS, HIV viral load \<1000 copies/mL) were assessed. Factors associated with mean CD4 changes were analysed using repeated measures linear regression, and combined AIDS event and mortality were analysed using survival analysis. RESULTS: Of 622 PWID from 12 countries in the Asia-Pacific, 93% were male and the median age at ART initiation was 31 years (IQR, 28 to 34). The median pre-ART CD4 count was 71 cells/µL. CD4 counts increased over time, with a mean difference of 401 (95% CI, 372 to 457) cells/µL at year-10 (n = 78). Higher follow-up HIV viral load and pre-ART CD4 counts were associated with smaller increases in CD4 counts. Among 361 PWID with ≥1 viral load after six months on ART, proportions with VS were 82%, 88% and 93% at 2-, 5- and 10-years following ART initiation. There were 52 new AIDS-defining events and 50 deaths during 3347 person-years of follow-up (PYS) (incidence 3.05/100 PYS, 95% CI, 2.51 to 3.70). Previous AIDS or TB diagnosis, lower current CD4 count and adherence \<95% were associated with combined new AIDS-defining event and death. CONCLUSIONS: Despite improved outcomes over time, our findings highlight the need for rapid ART initiation and adherence support among PWID within Asian settings.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN210, title = {Chronic respiratory disease surveys in adults in low- and middle-income countries: A systematic scoping review of methodological approaches and outcomes}, author = {N. S. Hanafi and D. Agarwal and S. Chippagiri and E. A. Brakema and H. Pinnock and A. Sheikh and S. M. Liew and C. W. Ng and R. Isaac and K. Chinna and L. P. Wong and N. Hussein and A. I. Abu Bakar and Y. K. Pang and S. Juvekar and E. M. Khoo}, doi = {10.7189/jogh.11.04026}, issn = {2047-2978 (Print) 2047-2978}, year = {2021}, date = {2021-01-01}, journal = {J Glob Health}, volume = {11}, pages = {04026}, abstract = {BACKGROUND: Chronic respiratory diseases (CRDs) contribute significantly towards the global burden of disease, but the true prevalence and burden of these conditions in adults is unknown in the majority of low- and middle-income countries (LMICs). We aimed to identify strategies - in particular the definitions, study designs, sampling frames, instruments, and outcomes - used to conduct prevalence surveys for CRDs in LMICs. The findings will inform a future RESPIRE Four Country ChrOnic Respiratory Disease (4CCORD) study, which will estimate CRD prevalence, including disease burden, in adults in LMICs. METHODS: We conducted a scoping review to map prevalence surveys conducted in LMICs published between 1995 and 2018. We followed Arksey and O'Malley's six-step framework. The search was conducted in OVID Medline, EMBASE, ISI Web of Science, Global Health, WHO Global Index Medicus and included three domains: CRDs, prevalence and LMICs. After an initial title sift, eight trained reviewers undertook duplicate study selection and data extraction. We charted: country and populations, random sampling strategies, CRD definitions/phenotypes, survey procedure (questionnaires, spirometry, tests), outcomes and assessment of individual, societal and health service burden of disease. RESULTS: Of 36 872 citations, 281 articles were included: 132 from Asia (41 from China). Study designs were cross-sectional surveys (n = 260), cohort studies (n = 11) and secondary data analysis (n = 10). The number of respondents in these studies ranged from 50 to 512 891. Asthma was studied in 144 studies, chronic obstructive pulmonary disease (COPD) in 112. Most studies (100/144) based identification of asthma on symptom-based questionnaires. In contrast, COPD diagnosis was typically based on spirometry findings (94/112); 65 used fixed-ratio thresholds, 29 reported fixed-ratio and lower-limit-of-normal values. Only five articles used the term 'phenotype'. Most studies used questionnaires derived from validated surveys, most commonly the European Community Respiratory Health Survey (n = 47). The burden/impact of CRD was reported in 33 articles (most commonly activity limitation). CONCLUSION: Surveys remain the most practical approach for estimating prevalence of CRD but there is a need to identify the most predictive questions for diagnosing asthma and to standardise diagnostic criteria.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN159, title = {Prevalence of common mental health issues among migrant workers: A systematic review and meta-analysis}, author = {S. I. Hasan and A. Yee and A. Rinaldi and A. A. Azham and F. Mohd Hairi and A. S. Amer Nordin}, doi = {10.1371/journal.pone.0260221}, issn = {1932-6203}, year = {2021}, date = {2021-01-01}, journal = {PLoS One}, volume = {16}, number = {12}, pages = {e0260221}, abstract = {Previous literature has shown that migrant workers manifested higher common mental issues (especially depressive symptom) compared to local workers due to stressors such as financial constraint and lack of access to healthcare. The aim of this systematic review and meta-analysis is to summarize the current body of evidence for the prevalence of depression and anxiety among migrant workers as well as exploring the risk factors and the availability of social support for migrant workers. Seven electronic databases, grey literature and Google Scholar were searched for studies from 2015 to 2021 related to mental health, social support and migrant workers. Study quality was assessed using the Newcastle Ottawa Scale and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Study heterogeneity was evaluated using I2 statistics. Random effects meta-analysis results were presented given heterogeneity among studies. The search returned 27 articles and only seven studies were included in meta-analysis, involving 44 365 migrant workers in 17 different countries. The overall prevalence of depression and anxiety among migrant workers was 38.99% (95% CI = 0.27, 0.51) and 27.31% (95% CI = 0.06, 0.58), respectively. Factors such as age, biological (health issue, family history of psychiatric disorder), individual (poor coping skills), occupational (workplace psychosocial stressors, poor working condition, salary and benefits issue, abuse), environmental (limited access towards healthcare, duration of residence, living condition) and social factor (limited social support) were associated with a mental health outcome in migrant workers. The availability of social support for migrant workers was mainly concentrated in emotional type of support. A high prevalence of depression and anxiety was found among migrant workers across the globe. This finding warrants a collective effort by different parties in providing assistance for migrant workers to promote their mental well-being.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN212, title = {Breast Cancer Screening in Malaysia: A Policy Review}, author = {M. N. N. Htay and M. Donnelly and D. Schliemann and S. Y. Loh and M. Dahlui and S. Somasundaram and N. S. B. Ibrahim Tamin and T. T. Su}, doi = {10.31557/apjcp.2021.22.6.1685}, issn = {1513-7368 (Print) 1513-7368}, year = {2021}, date = {2021-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {22}, number = {6}, pages = {1685-1693}, abstract = {BACKGROUND: Breast cancer is the leading cause of cancer among Malaysian women. The implementation of prevention measures including screening has the potential to reduce the burden of breast cancer which caused by late presentation. AIMS: This paper aimed to review the public health policy relating to breast cancer screening in Malaysia that was undertaken in order to contribute to policy development regarding cancer prevention, detection and the improvement of services for Malaysian women. METHODS: The policy review strategy included a specific search of the website of the Ministry of Health in Malaysia for relevant policies. In addition, we searched Google and Pubmed for breast cancer screening programmes, policies, and guidelines for women in Malaysia. In addition, experts and stakeholders provided additional resources, published in Malay language. Relevant guidelines in the Malay language were translated into English and included the document review. RESULTS: The policy analysis indicated that although it is known that screening, early detection and diagnosis improve survival rates, delayed diagnosis remains a significant issue. The Ministry of Health policy stipulates the provision of opportunistic mammography screening. However, the uptake is varied, and implementation is challenging due to a lack of awareness about screening and difficulties related to accessing services, especially in rural areas. The establishment and implementation of referral guidelines is essential to receive timely treatment for breast cancer patients. There is a need to enhance the cancer reporting by the doctors to the national cancer registry, in collaboration with government services and the private cancer-care sector to improve the monitoring and evaluation of cancer control policies and programmes. CONCLUSION: A focus on raising awareness, increasing the accessibility of screening facilities and improving referral processes and the overall connectivity of the cancer care system are key steps to down-staging breast cancer in Malaysia.\<br /\>.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN251, title = {Polygenic hazard score is associated with prostate cancer in multi-ethnic populations}, author = {M. P. Huynh-Le and C. C. Fan and R. Karunamuni and W. K. Thompson and M. E. Martinez and R. A. Eeles and Z. Kote-Jarai and K. Muir and J. Schleutker and N. Pashayan and J. Batra and H. Gr\"{o}nberg and D. E. Neal and J. L. Donovan and F. C. Hamdy and R. M. Martin and S. F. Nielsen and B. G. Nordestgaard and F. Wiklund and C. M. Tangen and G. G. Giles and A. Wolk and D. Albanes and R. C. Travis and W. J. Blot and W. Zheng and M. Sanderson and J. L. Stanford and L. A. Mucci and C. M. L. West and A. S. Kibel and O. Cussenot and S. I. Berndt and S. Koutros and K. D. S\orensen and C. Cybulski and E. M. Grindedal and F. Menegaux and K. T. Khaw and J. Y. Park and S. A. Ingles and C. Maier and R. J. Hamilton and S. N. Thibodeau and B. S. Rosenstein and Y. J. Lu and S. Watya and A. Vega and M. Kogevinas and K. L. Penney and C. Huff and M. R. Teixeira and L. Multigner and R. J. Leach and L. Cannon-Albright and H. Brenner and E. M. John and R. Kaneva and C. J. Logothetis and S. L. Neuhausen and K. De Ruyck and H. Pandha and A. Razack and L. F. Newcomb and J. H. Fowke and M. Gamulin and N. Usmani and F. Claessens and M. Gago-Dominguez and P. A. Townsend and W. S. Bush and M. J. Roobol and M\'{E} Parent and J. J. Hu and I. G. Mills and O. A. Andreassen and A. M. Dale and T. M. Seibert}, doi = {10.1038/s41467-021-21287-0}, issn = {2041-1723}, year = {2021}, date = {2021-01-01}, journal = {Nat Commun}, volume = {12}, number = {1}, pages = {1236}, abstract = {Genetic models for cancer have been evaluated using almost exclusively European data, which could exacerbate health disparities. A polygenic hazard score (PHS(1)) is associated with age at prostate cancer diagnosis and improves screening accuracy in Europeans. Here, we evaluate performance of PHS(2) (PHS(1), adapted for OncoArray) in a multi-ethnic dataset of 80,491 men (49,916 cases, 30,575 controls). PHS(2) is associated with age at diagnosis of any and aggressive (Gleason score ≥ 7, stage T3-T4, PSA ≥ 10 ng/mL, or nodal/distant metastasis) cancer and prostate-cancer-specific death. Associations with cancer are significant within European (n = 71,856), Asian (n = 2,382), and African (n = 6,253) genetic ancestries (p \< 10(-180)). Comparing the 80(th)/20(th) PHS(2) percentiles, hazard ratios for prostate cancer, aggressive cancer, and prostate-cancer-specific death are 5.32, 5.88, and 5.68, respectively. Within European, Asian, and African ancestries, hazard ratios for prostate cancer are: 5.54, 4.49, and 2.54, respectively. PHS(2) risk-stratifies men for any, aggressive, and fatal prostate cancer in a multi-ethnic dataset.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN236, title = {Virtual Group Exercises and Psychological Status among Community-Dwelling Older Adults during the COVID-19 Pandemic-A Feasibility Study}, author = {A. Ibrahim and M. C. Chong and S. Khoo and L. P. Wong and I. Chung and M. P. Tan}, doi = {10.3390/geriatrics6010031}, issn = {2308-3417}, year = {2021}, date = {2021-01-01}, journal = {Geriatrics (Basel)}, volume = {6}, number = {1}, abstract = {Social isolation, magnified by the restriction of movement order during the COVID-19 pandemic, may lead to negative psychosocial health impacts among community-dwelling older adults. We, therefore, aimed to evaluate recruitment rates, data collection, and group exercises conducted through virtual technology among individuals aged 60 years and over in Malaysia. Participants were recruited from the Promoting Independence in Seniors with Arthritis (PISA) pilot cohort through social media messaging. A four-week course of virtual group exercise was offered. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS) during the last attended follow-up of the cohort study (pre-pandemic), pre-intervention, and post-intervention. Exercise adherence was recorded using diaries with daily entries and attendance to the virtual group exercise sessions were also captured electronically daily. The outcomes of interest were changes in anxiety and depression scores from baseline to pre-intervention (pandemic-related) and post-intervention (virtual exercise related). Forty-three individuals were recruited. A significant increase in anxiety scores from baseline to pre-intervention was observed. Comparisons using repeated-measures analysis of variance between those who attendance ≥14 and \<14 group exercise sessions revealed no between-within subject differences in depression scores. There was a 23% dropout rate in the post intervention survey and 60.5% of diaries were returned. Virtual group exercises could be conducted among older adults residing in a middle-income country, though recruitment would have been limited to those with internet access.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN215, title = {Is pre-operative axillary ultrasound alone sufficient to determine need for axillary dissection in early breast cancer patients?}, author = {S. Jamaris and J. Jamaluddin and T. Islam and M. H. See and F. Fadzli and K. Rahmat and N. Bhoo-Pathy and N. A. M. Taib}, doi = {10.1097/md.0000000000025412}, issn = {0025-7974 (Print) 0025-7974}, year = {2021}, date = {2021-01-01}, journal = {Medicine (Baltimore)}, volume = {100}, number = {19}, pages = {e25412}, abstract = {Pre-operative status of axillary lymph node (ALN) in early breast cancer is usually initially assessed by pre-operative ultrasound, followed by ultrasound-guided needle biopsy (UNB) confirmation. Patients with positive nodal status will undergo axillary lymph node dissection (ALND), while those with negative nodal status will have sentinel lymph node biopsy. ALND is associated with higher morbidity than Sentinel lymph node biopsy. The objective of this study is to determine if axillary ultrasound alone without UNB is predictive enough to assign patients to ALND and to identify ultrasound features that are significantly associated with pathologically positive ALN.383 newly diagnosed primary breast cancer patients between 2012 and 2014, and who had undergone pre-operative axillary ultrasound in University Malaya Medical Centre with a complete histopathology report of the axillary surgery were retrospectively reviewed. ALN was considered positive if it had any of these features: cortical thickening \> 3 mm, loss of fatty hilum, hypoechoic solid node, mass-like appearance, round shape and lymph node size \> 5 mm. Post-operative histopathological reports were then analyzed for nodal involvement.The overall sensitivity, specificity, and accuracy of pre-operative axillary ultrasound in detecting diseased nodes were 45.5%, 80.7%, and 60.3% respectively. The positive (PPV) and negative predictive values were 76.5% and 51.8%. Round shape, loss of fatty hilum and mass-like appearance had the highest PPVs of 87%, 83% and 81.6% respectively and significant odds ratios (ORs) of 5.22 (95% confidence interval [CI]: 1.52 - 17.86), ORs of 4.77 (95% CI: 2.62 - 8.70) and ORs of 4.26 (95% CI: 2.37 - 7.67) respectively (P-value \< .05). Cortical thickness of \> 3 mm was identified to have low PPV at 69.1%, ORs of 1.71 (95% CI: 0.86 - 3.41}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN268, title = {Additional SNPs improve risk stratification of a polygenic hazard score for prostate cancer}, author = {R. A. Karunamuni and M. P. Huynh-Le and C. C. Fan and W. Thompson and R. A. Eeles and Z. Kote-Jarai and K. Muir and A. Lophatananon and J. Schleutker and N. Pashayan and J. Batra and H. Gr\"{o}nberg and E. I. Walsh and E. L. Turner and A. Lane and R. M. Martin and D. E. Neal and J. L. Donovan and F. C. Hamdy and B. G. Nordestgaard and C. M. Tangen and R. J. MacInnis and A. Wolk and D. Albanes and C. A. Haiman and R. C. Travis and J. L. Stanford and L. A. Mucci and C. M. L. West and S. F. Nielsen and A. S. Kibel and F. Wiklund and O. Cussenot and S. I. Berndt and S. Koutros and K. D. S\orensen and C. Cybulski and E. M. Grindedal and J. Y. Park and S. A. Ingles and C. Maier and R. J. Hamilton and B. S. Rosenstein and A. Vega and M. Kogevinas and K. L. Penney and M. R. Teixeira and H. Brenner and E. M. John and R. Kaneva and C. J. Logothetis and S. L. Neuhausen and A. Razack and L. F. Newcomb and M. Gamulin and N. Usmani and F. Claessens and M. Gago-Dominguez and P. A. Townsend and M. J. Roobol and W. Zheng and I. G. Mills and O. A. Andreassen and A. M. Dale and T. M. Seibert}, doi = {10.1038/s41391-020-00311-2}, issn = {1365-7852 (Print) 1365-7852}, year = {2021}, date = {2021-01-01}, journal = {Prostate Cancer Prostatic Dis}, volume = {24}, number = {2}, pages = {532-541}, abstract = {BACKGROUND: Polygenic hazard scores (PHS) can identify individuals with increased risk of prostate cancer. We estimated the benefit of additional SNPs on performance of a previously validated PHS (PHS46). MATERIALS AND METHOD: 180 SNPs, shown to be previously associated with prostate cancer, were used to develop a PHS model in men with European ancestry. A machine-learning approach, LASSO-regularized Cox regression, was used to select SNPs and to estimate their coefficients in the training set (75,596 men). Performance of the resulting model was evaluated in the testing/validation set (6,411 men) with two metrics: (1) hazard ratios (HRs) and (2) positive predictive value (PPV) of prostate-specific antigen (PSA) testing. HRs were estimated between individuals with PHS in the top 5% to those in the middle 40% (HR95/50), top 20% to bottom 20% (HR80/20), and bottom 20% to middle 40% (HR20/50). PPV was calculated for the top 20% (PPV80) and top 5% (PPV95) of PHS as the fraction of individuals with elevated PSA that were diagnosed with clinically significant prostate cancer on biopsy. RESULTS: 166 SNPs had non-zero coefficients in the Cox model (PHS166). All HR metrics showed significant improvements for PHS166 compared to PHS46: HR95/50 increased from 3.72 to 5.09, HR80/20 increased from 6.12 to 9.45, and HR20/50 decreased from 0.41 to 0.34. By contrast, no significant differences were observed in PPV of PSA testing for clinically significant prostate cancer. CONCLUSIONS: Incorporating 120 additional SNPs (PHS166 vs PHS46) significantly improved HRs for prostate cancer, while PPV of PSA testing remained the same.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN217, title = {Pre-schoolers' tooth brushing behaviour and association with their oral health: a cross sectional study}, author = {I. M. Khan and S. A. Mani and J. G. Doss and M. Danaee and L. Y. L. Kong}, doi = {10.1186/s12903-021-01643-8}, issn = {1472-6831}, year = {2021}, date = {2021-01-01}, journal = {BMC Oral Health}, volume = {21}, number = {1}, pages = {283}, abstract = {BACKGROUND: Toothbrushing is an important yet neglected behaviour that affects the oral health of preschool children. Little is reported on parental supervision, an essential aspect of routine effective toothbrushing in this age group. The aim of this study was to evaluate pre-schoolers' toothbrushing behaviour including parental involvement and its association with their oral health. METHODS: This was a cross-sectional study. A total of 92 preschool children (4-6 years) were invited to participate with their parents/guardians. Nine parameters of toothbrushing behaviour were assessed from parental responses (questionnaire) and observation of child and parents/guardians (video recording). Oral examination included recording plaque, gingival and dental caries indices. BORIS software was used to assess toothbrushing parameters and Smart PLS was used to perform association with a second-generation multivariate analysis to create models with and without confounding factors. RESULTS: Girls were slightly more (53%) than boys (47%). Children aged 4 years were slightly more in number (38%), followed by 6-year-olds and 5-year-olds. Nearly, 90% parents had tertiary education and 46% had more than 2 children. Differences were recorded in the reported and observed behaviour. Thirty-five percent parents/guardians reported using pea-size toothpaste amount but only 28% were observed. Forty percent reported to brush for 30 s-1 min, however 51% were observed to brush for 1-2 min. Half the children were observed to use fluoridated toothpaste (F \< 1000 ppm) under parental supervision (11%). The mean (SD) plaque score reduction after toothbrushing was 10.80 (2.46), mean pre-brushing plaque score was 90.3 (10.2), mean gingival index was 0.89 (0.65) and mean dental caries status (ICDAS((1-6))) was 18.87 (12.39). Toothbrushing behaviour in terms of toothbrushing technique, duration, pattern and frequency, toothbrush type and grip type, toothpaste type and amount, post-brushing mouth rinsing and parental involvement contributed significantly to plaque score change (86%), dental caries status (73%), gingival index (66%) and pre-brushing plaque score (31%). The significant confounding variables had a small influence on oral health of preschool children. CONCLUSIONS: Preschool children's toothbrushing behaviour was inadequate while their oral health was poor, with a significant association between the two parameters.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN258, title = {Prevalence, awareness, treatment and control of young-onset hypertension in Malaysia, 2006-2015}, author = {Y. Y. Khoo and N. D. N. Farid and W. Y. Choo and A. Omar}, doi = {10.1038/s41371-020-00478-0}, issn = {0950-9240}, year = {2021}, date = {2021-01-01}, journal = {J Hum Hypertens}, abstract = {The continuous presence of elevated blood pressure (BP) when young is a strong predictor of future cardiovascular risk. This study aimed to elucidate the prevalence, awareness, treatment and control of young-onset hypertension (YOH) in Malaysia during the period 2006-2015. Data on respondents aged 18-39 diagnosed with YOH according to the 7th Joint National Committee Report (USA) were extracted from three National Health and Morbidity Surveys (2006, 2011, and 2015). The prevalence of YOH remained stable: 17.7%, 95% CI [17.0, 18.3] in 2006, 17.0%, 95% CI [16.0, 17.9] in 2011 and 18.4%, 95% CI [17.4, 19.4] in 2015. Awareness, treatment and control rates were suboptimal; 15% were aware of their diagnosis, of which less than 50% were on treatment and less than 40% who were on treatment had their BP controlled. Trend analysis revealed a significant increase in YOH prevalence among urban dwellers; those with no formal and tertiary education and middle-income earners. YOH awareness and treatment rates were lower among respondents \<30 years; however, when treated, this group achieved overall better control rates. Females had higher awareness and treatment rates, but lower control. Treatment rates remained stable for all ethnicities with the exception of Chinese, which decreased. This study narrows the knowledge gap on YOH epidemiology in Malaysia by providing crucial information on the pervasiveness of hypertension among young adults. Results can be used to develop non-communicable disease policies and health promotion strategies specially targeted at young adults who are in the prime of life.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN158, title = {Changes in Dietary Intake of Breast Cancer Survivors: Early Findings of a Malaysian Breast Cancer Prospective Cohort Study}, author = {S. J. Kiew and N. A. Mohd Taib and T. Islam and H. Abdul Majid}, doi = {10.1080/01635581.2021.2013508}, issn = {0163-5581}, year = {2021}, date = {2021-01-01}, journal = {Nutr Cancer}, pages = {1-9}, abstract = {This study aimed to evaluate the changes in post-diagnosis dietary intake of breast cancer survivors. A total of 112 participants from the Malaysian Breast Cancer Survivorship Cohort study with dietary intake at one-year post-diagnosis (T1) and three-year post-diagnosis (T2) were included. A three-day food record was used to assess the dietary intake of breast cancer survivors. The participants' anthropometrical measurements were measured at both time points (n = 95). Notably, we found that around half of the participants were obese at both time points. Body weight and body mass index increased significantly between the two time points (P \< 0.01). Most of the participants did not meet the Malaysian recommended nutrient intake for dietary fat, fiber, and calcium at both time points. The energy intake significantly decreased (from 1,596 kcal/day to 1,524 kcal/day}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN19, title = {Uncovering Physical and Attitudinal Barriers to Adherence to Precautions for Preventing the Transmission of COVID-19 and Anxiety Level of People in Wuhan: 2 Months After the Lockdown}, author = {Y. Lin and H. Alias and X. Luo and Z. Hu and L. P. Wong}, doi = {10.1016/j.psym.2020.09.005}, issn = {2667-2979 (Print) 2667-2960}, year = {2021}, date = {2021-01-01}, journal = {J Acad Consult Liaison Psychiatry}, volume = {62}, number = {2}, pages = {201-210}, abstract = {BACKGROUND: Wuhan, the epicenter of the coronavirus disease 2019 outbreak, was locked down on January 23, 2020. We aimed to investigate the barriers to the physical prevention, negative attitudes, and anxiety levels. METHODS: A online cross-sectional survey was conducted with the people living in Wuhan between March 12th and 23rd, 2020. RESULTS: Of a total of 2411 complete responses, the mean and standard deviation for the total physical prevention barriers score was 19.73 (standard deviation ± 5.3; range 12-45) out of a possible score of 48. Using a cut-off score of 44 for the State-Trait Inventory score, 79.9% (95% confidence interval [CI]: 78.2-81.5) of the participants reported moderate to severe anxiety during the early phase of the outbreak, and 51.3% (95% CI 49.2-53.3) reported moderate to severe anxiety after the peak of coronavirus disease 2019 was over (during the study period). Comparing anxiety levels in the early phase of the outbreak and after the peak of the outbreak, 58.5% (95% CI 56.5-60.5) recorded a decreased anxiety. Females reported a higher likelihood of having decreased levels of anxiety than males (odds ratio = 1.78, 95% CI 1.48-2.14). Low negative attitudes score were associated with a higher decrease in anxiety (odds ratio = 1.59, 95% CI 1.33-1.89). CONCLUSIONS: The attitudinal barriers to prevention of transmission of coronavirus disease 2019 are more prominent than physical prevention barriers after the peak of coronavirus disease 2019. High anxiety levels even after the peak warrant serious attention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN241, title = {Quarantine for the coronavirus disease (COVID-19) in Wuhan city: Support, understanding, compliance and psychological impact among lay public}, author = {Y. Lin and Z. Hu and H. Alias and L. P. Wong}, doi = {10.1016/j.jpsychores.2021.110420}, issn = {0022-3999 (Print) 0022-3999}, year = {2021}, date = {2021-01-01}, journal = {J Psychosom Res}, volume = {144}, pages = {110420}, abstract = {OBJECTIVE: Wuhan, the epicentre of the coronavirus diseases (COVID-19) outbreak, has been locked down on January 23, 2020. We conducted a study among the lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine. METHODS: We conducted a cross-sectional, online-based survey study between January 28, 2020, and February 2, 2020 among the adult lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine. Multivariable logistic analysis was used to identify factors associated with psychological impacts. RESULTS: Among the 4100 participants investigated, a total of 15.9% were compliant with all the five household prevention measures, whereas 74.4% were compliant with all the three community prevention measures investigated. By demographics, participants of younger age, higher income, residing in an urban area, knowing neighbors infected with COVID-19 reported significantly higher psychological impact score. Participants with a lower level of support for quarantine were more likely to have a higher psychological impact score (OR = 1.45, 95% CI 1.07-1.96). Participants with a lower level of compliance with preventive measures (score of 0-19) reported higher psychological impact (OR = 1.40, 95% CI 1.22-1.60 vs. score 20-24). Participants who had been out of house socializing and attended public events expressed higher psychological impact. CONCLUSIONS: Support, understanding of the rationale for quarantine are essential in ensuring appropriate psychological well-being during the quarantine. Improvements in compliance with preventive measures are highly warranted and may bring about a reduction in psychological distress.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN150, title = {Reliability analysis of the Malay version of the center for epidemiologic studies-depression scale (CESD) among adolescents in Malaysia}, author = {S. Singh and R. A. Zaki and N. D. N. Farid and K. Kaur}, doi = {10.1016/j.pmedr.2021.101585}, issn = {2211-3355 (Print) 2211-3355}, year = {2021}, date = {2021-01-01}, journal = {Prev Med Rep}, volume = {24}, pages = {101585}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Depression is a common mental disorder that affects many adolescents worldwide. Therefore, there is a need for reliable instruments to screen for depression symptoms among adolescents. This study aims to determine the reliability of the Malay version of the Centre of Epidemiological Studies Depression Scale (CESD) among adolescents in Malaysia. A cross-sectional study was conducted among 65 adolescents ages between 12 and 14 years from two secondary schools in the Federal Territory of Kuala Lumpur from May 2017 to July 2017. Cronbach's alpha (α), McDonald's omega (ω), Spearman Brown split half reliability (r(SB)), and Intra-class Correlation Coefficient (ICC) were examine to determine the internal consistency and two week test-retest reliability. The overall CESD scale was found to have good internal consistency with α = 0.882 (95% CI 0.837, 0.914), ω = 0.886 (95% CI 0.837, 0.916) and r(SB) = 0.909. The CESD subscales, Somatic symptoms (α = 0.824; 95% CI 0.739, 0.878; ω = 0.828; 95% CI 0.738, 0.885; r(SB) = 0.825), Depressive affect (α = 0.822; 95% CI 0.745, 0.880; ω = 0.834; 95% CI 0.750, 0.884; r(SB) = 0.847) and Positive affect (α = 0.610; 95% CI 0.326, 0.721; ω = 0.612; 95% CI 0.379, 0.723 and r(SB) = 0.608) indicated acceptable to good internal consistency. The 2-week test-retest reliability ICC was 0.926 (95% CI 0.851, 0.961) for the total score reliability. The reliability analysis of the Malay version of CESD shows satisfactory α, ω, r(SB) and ICC values, therefore making it a reliable instrument to screen for depression among adolescents in Malaysia.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN156, title = {Chinese parents' intentions to vaccinate their children against SARS-CoV-2 infection and vaccine preferences}, author = {Y. Lin and Z. Hu and Q. Zhao and H. Alias and M. Danaee and L. P. Wong}, doi = {10.1080/21645515.2021.1999143}, issn = {2164-5515}, year = {2021}, date = {2021-01-01}, journal = {Hum Vaccin Immunother}, pages = {1-10}, abstract = {This study aims to determine the intention of Chinese parents to vaccinate their children against SARS-CoV-2. Secondly, preferences for foreign- or domestically made COVID-19 vaccines were also explored. A nationwide, cross-sectional, self-administered online survey based on the Health Belief Model (HBM) and new vaccine concerns was used. Participants were eligible if they were residents of China with children aged 12 years old or younger. A total of 2,026 parents responded to the survey. Half reported a probable intent (50.7%) and 26.9% reported a definite intent. The results of the data analysis of partial least squares structural equation modeling (PLS-SEM) found that perceived cost barriers (B = -0.210, p \< .001) and new vaccine concerns (B = -0.201, p \< .001) had major effects in vaccination intent. Important constructs of vaccine concerns that predict vaccination intent were efficacy (B = 0.898, p \< .001), followed by safety (B = 0.861, p \< .001), side-effect (B = 0.806, p \< .001) and faulty/fake vaccine (B = 0.579, p \< .001). Perceived benefits (B = 1.81, p \< .001), self-efficacy (B = 0.159, p \< .001) and severity (B = 0.083, p \< .01) were also significant predictors in vaccination intent. Almost two-thirds (62.0%; 95%CI 59.8 to 64.1) reported a preference for domestically made and 19.1% (95%CI 17.2 to 20.7) preferred foreign-made COVID-19 vaccines. Multivariable logistic regression analysis revealed that higher incomes and concern of side-effects of the new COVID-19 vaccine were two of the most important influencing factors of preference for a foreign-made vaccine. This study sheds light on the importance of addressing concerns of new vaccines and the helpfulness of HBM in understanding parental decisions toward their children being vaccinated against SARS-CoV-2.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN76, title = {Chinese mothers' intention to vaccinate daughters against human papillomavirus (HPV), and their vaccine preferences: a study in Fujian Province}, author = {Y. Lin and Z. Su and F. Chen and Q. Zhao and G. D. Zimet and H. Alias and S. He and Z. Hu and L. P. Wong}, doi = {10.1080/21645515.2020.1756152}, issn = {2164-5515 (Print) 2164-5515}, year = {2021}, date = {2021-01-01}, journal = {Hum Vaccin Immunother}, volume = {17}, number = {1}, pages = {304-315}, abstract = {Little is known regarding Chinese mothers' intention to vaccinate their daughters against human papillomavirus (HPV) since the HPV vaccine was approved for use in China in 2016. The aim was to explore maternal HPV vaccination acceptance, preference for 2-, 4- or 9-valent HPV vaccine and acceptance of domestically manufactured HPV vaccines. Study participants were mothers of primary school children in Southeastern region of Fujian. An online cross-sectional survey was undertaken between June and August 2019. Among the total of 3,586 completed responses (response rate 28.5%), the intention to vaccinate daughter against HPV was high (83.3%). Higher maternal education and perceived benefit and barriers were associated with greater intention to vaccinate. Among mothers who did not intend to vaccinate their daughters, the three most common reasons were daughter being too young to receive HPV vaccination (40.6%), fear of side effects (31.9%) and vaccine price is too high (16.0%). The largest proportion (41.4%) preferred their daughter to be vaccinated with the 9-valent HPV vaccine (9vHPV). Greater preference for 9vHPVwas strongly associated with higher maternal education level and annual household income. The majority of mothers expressed a preference for imported HPV vaccine (56.3%). Our result indicates that lower intentions to vaccinate daughters against HPV among less educated and lower-income mothers may lead to significant social inequalities in HPV vaccine uptake in the country.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN160, title = {Education for non-citizen children in Malaysia during the COVID-19 pandemic: A qualitative study}, author = {T. Loganathan and Z. X. Chan and F. Hassan and W. Kunpeuk and R. Suphanchaimat and H. Yi and H. A. Majid}, doi = {10.1371/journal.pone.0259546}, issn = {1932-6203}, year = {2021}, date = {2021-01-01}, journal = {PLoS One}, volume = {16}, number = {12}, pages = {e0259546}, abstract = {The COVID-19 pandemic disrupted schooling for children worldwide. Most vulnerable are non-citizen children without access to public education. This study aims to explore challenges faced in achieving education access for children of refugee and asylum-seekers, migrant workers, stateless and undocumented persons in Malaysia during the pandemic. In-depth interviews of 33 stakeholders were conducted from June 2020 to March 2021. Data were thematically analysed. Our findings suggest that lockdowns disproportionately impacted non-citizen households as employment, food and housing insecurity were compounded by xenophobia, exacerbating pre-existing inequities. School closures disrupted school meals and deprived children of social interaction needed for mental wellbeing. Many non-citizen children were unable to participate in online learning due to the scarcity of digital devices, and poor internet connectivity, parental support, and home learning environments. Teachers were forced to adapt to online learning and adopt alternative arrangements to ensure continuity of learning and prevent school dropouts. The lack of government oversight over learning centres meant that measures taken were not uniform. The COVID-19 pandemic presents an opportunity for the design of more inclusive national educational policies, by recognising and supporting informal learning centres, to ensure that no child is left behind.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN261, title = {Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial}, author = {P. S. Loh and C. H. Yeong and N. S. Masohood and N. Sulaiman and R. A. Zaki and K. Fabell and B. J. J. Abdullah}, doi = {10.1038/s41598-021-81913-1}, issn = {2045-2322}, year = {2021}, date = {2021-01-01}, journal = {Sci Rep}, volume = {11}, number = {1}, pages = {2299}, abstract = {Microwave ablation (MWA) is gaining popularity for the treatment of small primary hepatocellular carcinoma and metastatic lesions especially if patients are not candidates for surgical resection. Deep neuromuscular blockade (DMB) is perceived to improve surgical working conditions compared to moderate neuromuscular blockade (MMB) but no studies have examined the same benefits in MWA of liver tumours. This study aimed to compare the clinical outcomes of DMB and MMB in MWA of liver tumours in terms of liver excursion, performance scores by the interventional radiologists and patients, requirements of additional muscle relaxants and complications. 50 patients were recruited and 45 patients (22 in MMB group, 23 in DMB group) completed the study. The mean liver excursion for the MMB group (1.42 ± 1.83 mm) was significantly higher than the DMB group (0.26 ± 0.38 mm) (p = 0.001). The mean Leiden-Surgical Rating Scale (L-SRS) rated by the two interventional radiologists were 4.5 ± 0.59 and 3.6 ± 0.85 for the DMB and MMB groups, respectively (p = 0.01). There was also statistically significant difference on patient satisfaction scores (0-10: Extremely Dissatisfied-Extremely Satisfied) between DMB (8.74 ± 1.1) and MMB (7.86 ± 1.25) groups (p = 0.01). 5 patients from MMB group and none from DMB group required bolus relaxant during the MWA procedure. Adverse events were also noted to be more severe in the MMB group. In conclusion, DMB significantly reduced liver excursion and movement leading to improved accuracy, safety and success in ablating liver tumour.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN46, title = {Metabolic perturbations prior to hepatocellular carcinoma diagnosis: Findings from a prospective observational cohort study}, author = {M. Stepien and P. Keski-Rahkonen and A. Kiss and N. Robinot and T. Duarte-Salles and N. Murphy and G. Perlemuter and V. Viallon and A. Tj\onneland and A. L. Rostgaard-Hansen and C. C. Dahm and K. Overvad and M. C. Boutron-Ruault and F. R. Mancini and Y. Mahamat-Saleh and K. Aleksandrova and R. Kaaks and T. K\"{u}hn and A. Trichopoulou and A. Karakatsani and S. Panico and R. Tumino and D. Palli and G. Tagliabue and A. Naccarati and R. C. H. Vermeulen and H. B. Bueno-de-Mesquita and E. Weiderpass and G. Skeie and J. Ram\'{o}n Quir\'{o}s and E. Ardanaz and O. Mokoroa and N. Sala and M. J. S\'{a}nchez and J. M. Huerta and A. Winkvist and S. Harlid and B. Ohlsson and K. Sj\"{o}berg and J. A. Schmidt and N. Wareham and K. T. Khaw and P. Ferrari and J. A. Rothwell and M. Gunter and E. Riboli and A. Scalbert and M. Jenab}, doi = {10.1002/ijc.33236}, issn = {0020-7136}, year = {2021}, date = {2021-01-01}, journal = {Int J Cancer}, volume = {148}, number = {3}, pages = {609-625}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Hepatocellular carcinoma (HCC) development entails changes in liver metabolism. Current knowledge on metabolic perturbations in HCC is derived mostly from case-control designs, with sparse information from prospective cohorts. Our objective was to apply comprehensive metabolite profiling to detect metabolites whose serum concentrations are associated with HCC development, using biological samples from within the prospective European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (\>520 000 participants), where we identified 129 HCC cases matched 1:1 to controls. We conducted high-resolution untargeted liquid chromatography-mass spectrometry-based metabolomics on serum samples collected at recruitment prior to cancer diagnosis. Multivariable conditional logistic regression was applied controlling for dietary habits, alcohol consumption, smoking, body size, hepatitis infection and liver dysfunction. Corrections for multiple comparisons were applied. Of 9206 molecular features detected, 220 discriminated HCC cases from controls. Detailed feature annotation revealed 92 metabolites associated with HCC risk, of which 14 were unambiguously identified using pure reference standards. Positive HCC-risk associations were observed for N1-acetylspermidine, isatin, p-hydroxyphenyllactic acid, tyrosine, sphingosine, l,l-cyclo(leucylprolyl), glycochenodeoxycholic acid, glycocholic acid and 7-methylguanine. Inverse risk associations were observed for retinol, dehydroepiandrosterone sulfate, glycerophosphocholine, γ-carboxyethyl hydroxychroman and creatine. Discernible differences for these metabolites were observed between cases and controls up to 10 years prior to diagnosis. Our observations highlight the diversity of metabolic perturbations involved in HCC development and replicate previous observations (metabolism of bile acids, amino acids and phospholipids) made in Asian and Scandinavian populations. These findings emphasize the role of metabolic pathways associated with steroid metabolism and immunity and specific dietary and environmental exposures in HCC development.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN229, title = {Silver linings: a qualitative study of desirable changes to cancer care during the COVID-19 pandemic}, author = {D. Lombe and R. Sullivan and C. Caduff and Z. Ali and N. Bhoo-Pathy and J. Cleary and M. Jalink and T. Matsuda and D. Mukherji and D. Sarfati and V. Vanderpuye and A. Yusuf and C. Booth}, doi = {10.3332/ecancer.2021.1202}, issn = {1754-6605 (Print) 1754-6605}, year = {2021}, date = {2021-01-01}, journal = {Ecancermedicalscience}, volume = {15}, pages = {1202}, abstract = {INTRODUCTION: Public health emergencies and crises such as the current COVID-19 pandemic can accelerate innovation and place renewed focus on the value of health interventions. Capturing important lessons learnt, both positive and negative, is vital. We aimed to document the perceived positive changes (silver linings) in cancer care that emerged during the COVID-19 pandemic and identify challenges that may limit their long-term adoption. METHODS: This study employed a qualitative design. Semi-structured interviews (n = 20) were conducted with key opinion leaders from 14 countries. The participants were predominantly members of the International COVID-19 and Cancer Taskforce, who convened in March 2020 to address delivery of cancer care in the context of the pandemic. The Framework Method was employed to analyse the positive changes of the pandemic with corresponding challenges to their maintenance post-pandemic. RESULTS: Ten themes of positive changes were identified which included: value in cancer care, digital communication, convenience, inclusivity and cooperation, decentralisation of cancer care, acceleration of policy change, human interactions, hygiene practices, health awareness and promotion and systems improvement. Impediments to the scale-up of these positive changes included resource disparities and variation in legal frameworks across regions. Barriers were largely attributed to behaviours and attitudes of stakeholders. CONCLUSION: The COVID-19 pandemic has led to important value-based innovations and changes for better cancer care across different health systems. The challenges to maintaining/implementing these changes vary by setting. Efforts are needed to implement improved elements of care that evolved during the pandemic.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN225, title = {Comparison of cooling methods on denture base adaptation of rapid heat-cured acrylic using a three-dimensional superimposition technique}, author = {L. W. May and J. John and L. G. Seong and Z. Z. Abidin and N. Ibrahim and M. Danaee and N. R. Mohd}, doi = {10.4103/jips.jips_41_21}, issn = {0972-4052 (Print) 0972-4052}, year = {2021}, date = {2021-01-01}, journal = {J Indian Prosthodont Soc}, volume = {21}, number = {2}, pages = {198-203}, abstract = {AIM: To investigate the effect of different cooling methods on denture base adaptation of rapid heat-cured acrylic resin using 3D superimposition technique. SETTING AND DESIGN: In vitro - Comparative study. MATERIALS AND METHODS: Denture base adaptation of two different rapid heat-cured polymethyl methacrylate acrylic resins using five different cooling methods were compared. Forty maxillary edentulous stone cast were prepared to produce the denture bases with standardized thickness. The specimens were divided into five groups (n = 8) according to type of materials and cooling methods. The master stone cast and all forty denture bases were scanned with 3Shape E1 laboratory scanner. The scanned images of each of the denture bases were superimposed over the scanned image of the master cast using Materialize 3-matic software. Three dimensional differences between the two surfaces were calculated and color surface maps were generated for visual qualitative assessment. STATISTICAL ANALYSIS USED: Generalized Linear Model Test, Bonferroni Post Hoc Analysis. RESULTS: All bench-cooled specimens showed wide green-colored area in the overall palatal surface, while the rapid cooled specimens presented with increased red color areas especially at the palate and post dam area. Generalized Linear Model test followed by Bonferroni post hoc analysis showed significant difference in the root mean square values among the specimen groups. CONCLUSION: Samples that were bench cooled, demonstrated better overall accuracy compared to the rapid cooling groups. Regardless of need for shorter denture processing time, bench cooling of rapid heat-cured PMMA is essential for acceptable denture base adaptation.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN198, title = {Barriers, Enablers, and Perceptions on Dietary Salt Reduction in the Out-of-Home Sectors: A Scoping Review}, author = {V. Michael and Y. X. You and S. Shahar and Z. A. Manaf and H. Haron and S. N. Shahrir and H. A. Majid and Y. C. Chia and M. K. Brown and F. J. He and G. A. MacGregor}, doi = {10.3390/ijerph18158099}, issn = {1661-7827 (Print) 1660-4601}, year = {2021}, date = {2021-01-01}, journal = {Int J Environ Res Public Health}, volume = {18}, number = {15}, abstract = {In this review, we have investigated the perceptions, barriers, and enabling factors that were responsible for a dietary salt reduction in the out-of-home sectors. For this purpose, we examined different knowledge databases such as Google Scholar, Ebscohost, MEDLINE (PubMed), Ovid, and Cochrane Library for research articles from September to December 2020. The inclusion criteria for the research articles were that they had to be published in English and had to be a qualitative or quantitative study that was conducted after 2010. These studies also had to report the various enablers, barriers, and perceptions regarding salt reduction in the out-of-home sectors. After implementing the inclusion criteria, we successfully screened a total of 440 studies, out of which 65 articles fulfilled all the criteria. The perceived barriers that hindered salt reduction among the out-of-home sectors included lack of menu and food variabilities, loss of sales due to salt reduction, lack of technical skills for implementing the salt reduction processes for cooking or reformulation, and an absence of environmental and systemic support for reducing the salt concentration. Furthermore, the enablers for salt reduction included the intervention programs, easy accessibility to salt substitutes, salt intake measurement, educational availability, and a gradual reduction in the salt levels. With regards to the behavior or perceptions, the effect of organizational and individual characteristics on their salt intake were reported. The majority of the people were not aware of their salt intake or the effect of salt on their health. These people also believed that low salt food was recognized as tasteless. In conclusion, the enablers, barriers, and perceptions regarding salt reduction in the out-of-home sectors were multifaceted. Therefore, for the implementation of the strategies, policies, and initiatives for addressing the barriers, the policymakers need to encourage a multisectoral collaboration for reducing the salt intake in the population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN255, title = {Smoking Modifies Pancreatic Cancer Risk Loci on 2q21.3}, author = {E. Mocci and P. Kundu and W. Wheeler and A. A. Arslan and L. E. Beane-Freeman and P. M. Bracci and P. Brennan and F. Canzian and M. Du and S. Gallinger and G. G. Giles and P. J. Goodman and C. Kooperberg and L. Le Marchand and R. E. Neale and X. O. Shu and K. Visvanathan and E. White and W. Zheng and D. Albanes and G. Andreotti and A. Babic and W. R. Bamlet and S. I. Berndt and A. L. Blackford and B. Bueno-de-Mesquita and J. E. Buring and D. Campa and S. J. Chanock and E. J. Childs and E. J. Duell and C. S. Fuchs and J. M. Gaziano and E. L. Giovannucci and M. G. Goggins and P. Hartge and M. M. Hassan and E. A. Holly and R. N. Hoover and R. J. Hung and R. C. Kurtz and I. M. Lee and N. Malats and R. L. Milne and K. Ng and A. L. Oberg and S. Panico and U. Peters and M. Porta and K. G. Rabe and E. Riboli and N. Rothman and G. Scelo and H. D. Sesso and D. T. Silverman and V. L. Stevens and O. Strobel and Jr. I. M. Thompson and A. Tjonneland and A. Trichopoulou and S. K. Van Den Eeden and J. Wactawski-Wende and N. Wentzensen and L. R. Wilkens and H. Yu and F. Yuan and A. Zeleniuch-Jacquotte and L. T. Amundadottir and D. Li and E. J. Jacobs and G. M. Petersen and B. M. Wolpin and H. A. Risch and P. Kraft and N. Chatterjee and A. P. Klein and R. Stolzenberg-Solomon}, doi = {10.1158/0008-5472.Can-20-3267}, issn = {0008-5472 (Print) 0008-5472}, year = {2021}, date = {2021-01-01}, journal = {Cancer Res}, volume = {81}, number = {11}, pages = {3134-3143}, abstract = {Germline variation and smoking are independently associated with pancreatic ductal adenocarcinoma (PDAC). We conducted genome-wide smoking interaction analysis of PDAC using genotype data from four previous genome-wide association studies in individuals of European ancestry (7,937 cases and 11,774 controls). Examination of expression quantitative trait loci data from the Genotype-Tissue Expression Project followed by colocalization analysis was conducted to determine whether there was support for common SNP(s) underlying the observed associations. Statistical tests were two sided and P \< 5 × 10(-8) was considered statistically significant. Genome-wide significant evidence of qualitative interaction was identified on chr2q21.3 in intron 5 of the transmembrane protein 163 (TMEM163) and upstream of the cyclin T2 (CCNT2). The most significant SNP using the Empirical Bayes method, in this region that included 45 significantly associated SNPs, was rs1818613 [per allele OR in never smokers 0.87, 95% confidence interval (CI), 0.82-0.93; former smokers 1.00, 95% CI, 0.91-1.07; current smokers 1.25, 95% CI 1.12-1.40, P (interaction) = 3.08 × 10(-9)). Examination of the Genotype-Tissue Expression Project data demonstrated an expression quantitative trait locus in this region for TMEM163 and CCNT2 in several tissue types. Colocalization analysis supported a shared SNP, rs842357, in high linkage disequilibrium with rs1818613 (r (2) = 0. 94) driving both the observed interaction and the expression quantitative trait loci signals. Future studies are needed to confirm and understand the differential biologic mechanisms by smoking status that contribute to our PDAC findings. SIGNIFICANCE: This large genome-wide interaction study identifies a susceptibility locus on 2q21.3 that significantly modified PDAC risk by smoking status, providing insight into smoking-associated PDAC, with implications for prevention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN194, title = {A systematic review of group therapy programs for smoking cessation in Asian countries}, author = {R. Mohamed and C. Bullen and F. M. Hairi and A. S. A. Nordin}, doi = {10.18332/tid/140089}, issn = {2070-7266 (Print) 1617-9625}, year = {2021}, date = {2021-01-01}, journal = {Tob Induc Dis}, volume = {19}, pages = {63}, abstract = {INTRODUCTION: Tobacco causes more than 8 million deaths each year. Behavioral interventions such as group therapy, which provides counselling for smoking cessation, can be delivered in group form and smokers who receive cessation counselling are more likely to quit smoking compared to no assistance. We review the evidence of group-based counselling for smoking cessation for smokers in Asian countries. METHODS: The review aims to determine the availability of group-based therapy for smoking cessation in Asian countries. The outcome measured was abstinence from smoking following group therapy. Electronic database searches in PubMed, OVID Medline, SCOPUS, Google Scholar, and PsycINFO, using keywords such as: 'smoking', 'cigarette', 'tobacco', 'nicotine', 'group therapy' and 'cessation' (smok*, *cigarette*, tobacco, nicotine, group therap*, cessation) were used. The results were reported following PRISMA and PROSPERO guidelines. Review Manager was used for data analysis. RESULTS: A total of 21251 records were retrieved for screening the abstracts. In all, 300 articles for review were identified and assessed for eligibility. Nine articles, including Cochrane reviews, randomized control trials, cohort, observational and cross-sectional studies, were included in the final review. There were three observational qualitative studies, two prospective cohort studies, two crosssectional studies, one non-randomized quasi-experimental study and a single cluster-randomized, controlled trial. Group therapy was found to significantly increase the abstinence rate. Group therapy provided at the workplace, smoking cessation services, availability of pharmacotherapy, and socioeconomic status, appear to be key factors determining success. CONCLUSIONS: Evidence of the use of group therapy for smoking cessation in Asian countries is still lacking despite publications in the Western population showed that group therapy was effective. Further research on group-based interventions for smoking cessation in Asian countries is required and direct one-to-one comparisons between group therapy and individual therapy for smokers who want to quit smoking, are needed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN31, title = {Breaking News of Cancer Diagnosis: A Qualitative Study on the Experiences and Emotional Needs of Patients With Cancer in a Multiethnic Asian Setting}, author = {L. P. Wong and Y. C. Kong and N. T. Bhoo-Pathy and S. Subramaniam and R. S. Bustamam and N. A. Taib and G. F. Ho and H. Zaharah and M. Mellor and Y. L. Woo and C. H. Yip and N. Bhoo-Pathy}, doi = {10.1200/jop.20.00002}, issn = {2688-1527}, year = {2021}, date = {2021-01-01}, journal = {JCO Oncol Pract}, volume = {17}, number = {4}, pages = {e548-e555}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: The breaking of news of a cancer diagnosis is an important milestone in a patient's cancer journey. We explored the emotional experiences of patients with cancer during the breaking of news of a cancer diagnosis and the arising needs in a multiethnic Asian setting with limited supportive cancer care services. METHODS: Twenty focus group discussions were conducted with 102 Asian patients with cancer from diverse sociodemographic backgrounds. Thematic analysis was performed. RESULTS: While most participants, especially younger patients with young children, experienced intense emotional distress upon receiving a cancer diagnosis, those with a family history of cancer were relatively calm and resigned. Nonetheless, the prior negative experience with cancer in the family made affected participants with a family history less eager to seek cancer treatment and less hopeful for a cure. Although a majority viewed the presence of family members during the breaking of bad news as important, a minority opted to face it alone to lessen the emotional impact on their family members. Difficulties disclosing the news of a cancer diagnosis to loved ones also emerged as an important need. Sensitive and empathetic patient-physician communication during the breaking of news of a cancer diagnosis was stressed as paramount. CONCLUSION: A patient-centered communication approach needs to be developed to reduce the emotional distress to patients and their families after the breaking of bad news of a cancer diagnosis. This is expected to positively affect the patients' subsequent coping skills and attitudes toward cancer, which may improve adherence to cancer therapy.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN240, title = {C-reactive protein/albumin ratio is a prognostic indicator for predicting surgical intervention and mortality in neonates with necrotizing enterocolitis}, author = {A. T. Mohd Amin and R. A. Zaki and F. Friedmacher and S. P. Sharif}, doi = {10.1007/s00383-021-04879-1}, issn = {0179-0358 (Print) 0179-0358}, year = {2021}, date = {2021-01-01}, journal = {Pediatr Surg Int}, volume = {37}, number = {7}, pages = {881-886}, abstract = {PURPOSE: The role of hypoalbuminemia and raised C-reactive protein (CRP) levels in predicting critical prognosis has been described extensively in adult literature. However, there are limited studies in pediatrics, particularly neonates. The CRP/albumin (CRP/ALB) ratio is often associated with higher mortality, organ failure and prolonged hospital stay. We hypothesized that the serum CRP/ALB ratio has a prognostic value in predicting surgery and mortality in neonates with necrotizing enterocolitis (NEC). METHODS: Retrospective review of all neonates with clinical and radiological evidence of non-perforated NEC that were treated in a tertiary-level referral hospital between 2009 and 2018. General patient demographics, laboratory parameters and outcomes were recorded. Receiver operating characteristics analysis was performed to evaluated optimal cut-offs and area under the curve (AUC) with 95% confidence intervals (CI). RESULTS: A total of 191 neonates were identified. Of these, 103 (53.9%) were born at ≤ 28 weeks of gestation and 101 (52.9%) had a birth weight of ≤ 1000 g. Eighty-four (44.0%) patients underwent surgical intervention for NEC. The overall survival rate was 161/191 (84.3%). A CRP/ALB ratio of ≥ 3 on day 2 of NEC diagnosis was associated with a statistically significant higher likelihood for surgery [AUC 0.71 (95% CI 0.63-0.79); p \< 0.0001] and mortality [AUC 0.66 (95% CI 0.54-0.77); p = 0.0150], respectively. CONCLUSIONS: A CRP/ALB ratio of ≥ 3 on day 2 is indicative of a critical pathway in neonates with radiologically confirmed, non-perforated NEC. This could be used as an additional criterion to guide parental counselling in NEC for surgical intervention and mortality.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN228, title = {Supporting family doctors to address elder abuse: a quasi-experimental study in Malaysia}, author = {F. H. Mohd Mydin and S. Othman and W. Y. Choo and N. N. M. Hairi and F. M. Hairi and S. N. Syed Karim and M. P. Tan and Z. Ali and S. Abdul Aziz and R. Mohd and R. Mohamad and R. Ramli and L. R. Awaludin}, doi = {10.1080/08946566.2021.1919272}, issn = {0894-6566}, year = {2021}, date = {2021-01-01}, journal = {J Elder Abuse Negl}, volume = {33}, number = {2}, pages = {151-167}, abstract = {This quasi-experimental study examined the effect of Supporting Family Doctors to Address Elder Abuse (SAFE) educational intervention among family doctors practicing at public primary care clinics in Malaysia. SAFE is an intensive, multimodal, locally tailored, and culturally sensitive face-to-face educational intervention on elder abuse. A significant mean score improvement of knowledge [Baseline: 5.33 (SD:1.33) to 6-month post-intervention: 6.45 (SD: 1.35); p\<0.001] and perceived behavioral control [Baseline: 50.83 (SD: 8.87) to six-month post-intervention: 56.16 (SD: 9.56); p\<0.001] observed in the intervention group compared to the control group. No significant difference in attitude, subjective norm, and practice scores between the two groups over time. SAFE educational intervention for family doctors was effective to improve but not sustainable knowledge and perceived behavioral control toward elder abuse identification and management. We recommend SAFE educational intervention as part of the continuous medical education for family doctors supplemented with a change in organization and national policy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN195, title = {Primary care nurses' challenges, opportunities, and facilitators of elder abuse intervention in Malaysia}, author = {F. H. Mohd Mydin and S. Othman and W. Y. Choo and N. N. Mohd Hairi and F. Mohd Hairi and Z. Ali and S. Abdul Aziz}, doi = {10.1111/phn.12961}, issn = {0737-1209}, year = {2021}, date = {2021-01-01}, journal = {Public Health Nurs}, abstract = {OBJECTIVES: To explore the views of nurses on challenges, perceived roles and improvement strategies concerning elder abuse intervention in Malaysia. DESIGN AND SAMPLE: Eleven focus group discussions were conducted using a semi-structured interview based on the socio-ecological framework. The data were analyzed using a multistep process of thematic analysis. RESULTS: Three themes emerged from the data analysis: (1) The predicament: being unwilling or not able to intervene (2) Bridging the older people and health system gap (3) Getting to grips with the barriers. There are multifactorial contributors identified at the individual, interpersonal, organizational, community and policy levels in each theme. These factors interact across the levels to influence nurses' capability to intervene in elder abuse. CONCLUSION: A framework is needed to articulate Malaysian nurses' role in elder abuse intervention in terms of personal and professional development through culturally sensitive education and the establishment of clinical guidelines in the primary care setting. Strengthening organizational support and the institution of national policy and permissive reporting laws of elder abuse will empower the primary care nurses to address elder abuse in primary care settings and communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN248, title = {Nicotine Dependence among Adolescents Single and Dual Cigarette Users}, author = {N. A. Mohd Radzi and R. Saub and Z. Y. Mohd Yusof and M. Dahlui and S. L. Sujak}, doi = {10.3390/children8020144}, issn = {2227-9067 (Print) 2227-9067}, year = {2021}, date = {2021-01-01}, journal = {Children (Basel)}, volume = {8}, number = {2}, abstract = {The prevalence of concurrent use of combustible and electronic cigarettes (dual-use) is on the rise among Malaysian adolescents. This study compares nicotine dependence among exclusive cigarette users, e-cigarette users, and dual adolescent users. A total of 227 adolescent smokers completed a self-administrated questionnaire with items based on Hooked on Nicotine Checklist (HONC) incorporated. Endorsement of at least one HONC item indicates nicotine dependence. Exhaled carbon monoxide readings and salivary cotinine data were also collected. Over half (52.9%) of the participants were exclusive e-cigarette users (EC). The prevalence of exclusive conventional cigarette smokers (CC) and dual users was 11.9% and 35.2%, respectively. Adolescents who have mothers with secondary school education were more likely to become addicted to nicotine (Adjusted Odd Ratio (aOR) = 2.72; 95% CI = 1.17-6.32). Adolescents' "mother's education" level predicted nicotine dependence. This highlighted the need to target families within the identified demography with a more supportive anti-tobacco program.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN220, title = {Beliefs, Facilitating Factors, and Barriers in Using Personal Dosimeter among Medical Radiation Workers in a Middle-Income Asian Setting}, author = {S. F. Mohd Ridzwan and N. Bhoo-Pathy and L. H. Wee and M. Isahak}, doi = {10.1093/annweh/wxab025}, issn = {2398-7308}, year = {2021}, date = {2021-01-01}, journal = {Ann Work Expo Health}, volume = {65}, number = {8}, pages = {940-954}, abstract = {This qualitative study explores the medical radiation workers' (MRWs) beliefs with the support of the theory of planned behaviour's constructs regarding the use of personal dosimeters in order to identify the facilitating factors and barriers to practising good personal dose monitoring. The exploration was conducted through semi-structured face-to-face interviews with 63 MRWs from the public, private, and university hospitals. Belief statements from the informants were organized under the behavioural, normative, and control belief, as guided by the theory. A thematic analysis found that a majority of informants acknowledged the benefits of using dosimeters. However, several factors influenced the actual usage. The informants were hesitant to use the dosimeter as the loss of the device involved an expensive penalty. They also mentioned that delayed dosimeter supplies due to late budget approval in the hospitals and some other reasons had got them disconnected from the monitoring system. The workers' attitudes and social norms highly induced their dosimeter usage as well; some perceived themselves to be at low risk for high exposure to radiation, and forgetfulness was also mentioned as a reason for lack of adherence. Device physical factor influenced low dosimeter use too. This study highlighted some unique findings in Asian settings. A better understanding of the underlying reasons for the lack of dosimeter use will be useful in developing strategies to increase good practices in personal radiation monitoring.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN211, title = {The Implementation of Childhood Obesity Related Policy Interventions in Malaysia-A Non Communicable Diseases Scorecard Project}, author = {W. K. H. Mok and N. N. Hairi and C. M. H. Chan and F. I. Mustapha and T. A. Saminathan and W. Y. Low}, doi = {10.3390/ijerph18115950}, issn = {1661-7827 (Print) 1660-4601}, year = {2021}, date = {2021-01-01}, journal = {Int J Environ Res Public Health}, volume = {18}, number = {11}, abstract = {(1) Background: The prevalence of overweight and obesity among children has increased tremendously in the ASEAN region, including Malaysia. In Malaysia, the National Strategic Plan for Non-Communicable Diseases (2015-2025) provides the overall framework for its response to the non-communicable diseases (NCD) epidemic. Preventing childhood obesity is one of the key strategies for early intervention to prevent NCDs. The objective of this research is to examine the current status of policy interventions in addressing childhood obesity in Malaysia. (2) Methods: A panel of 22 stakeholders and experts from Malaysia, representing the government, industry, academia and non-governmental organizations, were sampled using a modified Delphi technique. Data were collected using a modified NCD scorecard under four domains (governance, risk factors, surveillance and research and health systems response). A heat map was used to measure the success of the four realms of the NCD scorecard. For each domain of the NCD scorecard, the final score was grouped in quintiles. (3) Results: A total of 22 participants responded, comprising of eight (36.4%) males and 14 (63.4%) females. All the domains measured in implementing policies related to childhood obesity were of low progress. Nine governance indicators were reported as 22.5% (low progress), four in the risk factors domain, and two in the surveillance. This shows that timely and accurate monitoring, participatory review and evaluation, and effective remedies are necessary for a country's surveillance system. (4) Conclusion: Although Malaysia has published several key strategic documents relating to childhood obesity and implemented numerous policy interventions, we have identified several gaps that must be addressed to leverage the whole-of-government and whole-of-society approach in addressing childhood obesity in the country.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN209, title = {Perception towards E-learning and COVID-19 on the mental health status of university students in Malaysia}, author = {F. M. Moy and Y. H. Ng}, doi = {10.1177/00368504211029812}, issn = {0036-8504}, year = {2021}, date = {2021-01-01}, journal = {Sci Prog}, volume = {104}, number = {3}, pages = {368504211029812}, abstract = {The COVID-19 pandemic has disrupted the lives of all including university students. With the preventive measures to reduce the transmission of COVID-19, all face-to-face teaching and learning are converted to e-learning. The COVID-19 pandemic and the implementation of e-learning may influence these students' mental conditions. This study aimed to determine the association of factors with mental health status (depression, anxiety and stress) among university students in Malaysia. Study participants were tertiary education students from both the private and public universities in Malaysia. Participants were recruited via university emails and social media. The survey was administered via the online REDCap platform, from April to June 2020, during the movement control order period in the country. The questionnaire captured data on socio-demographic characteristics, academic information, implementation of e-learning, perception towards e-learning and COVID-19; as well as DASS 21 to screen for depression, anxiety and stress. The levels of stress, anxiety and depression were 56.5% (95% CI: 50.7%, 62.1%), 51.3% (95% CI: 45.6%, 57.0%) and 29.4% (95% CI: 24.3%, 34.8%) respectively. Most participants had good perception towards e-learning but negative perception on COVID-19. From the multivariate analysis, participants with positive perception on COVID-19 were protective towards stress (aOR: 0.96; 95% CI: 0.92, 0.99), anxiety (aOR: 0.94, 95% CI: 0.90, 0.98) and depression (aOR: 0.95; 95% CI: 0.91, 0.99). Older students were 14% (aOR: 0.86, 95% CI: 0.79, 0.94) and 11% (aOR: 0.89: 95% CI: 0.80, 0.99) less likely for anxiety and depression, respectively. Students originated from the Malay ethnicity had higher odds (aOR: 1.93; 95% CI: 1.05, 3.56) for depression. These findings demonstrated that the mental status of university students was greatly affected during the COVID-19 pandemic. Timely and credible information should be disseminated to alleviate their negative perception towards COVID-19.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN256, title = {Knowledge acquisition and retention among nurses after an educational intervention on endotracheal cuff pressure}, author = {U. R. Murugiah and V. Ramoo and M. F. H. Jamaluddin and A. Yahya and A. A. Baharudin and H. Abu and R. R. R. Thinagaran}, doi = {10.1111/nicc.12600}, issn = {1362-1017}, year = {2021}, date = {2021-01-01}, journal = {Nurs Crit Care}, volume = {26}, number = {5}, pages = {363-371}, abstract = {BACKGROUND: Nurses play a key role in the proper management of endotracheal tube (ETT) cuff pressure, which is important for patients' safety, so it is vital to improve nurses' knowledge on safe cuff management practices. AIMS AND OBJECTIVES: This study aimed to evaluate the effectiveness of an educational intervention related to ETT cuff pressure management on improving and retaining critical care nurses' knowledge. DESIGN: A single group pre-post interventional study was conducted involving 112 registered nurses (RNs) from a 24-bed adult general intensive care unit at a teaching hospital in Malaysia. METHODS: The educational intervention included a theoretical session on endotracheal cuff pressure management and demonstration plus hands-on practice with the conventional cuff pressure monitoring method. Nurses' knowledge was measured using a self-administered questionnaire pre- and post-intervention. Data were analysed using repeated measure analysis of variance and bivariate analysis. RESULTS: In this study, 92% of the total number of RNs in the unit participated. A significant difference in mean knowledge score was noted between the pre- (mean = 8.13; SD = 1.53) and post-intervention phases (3 months [mean = 8.97; SD = 1.57) and 9 months post-intervention [mean = 10.34; SD = 1.08), P \< .001), indicating significant knowledge acquisition and retention between the phases. Knowledge gained between the pre- and 9 months post-intervention phases significantly differed according to nurses' educational level. CONCLUSIONS: This study supports existing evidence that ongoing educational interventions are essential to improve nurses' knowledge. However, further exploration is suggested to assess how well this knowledge is translated into clinical practice. RELEVANCE TO CLINICAL PRACTICE: Regular educational programmes with current updates would enhance nurses' knowledge through proper practice and clinical decision-making skills; this, in turn, would help to standardize cuff management practices.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN237, title = {Measuring Time-Varying Effective Reproduction Numbers for COVID-19 and Their Relationship with Movement Control Order in Malaysia}, author = {K. I. Musa and W. N. Arifin and M. H. Mohd and M. S. Jamiluddin and N. A. Ahmad and X. W. Chen and T. M. Hanis and A. Bulgiba}, doi = {10.3390/ijerph18063273}, issn = {1661-7827 (Print) 1660-4601}, year = {2021}, date = {2021-01-01}, journal = {Int J Environ Res Public Health}, volume = {18}, number = {6}, abstract = {To curb the spread of SARS-CoV-2 virus (COVID-19) in Malaysia, the government imposed a nationwide movement control order (MCO) from 18 March 2020 to 3 May 2020. It was enforced in four phases (i.e., MCO 1, MCO 2, MCO 3 and MCO 4). In this paper, we propose an initiative to assess the impact of MCO by using time-varying reproduction number (Rt). We used data from the Johns Hopkins University Centre for Systems Science and Engineering Coronavirus repository. Day 1 was taken from the first assumed local transmission of COVID-19. We estimated Rt by using the EpiEstim package and plotted the epidemic curve and Rt. Then, we extracted the mean Rt at day 1, day 5 and day 10 for all MCO phases and compared the differences. The Rt values peaked around day 43, which was shortly before the start of MCO 1. The means for Rt at day 1, day 5, and day 10 for all MCOs ranged between 0.665 and 1.147. The average Rt gradually decreased in MCO 1 and MCO 2. Although spikes in the number of confirmed cases were observed when restrictions were gradually relaxed in the later MCO phases, the situation remained under control with Rt values being stabilised to below unity level (Rt value less than one).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN207, title = {Longitudinal Vitamin D Deficiency Among Malaysian Pregnant Women and Its Correlation With Neonatal Serum 25-Hydroxyvitamin D Levels}, author = {M. A. Mustapa Kamal Basha and H. Abdul Majid and N. Razali and A. Abd Rashed and H. Muhammad and A. Yahya}, doi = {10.3389/fpubh.2021.654292}, issn = {2296-2565}, year = {2021}, date = {2021-01-01}, journal = {Front Public Health}, volume = {9}, pages = {654292}, abstract = {Objective: This study aimed to investigate the longitudinal relationship between maternal vitamin D concentrations during pregnancy and neonatal vitamin D concentrations at birth. Materials and Methods: A prospective cohort of 236 healthy pregnant women from various ethnicity in early pregnancy (≤20 weeks of pregnancy) was followed at late pregnancy (28-40 weeks of pregnancy) and birth. Maternal serum 25-hydroxyvitamin D (25(OH)D) was assessed at early pregnancy (baseline) and late pregnancy, while neonatal cord serum 25(OH)D at birth. General estimating equations (GEE) were used to analyze the longitudinal association of maternal serum 25(OH)D levels during pregnancy and neonatal cord serum 25(OH)D levels at birth with adjusting for the time exposure, maternal weight gain, ethnicity, and skin type. Results: The results showed that the prevalence of vitamin D deficiency (25(OH)D \<50 nmol/L) was at 89.9, 92.2, and 96.1% in early, late pregnancy and in neonatal cord serum, respectively. The GEE analysis showed a trend that longitudinal vitamin D deficiency during pregnancy leads to lower vitamin D concentrations in neonatal cord blood (RR = 1.17; 95% CI (1.05-1.36); p = 0.04). Conclusion: Longitudinal vitamin D deficiency during pregnancy leads to vitamin D deficiency in neonates at birth. A further trial is needed to affirm this association.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN60, title = {Germline HOXB13 mutations p.G84E and p.R217C do not confer an increased breast cancer risk}, author = {J. Liu and W. J. C. Prager-van Smissen and J. M. Coll\'{e}e and M. K. Bolla and Q. Wang and K. Michailidou and J. Dennis and T. U. Ahearn and K. Aittom\"{a}ki and C. B. Ambrosone and I. L. Andrulis and H. Anton-Culver and N. N. Antonenkova and V. Arndt and N. Arnold and K. J. Aronson and A. Augustinsson and P. Auvinen and H. Becher and M. W. Beckmann and S. Behrens and M. Bermisheva and L. Bernstein and N. V. Bogdanova and N. Bogdanova-Markov and S. E. Bojesen and H. Brauch and H. Brenner and I. Briceno and S. Y. Brucker and T. Br\"{u}ning and B. Burwinkel and Q. Cai and H. Cai and D. Campa and F. Canzian and J. E. Castelao and J. Chang-Claude and S. J. Chanock and J. Y. Choi and M. Christiaens and C. L. Clarke and F. J. Couch and K. Czene and M. B. Daly and P. Devilee and I. Dos-Santos-Silva and M. Dwek and D. M. Eccles and A. H. Eliassen and P. A. Fasching and J. Figueroa and H. Flyger and L. Fritschi and M. Gago-Dominguez and S. M. Gapstur and M. Garc\'{i}a-Closas and J. A. Garc\'{i}a-S\'{a}enz and M. M. Gaudet and G. G. Giles and M. S. Goldberg and D. E. Goldgar and P. Gu\'{e}nel and C. A. Haiman and N. Hr{a}kansson and P. Hall and P. A. Harrington and S. N. Hart and M. Hartman and P. Hillemanns and J. L. Hopper and M. F. Hou and D. J. Hunter and D. Huo and H. Ito and M. Iwasaki and M. Jakimovska and A. Jakubowska and E. M. John and R. Kaaks and D. Kang and R. Keeman and E. Khusnutdinova and S. W. Kim and P. Kraft and V. N. Kristensen and A. W. Kurian and L. Le Marchand and J. Li and A. Lindblom and A. Lophatananon and R. N. Luben and J. Lubi\'{n}ski and A. Mannermaa and M. Manoochehri and S. Manoukian and S. Margolin and S. Mariapun and K. Matsuo and T. Maurer and others}, doi = {10.1038/s41598-020-65665-y}, issn = {2045-2322}, year = {2020}, date = {2020-01-01}, journal = {Sci Rep}, volume = {10}, number = {1}, pages = {9688}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {In breast cancer, high levels of homeobox protein Hox-B13 (HOXB13) have been associated with disease progression of ER-positive breast cancer patients and resistance to tamoxifen treatment. Since HOXB13 p.G84E is a prostate cancer risk allele, we evaluated the association between HOXB13 germline mutations and breast cancer risk in a previous study consisting of 3,270 familial non-BRCA1/2 breast cancer cases and 2,327 controls from the Netherlands. Although both recurrent HOXB13 mutations p.G84E and p.R217C were not associated with breast cancer risk, the risk estimation for p.R217C was not very precise. To provide more conclusive evidence regarding the role of HOXB13 in breast cancer susceptibility, we here evaluated the association between HOXB13 mutations and increased breast cancer risk within 81 studies of the international Breast Cancer Association Consortium containing 68,521 invasive breast cancer patients and 54,865 controls. Both HOXB13 p.G84E and p.R217C did not associate with the development of breast cancer in European women, neither in the overall analysis (OR = 1.035, 95% CI = 0.859-1.246}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN108, title = {Post-traumatic brain injury olfactory dysfunction: factors influencing quality of life}, author = {F. Ahmedy and M. Mazlan and M. Danaee and M. Z. Abu Bakar}, doi = {10.1007/s00405-020-05823-0}, issn = {0937-4477}, year = {2020}, date = {2020-01-01}, journal = {Eur Arch Otorhinolaryngol}, volume = {277}, number = {5}, pages = {1343-1351}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: To evaluate if and how post-traumatic brain injury (TBI) olfactory dysfunction affects the quality of life (QoL). METHODS: In this case-control observational study, 32 adults with post-TBI olfactory dysfunction (cases) were matched with 32 TBI patients with intact olfactory function (controls). All subjects self-rated their olfactory function using the Visual Analogue Scale (VAS). Cases also underwent objective olfactory function assessment with the Sniffin' Sticks test, which generated a Threshold, Discrimination, and Identification (TDI) score. QoL was assessed with the Questionnaire for Olfactory Disorders (QOD). Factors evaluated included age, gender, smoking, TBI severity and duration, lesion localisation, and Disability Rating Scale (DRS) score. RESULTS: Cases had a higher mean QOD score than controls at 26.31 ± 14.37 and 9.44 ± 8.30, respectively (F = 16.426, p \< 0.001, η(2) = 0.224). The effect size was large (d = 1.07) with an odds ratio of 7.02. The features of QoL most affected were perception of smell changes, adapting to smell changes, and fear of hazardous substance exposure. DRS score and severity of olfactory dysfunction significantly affected QoL (p \< 0.05). CONCLUSION: Post-TBI olfactory dysfunction significantly lowered QoL and increased the likelihood of having a low QoL relative to TBI alone.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN42, title = {Low serum albumin concentration predicts the need for surgical intervention in neonates with necrotizing enterocolitis}, author = {S. P. Sharif and F. Friedmacher and A. Amin and R. A. Zaki and M. F. Hird and M. Khashu and S. R. Phelps}, doi = {10.1016/j.jpedsurg.2020.07.003}, issn = {0022-3468}, year = {2020}, date = {2020-01-01}, journal = {J Pediatr Surg}, volume = {55}, number = {12}, pages = {2625-2629}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: To investigate whether serum albumin (SA) concentration can predict the need for surgical intervention in neonates with necrotizing enterocolitis (NEC). METHODS: Retrospective review of all cases with NEC Bell's stage 2 and 3 that were treated in a single center between 2009 and 2015. Data on patient demographics, clinical parameters, laboratory findings and surgical status were recorded. Receiver operating characteristics analysis was used to evaluate optimal cutoffs and predictive values. RESULTS: Overall, 151 neonates with NEC were identified. Of these, 132 (87.4%) had confirmed NEC Bell's stage 2. The median gestational age was 28.4 (range, 23.1-39.0) weeks and 69 (52.3%) had a birth weight of ≤1000 g. Sixty-eight (51.5%) underwent surgery, showing a sustained reduction in SA over time with significantly lower median SA levels compared to 64 (48.5%) cases that responded well to medical treatment (18.3 ± 3.7 g/L vs. 26.0 ± 2.0 g/L; P \< 0.001). SA concentration of ≤20 g/L on day 2 of NEC diagnosis was a significant predictor for surgery (OR 3.41; P = 0.019) with a positive predictive value of 71.4%. CONCLUSIONS: An SA concentration of ≤20 g/L on day 2 of the NEC disease process is associated with a higher likelihood for surgical intervention in neonates with NEC Bell's stage 2. SA, in combination with other clinical parameters and serological markers, may be a useful predictive tool for surgery in NEC. LEVEL OF EVIDENCE: II.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN65, title = {Uncovering psychobehavioural implications of SARS-CoV-2 infection in Iran}, author = {L. P. Wong and H. Alias and M. Danaee and M. Ziaee and F. Abedi and A. Ziaee and S. Mohajer and R. HajiAliBeigloo and M. N. Nia and F. Jamei and S. R. Mazlom}, doi = {10.1111/tbed.13662}, issn = {1865-1674}, year = {2020}, date = {2020-01-01}, journal = {Transbound Emerg Dis}, volume = {67}, number = {6}, pages = {2892-2900}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Iran is the country in Western Asia most impacted by the COVID-19 outbreak. A survey was conducted among the general public in Iran aimed at investigating psychobehavioural issues related to the COVID-19 outbreak, namely (a) barriers to preventive measures against SARS-CoV-2 infection; (b) negative emotions towards SARS-CoV-2 infection; and (c) anxiety levels among the general public in Iran. A cross-sectional, web-based survey using an online questionnaire was carried out between 16 March and 1 April 2020. The six-item version of the State-Trait Anxiety Inventory (STAI-6) was used to assess anxiety levels. A total of 1,789 complete responses were received. Nearly 60% reported having difficulty in wearing a face mask to protect against SARS-CoV-2 infection. The mean and standard deviation (SD) for the total prevention barrier score was 35.8 (SD ± 7.1; range 18-68) out of a possible score of 72. Male respondents [odds ratio (OR) = 1.25; 95% confidence interval (CI) 1.03-1.51] and respondents who perceived their health status as poor/fair (OR = 1.49; 95% CI 1.31-1.82) were predictors of high prevention barriers. Negative emotions such as fear (74.6%) followed by depression (43.4%) and stigma (23.0%) associated with SARS-CoV-2 infection were reported. Respondents who perceived their health as poor/fair (OR = 2.19; 95% CI 1.57-3.04) reported a higher likelihood of having higher negative emotions. Findings on anxiety level revealed 68.0% (95% CI 65.8-70.1) reported moderate to severe anxiety. Respondents who perceived their health as poor/fair (OR = 3.46; 95% CI 12.22-5.40) and who were females (OR = 1.91; 95% CI 1.55-2.36) were predictors of moderate to severe anxiety. In conclusion, psychobehavioural interventions are needed to facilitate management and control of the COVID-19 outbreak.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN92, title = {A Double-Blind, Randomized Controlled Trial of Pre-incision Wound Infiltration Using Diclofenac Versus Bupivacaine for Post-operative Pain Relief in Open Thyroid and Parathyroid Surgery}, author = {J. W. Loh and N. A. Taib and Y. T. Cheong and T. S. Tin}, doi = {10.1007/s00268-020-05458-6}, issn = {0364-2313}, year = {2020}, date = {2020-01-01}, journal = {World J Surg}, volume = {44}, number = {8}, pages = {2656-2666}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Pre-incision wound infiltration using NSAID is an alternative method to manage post-operative pain in surgery. It is postulated that NSAID delivered peripherally exerts efficient analgesic and anti-inflammatory effect with minimal systemic complication. This study explored the efficacy of using diclofenac for wound infiltration in open thyroidectomy and parathyroidectomy as compared to conventional agent, bupivacaine. METHODOLOGY: The study was designed as a double-blind, randomized controlled trial involving 94 patients who underwent open thyroidectomy or parathyroidectomy in Hospital Pulau Pinang, Malaysia, from November 2015 to November 2016. The study compared the efficacy of pre-incision wound infiltration of diclofenac (n = 47) versus bupivacaine (n = 47) in post-operative pain relief. Wound infiltration is given prior to skin incision. Mean pain score at designated time interval within the 24-h post-operative period, time to first analgesia, total analgesic usage and total analgesic cost were assessed. RESULTS: Ninety-four patients were recruited with no dropouts. Mean age was 49.3 (SD = 14.2) with majority being female (74.5%). Ethnic distribution recorded 42.6% Chinese, 38.3% Malay, followed by 19.1% Indian. Mean duration of surgery was 123.8 min (SD = 56.5), and mean length of hospital stay was 4.7 days (SD = 1.8). The characteristics of patient in both groups were generally comparable except that there were more cases of total thyroidectomy in the diclofenac group (n = 31) as compared to the bupivacaine group (n = 16). Mean pain score peaked at immediate post-operative period (post-operative 0.5 h) with a score of 3.5 out of 10 and the level decreased steadily over the next 20 h starting from 4 h post-operatively. Pre-incision wound infiltration using diclofenac had better pain control as compared to bupivacaine at all time interval assessed. In the resting state, the mean post-operative pain score difference was statistically significant at 2 h [2.1 (SD = 1.5) vs. 2.8 (SD = 1.8)}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN47, title = {The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay}, author = {L. P. Wong and H. Alias and P. F. Wong and H. Y. Lee and S. AbuBakar}, doi = {10.1080/21645515.2020.1790279}, issn = {2164-5515 (Print) 2164-5515}, year = {2020}, date = {2020-01-01}, journal = {Hum Vaccin Immunother}, volume = {16}, number = {9}, pages = {2204-2214}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: The development of a vaccine against SARS-CoV-2 infection is on the way. To prepare for public availability, the acceptability of a hypothetical COVID-19 vaccine and willingness to pay (WTP) were assessed to provide insights into future demand forecasts and pricing considerations. METHODS: A cross-sectional survey was conducted from 3 to 12 April 2020. The health belief model (HBM) was used to assess predictors of the intent to receive the vaccine and the WTP. RESULTS: A total of 1,159 complete responses was received. The majority reported a definite intent to receive the vaccine (48.2%), followed by a probable intent (29.8%) and a possible intent (16.3%). Both items under the perceived benefits construct in the HBM, namely believe the vaccination decreases the chance of infection (OR = 2.51, 95% CI 1.19-5.26) and the vaccination makes them feel less worry (OR = 2.19, 95% CI 1.03-4.65), were found to have the highest significant odds of a definite intention to take the vaccine. The mean ± standard deviation (SD) for the amount that participants were willing to pay for a dose of COVID-19 vaccine was MYR$134.0 (SD±79.2) [US$30.66 ± 18.12]. Most of the participants were willing to pay an amount of MYR$100 [US$23] (28.9%) and MYR$50 [US$11.5] (27.2%) for the vaccine. The higher marginal WTP for the vaccine was influenced by no affordability barriers as well as by socio-economic factors, such as higher education levels, professional and managerial occupations and higher incomes. CONCLUSIONS: The findings demonstrate the utility of HBM constructs in understanding COVID-19 vaccination intention and WTP.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN94, title = {Diagnostic accuracy and utility of three dengue diagnostic tests for the diagnosis of acute dengue infection in Malaysia}, author = {Z. L. Chong and S. D. Sekaran and H. J. Soe and D. Peramalah and S. Rampal and C. W. Ng}, doi = {10.1186/s12879-020-4911-5}, issn = {1471-2334}, year = {2020}, date = {2020-01-01}, journal = {BMC Infect Dis}, volume = {20}, number = {1}, pages = {210}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Dengue is an emerging infectious disease that infects up to 390 million people yearly. The growing demand of dengue diagnostics especially in low-resource settings gave rise to many rapid diagnostic tests (RDT). This study evaluated the accuracy and utility of ViroTrack Dengue Acute - a new biosensors-based dengue NS1 RDT, SD Bioline Dengue Duo NS1/IgM/IgG combo - a commercially available RDT, and SD Dengue NS1 Ag enzyme-linked immunosorbent assay (ELISA), for the diagnosis of acute dengue infection. METHODS: This prospective cross-sectional study consecutively recruited 494 patients with suspected dengue from a health clinic in Malaysia. Both RDTs were performed onsite. The evaluated ELISA and reference tests were performed in a virology laboratory. The reference tests comprised of a reverse transcription-polymerase chain reaction and three ELISAs for the detection of dengue NS1 antigen, IgM and IgG antibodies, respectively. The diagnostic performance of evaluated tests was computed using STATA version 12. RESULTS: The sensitivity and specificity of ViroTrack were 62.3% (95%CI 55.6-68.7) and 95.0% (95%CI 91.7-97.3), versus 66.5% (95%CI 60.0-72.6) and 95.4% (95%CI 92.1-97.6) for SD NS1 ELISA, and 52.4% (95%CI 45.7-59.1) and 97.7% (95%CI 95.1-99.2) for NS1 component of SD Bioline, respectively. The combination of the latter with its IgM and IgG components were able to increase test sensitivity to 82.4% (95%CI 76.8-87.1) with corresponding decrease in specificity to 87.4% (95%CI 82.8-91.2). Although a positive test on any of the NS1 assays would increase the probability of dengue to above 90% in a patient, a negative result would only reduce this probability to 23.0-29.3%. In contrast, this probability of false negative diagnosis would be further reduced to 14.7% (95%CI 11.4-18.6) if SD Bioline NS1/IgM/IgG combo was negative. CONCLUSIONS: The performance of ViroTrack Dengue Acute was comparable to SD Dengue NS1 Ag ELISA. Addition of serology components to SD Bioline Dengue Duo significantly improved its sensitivity and reduced its false negative rate such that it missed the fewest dengue patients, making it a better point-of-care diagnostic tool. New RDT like ViroTrack Dengue Acute may be a potential alternative to existing RDT if its combination with serology components is proven better in future studies.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN134, title = {Outcome and presentation of heart failure in breast cancer patients: findings from a Swedish register-based study}, author = {E. Hedayati and A. Papakonstantinou and S. A. M. Gernaat and R. Altena and J. S. Brand and J. Alfredsson and N. Bhoo-Pathy and J. Herrmann and C. Linde and U. Dahlstrom and J. Bergh and L. Hubbert}, doi = {10.1093/ehjqcco/qcz039}, issn = {2058-5225 (Print) 2058-1742}, year = {2020}, date = {2020-01-01}, journal = {Eur Heart J Qual Care Clin Outcomes}, volume = {6}, number = {2}, pages = {147-155}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {AIMS: Heart failure (HF) patients diagnosed with breast cancer (BC) may have a higher risk of death, and different HF presentation and treatment than patients without BC. METHODS AND RESULTS: A total of 14 998 women with incident HF (iHF) or prevalent HF (pHF) enrolled in the Swedish HF Registry within and after 1 month since HF diagnosis, respectively, between 2008 and 2013. Patients were linked with the National Patient-, Cancer-, and Cause-of-Death Registry. Two hundred and ninety-four iHF and 338 pHF patients with BC were age-matched to 1470 iHF and 1690 pHF patients without BC. Comorbidity and treatment characteristics were compared using the χ2 tests for categories. Cox proportional hazard models assessed the hazard ratio (HR) and 95% confidence intervals (95% CIs) of all-cause and cardiovascular mortality among HF patients with and without BC. In the pHF group, BC patients had less often myocardial infarction (21.6% vs. 28.6%, P \< 0.01) and received less often aspirin (47.6% vs. 55.1%}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN51, title = {Investigation of the key factors that influence the girls to enter into child marriage: A meta-synthesis of qualitative evidence}, author = {A. Kohno and T. Techasrivichien and S. P. Suguimoto and M. Dahlui and N. D. Nik Farid and T. Nakayama}, doi = {10.1371/journal.pone.0235959}, issn = {1932-6203}, year = {2020}, date = {2020-01-01}, journal = {PLoS One}, volume = {15}, number = {7}, pages = {e0235959}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {In this study, we synthesized findings from qualitative studies to identify the key factors that influence child marriage. We used a meta-ethnographic approach coupled with thematic synthesis. We searched literature from nine databases, which were in English language, covering areas in public health, psychology, and social science between 2008 and 2018. Twelve studies were included in the synthesis. We identified six main themes: human insecurity and conflict; legal issues; family values and circumstances; religious beliefs; individual circumstances, beliefs, and knowledge; and social norms. Our findings highlight the impact of human insecurity and conflict, as well as legal issues. In spite of global progress scaling up legislation against child marriage, the legal framework is insufficiently enforced in many settings. Most of the included studies were from the Middle East, Africa, and South Asia. Studies from other parts of the world such as Latin America and Southeast Asia, which have the highest rates of child marriage, are needed.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN72, title = {Menstrual Factors, Reproductive History, Hormone Use, and Urothelial Carcinoma Risk: A Prospective Study in the EPIC Cohort}, author = {L. Lujan-Barroso and E. Botteri and S. Caini and B. Ljungberg and N. Roswall and A. Tj\onneland and B. Bueno-de-Mesquita and I. T. Gram and R. Tumino and L. A. Kiemeney and F. Liedberg and T. Stocks and M. J. Gunter and N. Murphy and I. Cervenka and A. Fournier and M. Kvaskoff and C. H\"{a}ggstr\"{o}m and K. Overvad and E. Lund and M. Waaseth and R. T. Fortner and T. K\"{u}hn and V. Men\'{e}ndez and M. J. S\'{a}nchez and C. Santiuste and A. Perez-Cornago and R. Zamora-Ros and A. J. Cross and A. Trichopoulou and A. Karakatsani and E. Peppa and D. Palli and V. Krogh and V. Sciannameo and A. Mattiello and S. Panico and C. H. Gils and N. C. Onland-Moret and A. Barricarte and P. Amiano and K. T. Khaw and H. Boeing and E. Weiderpass and E. J. Duell}, doi = {10.1158/1055-9965.Epi-20-0184}, issn = {1055-9965}, year = {2020}, date = {2020-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {29}, number = {8}, pages = {1654-1664}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Urothelial carcinoma is the predominant (95%) bladder cancer subtype in industrialized nations. Animal and epidemiologic human studies suggest that hormonal factors may influence urothelial carcinoma risk. METHODS: We used an analytic cohort of 333,919 women from the European Prospective Investigation into Cancer and Nutrition Cohort. Associations between hormonal factors and incident urothelial carcinoma (overall and by tumor grade, tumor aggressiveness, and non-muscle-invasive urothelial carcinoma) risk were evaluated using Cox proportional hazards models. RESULTS: During a mean of 15 years of follow-up, 529 women developed urothelial carcinoma. In a model including number of full-term pregnancies (FTP), menopausal status, and menopausal hormone therapy (MHT), number of FTP was inversely associated with urothelial carcinoma risk (HR(≥5vs1) = 0.48; 0.25-0.90; P (trend) in parous women = 0.010) and MHT use (compared with nonuse) was positively associated with urothelial carcinoma risk (HR = 1.27; 1.03-1.57), but no dose response by years of MHT use was observed. No modification of HRs by smoking status was observed. Finally, sensitivity analyses in never smokers showed similar HR patterns for the number of FTP, while no association between MHT use and urothelial carcinoma risk was observed. Association between MHT use and urothelial carcinoma risk remained significant only in current smokers. No heterogeneity of the risk estimations in the final model was observed by tumor aggressiveness or by tumor grade. A positive association between MTH use and non-muscle-invasive urothelial carcinoma risk was observed. CONCLUSIONS: Our results support that increasing the number of FTP may reduce urothelial carcinoma risk. IMPACT: More detailed studies on parity are needed to understand the possible effects of perinatal hormone changes in urothelial cells.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN50, title = {Health Literacy, Knowledge on Cervical Cancer and Pap Smear and Its Influence on Pre-Marital Malay Muslim Women Attitude towards Pap Smear}, author = {N. N. Baharum and F. Ariffin and M. R. Isa and S. T. Tin}, doi = {10.31557/apjcp.2020.21.7.2021}, issn = {1513-7368 (Print) 1513-7368}, year = {2020}, date = {2020-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {21}, number = {7}, pages = {2021-2028}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Cervical cancer is preventable. In Malaysia, women are found to have good awareness of the disease and yet, the Pap smear uptake is still poor. Measuring health literacy level could explain this discrepancy. This study aims to determine the relationship between health literacy, level of knowledge of cervical cancer and Pap smear with attitude towards Pap smear among women attending pre-marital course. METHODS: A cross sectional study was performed in three randomly selected centres that organised pre-marital courses. All Malay Muslim women participants aged 18 to 40 years old were recruited while non-Malaysian, illiterate, and had hysterectomy were excluded. Validated self-administered questionnaires used were European Health Literacy Questionnaire (HLS-EU-Q16 Malay) and Knowledge and attitude towards Cervical Cancer and Pap Smear Questionnaire. The mean percentage score (mean± SD) was calculated, with higher scores showed better outcomes. Multiple linear regression was used to measure the relationship of independent variables with attitude towards Pap smear. RESULTS: A total of 417 participants were recruited with a mean age of 24.9 ± 3.56 years old. Prevalence of awareness of cervical cancer was 91.6% (n=382, 95% CI: 89.0%, 94.2%) and mean percentage score was 74.7%±7.6. Prevalence of awareness of Pap smear was 59.0% (n=246, 95% CI: 54.2%, 63.8%) and mean percentage score was 80.2% ± 6.5. The health literacy mean score was 13.3±3.6, with minimum score 0 and maximum score 16. The mean percentage score of attitudes towards Pap smear was 64.8%±9.3. Multiple linear regression analysis demonstrated significant relationship between health literacy (p=0.047) and knowledge of Pap smear (p\<0.001) with attitude towards Pap smear. CONCLUSION: A higher health literacy with high knowledge of Pap smear improves the attitude towards Pap smear. Pre-marital course is an opportunistic platform to disseminate information to improve health literacy and knowledge of cervical cancer and Pap smear screening.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN25, title = {The impact of COVID-19 on globalization}, author = {N. Shrestha and M. Y. Shad and O. Ulvi and M. H. Khan and A. Karamehic-Muratovic and U. D. T. Nguyen and M. Baghbanzadeh and R. Wardrup and N. Aghamohammadi and D. Cervantes and K. M. Nahiduzzaman and R. A. Zaki and U. Haque}, doi = {10.1016/j.onehlt.2020.100180}, issn = {2352-7714 (Print) 2352-7714}, year = {2020}, date = {2020-01-01}, journal = {One Health}, volume = {11}, pages = {100180}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Globalization has altered the way we live and earn a livelihood. Consequently, trade and travel have been recognized as significant determinants of the spread of disease. Additionally, the rise in urbanization and the closer integration of the world economy have facilitated global interconnectedness. Therefore, globalization has emerged as an essential mechanism of disease transmission. This paper aims to examine the potential impact of COVID-19 on globalization and global health in terms of mobility, trade, travel, and countries most impacted. The effect of globalization were operationalized in terms of mobility, economy, and healthcare systems. The mobility of individuals and its magnitude was assessed using airline and seaport trade data and travel information. The economic impact was measured based on the workforce, event cancellations, food and agriculture, academic institutions, and supply chain. The healthcare capacity was assessed by considering healthcare system indicators and preparedness of countries. Utilizing a technique for order of preference by similarity to ideal solution (TOPSIS), we calculated a pandemic vulnerability index (PVI) by creating a quantitative measure of the potential global health. The pandemic has placed an unprecedented burden on the world economy, healthcare, and globalization through travel, events cancellation, employment workforce, food chain, academia, and healthcare capacity. Based on PVI results, certain countries were more vulnerable than others. In Africa, more vulnerable countries included South Africa and Egypt; in Europe, they were Russia, Germany, and Italy; in Asia and Oceania, they were India, Iran, Pakistan, Saudi Arabia, and Turkey; and for the Americas, they were Brazil, USA, Chile, Mexico, and Peru. The impact on mobility, economy, and healthcare systems has only started to manifest. The findings of this study may help in the planning and implementation of strategies at the country level to help ease this emerging burden.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN10, title = {Assessing the willingness to pay for HIV counselling and testing service: a contingent valuation study in Lagos State, Nigeria}, author = {F. O. Adekunjo and R. Rasiah and M. Dahlui and C. W. Ng}, doi = {10.2989/16085906.2020.1834417}, issn = {1608-5906}, year = {2020}, date = {2020-01-01}, journal = {Afr J AIDS Res}, volume = {19}, number = {4}, pages = {287-295}, abstract = {HIV/AIDS is a major health issue faced by the world, generally, but particularly sub-Saharan Africa. Nigeria ranked third in the world by number of people living with HIV/AIDS in 2019. Despite prominent HIV counselling and testing (HCT) intervention programmes, Nigeria faces serious challenges, such as inadequate funding and low utilisation rates. Paucity of research into such a critical topic has restricted the capacity of policy makers to address the problem adequately. Consequently, a cross-sectional study was carried out using the contingent valuation method to assess the economic quantum of payment and determining factors associated with people's willingness to pay for HCT services. Data were collected from 768 people selected by convenience sampling of three local government areas - Alimosho, Ikorodu and Surulere in Lagos State, Nigeria. Data were analysed using descriptive statistics, chi-square, Mann-Whitney, and general linear regression model analysis. Findings show that 75% of respondents were willing to pay an average fee of N1 291 ($4.22) for HCT services. Significant determinants of willingness to pay were: income; knowledge of someone living with HIV or died of AIDS; worry about HIV infection; and fear of HIV-related stigma. The findings offer vital information germane to co-payment schemes aimed at financial sustainability of HCT and HIV/AIDS programmes in Nigeria.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN137, title = {Consumption of Fish and Long-chain n-3 Polyunsaturated Fatty Acids Is Associated With Reduced Risk of Colorectal Cancer in a Large European Cohort}, author = {E. K. Aglago and I. Huybrechts and N. Murphy and C. Casagrande and G. Nicolas and T. Pischon and V. Fedirko and G. Severi and M. C. Boutron-Ruault and A. Fournier and V. Katzke and T. K\"{u}hn and A. Olsen and A. Tj\onneland and C. C. Dahm and K. Overvad and C. Lasheras and A. Agudo and M. J. S\'{a}nchez and P. Amiano and J. M. Huerta and E. Ardanaz and A. Perez-Cornago and A. Trichopoulou and A. Karakatsani and G. Martimianaki and D. Palli and V. Pala and R. Tumino and A. Naccarati and S. Panico and B. Bueno-de-Mesquita and A. May and J. W. G. Derksen and S. Hellstrand and B. Ohlsson and M. Wennberg and B. Van Guelpen and G. Skeie and M. Brustad and E. Weiderpass and A. J. Cross and H. Ward and E. Riboli and T. Norat and V. Chajes and M. J. Gunter}, doi = {10.1016/j.cgh.2019.06.031}, issn = {1542-3565}, year = {2020}, date = {2020-01-01}, journal = {Clin Gastroenterol Hepatol}, volume = {18}, number = {3}, pages = {654-666.e6}, abstract = {BACKGROUND \& AIMS: There is an unclear association between intake of fish and long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFAs) and colorectal cancer (CRC). We examined the association between fish consumption, dietary and circulating levels of n-3 LC-PUFAs, and ratio of n-6:n-3 LC-PUFA with CRC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Dietary intake of fish (total, fatty/oily, lean/white) and n-3 LC-PUFA were estimated by food frequency questionnaires given to 521,324 participants in the EPIC study; among these, 6291 individuals developed CRC (median follow up, 14.9 years). Levels of phospholipid LC-PUFA were measured by gas chromatography in plasma samples from a sub-group of 461 CRC cases and 461 matched individuals without CRC (controls). Multivariable Cox proportional hazards and conditional logistic regression models were used to calculate hazard ratios (HRs) and odds ratios (ORs), respectively, with 95% CIs. RESULTS: Total intake of fish (HR for quintile 5 vs 1, 0.88; 95% CI, 0.80-0.96; P(trend) = .005), fatty fish (HR for quintile 5 vs 1, 0.90; 95% CI, 0.82-0.98; P(trend) = .009), and lean fish (HR for quintile 5 vs 1, 0.91; 95% CI, 0.83-1.00; P(trend) = .016) were inversely associated with CRC incidence. Intake of total n-3 LC-PUFA (HR for quintile 5 vs 1, 0.86; 95% CI, 0.78-0.95; P(trend) = .010) was also associated with reduced risk of CRC, whereas dietary ratio of n-6:n-3 LC-PUFA was associated with increased risk of CRC (HR for quintile 5 vs 1, 1.31; 95% CI, 1.18-1.45; P(trend) \< .001). Plasma levels of phospholipid n-3 LC-PUFA was not associated with overall CRC risk, but an inverse trend was observed for proximal compared with distal colon cancer (P(heterogeneity) = .026). CONCLUSIONS: In an analysis of dietary patterns of participants in the EPIC study, we found regular consumption of fish, at recommended levels, to be associated with a lower risk of CRC, possibly through exposure to n-3 LC-PUFA. Levels of n-3 LC-PUFA in plasma were not associated with CRC risk, but there may be differences in risk at different regions of the colon.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN81, title = {Quantitative Microbial Risk Assessment of Drinking Water Quality to Predict the Risk of Waterborne Diseases in Primary-School Children}, author = {J. Ahmed and L. P. Wong and Y. P. Chua and N. Channa and R. B. Mahar and A. Yasmin and J. A. VanDerslice and J. V. Garn}, doi = {10.3390/ijerph17082774}, issn = {1661-7827 (Print) 1660-4601}, year = {2020}, date = {2020-01-01}, journal = {Int J Environ Res Public Health}, volume = {17}, number = {8}, abstract = {Primary-school children in low- and middle-income countries are often deprived of microbiologically safe water and sanitation, often resulting in a high prevalence of gastrointestinal diseases and poor school performance. We used Quantitative Microbial Risk Assessment (QMRA) to predict the probability of infection in schoolchildren due to consumption of unsafe school water. A multistage random-sampling technique was used to randomly select 425 primary schools from ten districts of Sindh, Pakistan, to produce a representative sample of the province. We characterized water supplies in selected schools. Microbiological testing of water resulted in inputs for the QMRA model, to estimate the risks of infections to schoolchildren. Groundwater (62%) and surface water (38%) were identified as two major sources of drinking water in the selected schools, presenting varying degrees of health risks. Around half of the drinking-water samples were contaminated with Escherichia coli (49%), Shigella spp. (63%), Salmonella spp. (53%), and Vibrio cholerae (49%). Southern Sindh was found to have the highest risk of infection and illness from Campylobacter and Rotavirus. Central and Northern Sindh had a comparatively lower risk of waterborne diseases. Schoolchildren of Karachi were estimated to have the highest probability of illness per year, due to Campylobacter (70%) and Rotavirus (22.6%). Pearson correlation was run to assess the relationship between selected pathogens. V. cholerae was correlated with Salmonella spp., Campylobacter, Rotavirus, and Salmonella spp. Overall, the risk of illness due to the bacterial infection (E. coli, Salmonella spp., V. cholerae, Shigella, and Campylobacter) was high. There is a dire need for management plans in the schools of Sindh, to halt the progression of waterborne diseases in school-going children.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN12, title = {Factors Associated With Falls Among Urban-Dwellers Aged 55 Years and Over in the Malaysian Elders Longitudinal Research (MELoR) Study}, author = {D. Alex and H. M. Khor and A. V. Chin and N. N. Hairi and R. G. Cumming and S. Othman and S. Khoo and S. B. Kamaruzzaman and M. P. Tan}, doi = {10.3389/fpubh.2020.506238}, issn = {2296-2565}, year = {2020}, date = {2020-01-01}, journal = {Front Public Health}, volume = {8}, pages = {506238}, abstract = {Falls are major issues affecting the older population with potentially serious complications, including fractures, head injury, institutionalization, fear of falling and depression. While risk factors for falls have been established across Western Europe and North America, geographical differences in falls risk have not been well researched. We aim to examine the clinical and physical risk factors for falls in a middle-income South East Asian country. Cross-sectional data from the Malaysian Elders Longitudinal Research (MELoR) study involving 1,362 community dwelling individuals aged 55 years and above was utilized. Information on sociodemographic and medical history was obtained by computer-assisted questionnaires completed during home visits and hospital-based detailed health checks. Univariate and multivariate analyses compared non-fallers and fallers in the previous 12 months. Urinary incontinence, hearing impairment, depression, arthritis and cognitive impairment were risk factors for falls in the past 12 months after adjustment for age in our study population. Awareness about the risk factors in a population helps the design of fall prevention strategies that target specific or multiple risk factors.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN146, title = {Dentition status among an ethnically diverse older urban Malaysian population}, author = {M. A. Amanat and J. John and T. M. Pin and M. Danaee and V. Malhotra and S. A. Abbas and S. B. Kamaruzzaman}, doi = {10.1093/pubmed/fdz014}, issn = {1741-3842}, year = {2020}, date = {2020-01-01}, journal = {J Public Health (Oxf)}, volume = {42}, number = {2}, pages = {304-311}, abstract = {BACKGROUND: Poor oral health affects not only dietary choices but overall well-being. This study explores the influence of lifestyle, socio-demographics and utilization of dental services on the dentition status of an older urban Malaysian population. METHODS: A total of 1210 participants 60 years and above, representing the three main ethnic groups were recruited from a larger cohort study. Weighted factors valued for comparison included socio demographics and health status. Knowledge of and attitude and behaviour towards personal oral health were also assessed. Dentition status, adapted from WHO oral health guidelines, was the dependent variable investigated. Data were analysed using descriptive chi square test and multivariate binary logistic regression. RESULTS: Overall, 1187 respondents completed the study. The dentition status and oral health related knowledge, attitude and behaviour varied between the three ethnic groups. The Chinese were significantly less likely to have ≥13 missing teeth (OR = 0.698, 95% CI: 0.521-0.937) and ≥1 decayed teeth (0.653; 0.519-0.932) compared to the Malays, while the Indians were significantly less likely than the Malays to have ≥1 decayed teeth (0.695; 0.519-0.932) and ≥2 filled teeth (0.781; 0.540-1.128). CONCLUSION: Ethnic differences in dentition outcome are related to oral health utilization highlighting the influence of cultural differences and the need for culturally sensitivity interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN143, title = {Mediation analysis of the alcohol-postmenopausal breast cancer relationship by sex hormones in the EPIC cohort}, author = {N. Assi and S. Rinaldi and V. Viallon and S. G. Dashti and L. Dossus and A. Fournier and I. Cervenka and M. Kvaskoff and R. Turzanski-Fortner and M. Bergmann and H. Boeing and S. Panico and F. Ricceri and D. Palli and R. Tumino and S. Grioni and M. J. S\'{a}nchez P\'{e}rez and M. D. Chirlaque and C. Bonet and A. B. Gurrea and P. Amiano Etxezarreta and S. Merino and H. B. Bueno Mesquita and C. H. Gils and C. Onland-Moret and A. Tj\onneland and K. Overvad and A. Trichopoulou and G. Martimianaki and A. Karakatsani and T. Key and S. Christakoudi and M. Ellingjord-Dale and K. Tsilidis and E. Riboli and R. Kaaks and M. J. Gunter and P. Ferrari}, doi = {10.1002/ijc.32324}, issn = {0020-7136 (Print) 0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {146}, number = {3}, pages = {759-768}, abstract = {Alcohol consumption is associated with higher risk of breast cancer (BC); however, the biological mechanisms underlying this association are not fully elucidated, particularly the extent to which this relationship is mediated by sex hormone levels. Circulating concentrations of estradiol, testosterone, their free fractions and sex-hormone binding globulin (SHBG), were examined in 430 incident BC cases and 645 matched controls among alcohol-consuming postmenopausal women nested within the European Prospective Investigation into Cancer and Nutrition. Mediation analysis was applied to assess whether individual hormone levels mediated the relationship between alcohol intake and BC risk. An alcohol-related hormonal signature, obtained by partial least square (PLS) regression, was evaluated as a potential mediator. Total (TE), natural direct and natural indirect effects (NIE) were estimated. Alcohol intake was positively associated with overall BC risk and specifically with estrogen receptor-positive tumors with respectively TE = 1.17(95%CI: 1.01,1.35) and 1.36(1.08,1.70) for a 1-standard deviation (1-SD) increase of intake. There was no evidence of mediation by sex steroids or SHBG separately except for a weak indirect effect through free estradiol where NIE = 1.03(1.00,1.06). However, an alcohol-related hormonal signature negatively associated with SHBG and positively with estradiol and testosterone was associated with BC risk (odds ratio [OR] = 1.25 [1.07,1.47]) for a 1-SD higher PLS score, and had a statistically significant NIE accounting for a mediated proportion of 24%. There was limited evidence of mediation of the alcohol-BC association by individual sex hormones. However, a hormonal signature, reflecting lower levels of SHBG and higher levels of sex steroids, mediated a substantial proportion of the association.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN1, title = {Type 2 Diabetes Patients' Perspectives, Experiences, and Barriers Toward Diabetes-Related Self-Care: A Qualitative Study From Pakistan}, author = {A. Bukhsh and B. H. Goh and E. Zimbudzi and C. Lo and S. Zoungas and K. G. Chan and T. M. Khan}, doi = {10.3389/fendo.2020.534873}, issn = {1664-2392 (Print) 1664-2392}, year = {2020}, date = {2020-01-01}, journal = {Front Endocrinol (Lausanne)}, volume = {11}, pages = {534873}, abstract = {Objective: This study aimed to qualitatively explore perspectives, practices, and barriers to self-care practices (eating habits, physical activity, self-monitoring of blood glucose, and medicine intake behavior) in urban Pakistani adults with type 2 diabetes mellitus (T2DM). Methods: Pakistani adults with T2DM were recruited from the outpatient departments of two hospitals in Lahore. Semistructured interviews were conducted and audiorecorded until thematic saturation was reached. Two researchers thematically analyzed the data independently using NVivo® software with differences resolved by a third researcher. Results: Thirty-two Pakistani adults (aged 35-75 years, 62% female) participated in the study. Six themes were identified from qualitative analysis: role of family and friends, role of doctors and healthcare, patients' understanding about diabetes, complication of diabetes and other comorbidities, burden of self care, and life circumstances. A variable experience was observed with education and healthcare. Counseling by healthcare providers, family support, and fear of diabetes-associated complications are the key enablers that encourage study participants to adhere to diabetes-related self-care practices. Major barriers to self care are financial constraints, physical limitations, extreme weather conditions, social gatherings, loving food, forgetfulness, needle phobia, and a hectic job. Conclusion: Respondents identified many barriers to diabetes self care, particularly related to life situations and diabetes knowledge. Family support and education by healthcare providers were key influencers to self-care practices among Pakistani people with diabetes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN78, title = {Antibody Responses to Helicobacter pylori and Risk of Developing Colorectal Cancer in a European Cohort}, author = {J. Butt and M. Jenab and M. Pawlita and A. Tj\onneland and C. Kyr\o and M. C. Boutron-Ruault and F. Carbonnel and C. Dong and R. Kaaks and T. K\"{u}hn and H. Boeing and M. B. Schulze and A. Trichopoulou and A. Karakatsani and C. La Vecchia and D. Palli and C. Agnoli and R. Tumino and C. Sacerdote and S. Panico and B. Bueno-de-Mesquita and R. Vermeulen and I. T. Gram and E. Weiderpass and K. B. Borch and J. R. Quir\'{o}s and A. Agudo and M. Rodr\'{i}guez-Barranco and C. Santiuste and E. Ardanaz and B. Van Guelpen and S. Harlid and L. Imaz and A. Perez-Cornago and M. J. Gunter and S. Zouiouich and J. Y. Park and E. Riboli and A. J. Cross and A. K. Heath and T. Waterboer and D. J. Hughes}, doi = {10.1158/1055-9965.Epi-19-1545}, issn = {1055-9965}, year = {2020}, date = {2020-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {29}, number = {7}, pages = {1475-1481}, abstract = {BACKGROUND: While Helicobacter pylori (H. pylori) is the major cause of gastric cancer, it has also been suggested to be involved in colorectal cancer development. However, prospective studies addressing H. pylori and colorectal cancer are sparse and inconclusive. We assessed the association of antibody responses to H. pylori proteins with colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: We applied H. pylori multiplex serology to measure antibody responses to 13 H. pylori proteins in prediagnostic serum samples from 485 colorectal cancer cases and 485 matched controls nested within the EPIC study. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable conditional logistic regression to estimate the association of H. pylori overall and protein-specific seropositivity with odds of developing colorectal cancer. RESULTS: Fifty-one percent of colorectal cancer cases were H. pylori seropositive compared with 44% of controls, resulting in an OR of 1.36 (95% CI, 1.00-1.85). Among the 13 individual H. pylori proteins, the association was driven mostly by seropositivity to Helicobacter cysteine-rich protein C (HcpC; OR: 1.66; 95% CI, 1.19-2.30) and Vacuolating cytotoxin A (VacA) (OR: 1.34; 95% CI, 0.99-1.82), the latter being nonstatistically significant only in the fully adjusted model. CONCLUSIONS: In this prospective multicenter European study, antibody responses to H. pylori proteins, specifically HcpC and VacA, were associated with an increased risk of developing colorectal cancer. IMPACT: Biological mechanisms for a potential causal role of H. pylori in colorectal carcinogenesis need to be elucidated, and subsequently whether H. pylori eradication may decrease colorectal cancer incidence.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN7, title = {Prevalence and factors associated with physical inactivity among older adults in Malaysia: A cross-sectional study}, author = {Y. Y. Chan and K. K. Lim and M. A. Omar and M. F. Mohd Yusoff and R. Sooryanarayana and N. A. Ahmad and M. A. Abd Razak and A. Baharudin Shaharuddin and N. A. Mahmud and M. A. F. Mahmud and M. H. Abdul Mutalip and N. N. Mohd Hairi}, doi = {10.1111/ggi.13977}, issn = {1447-0594}, year = {2020}, date = {2020-01-01}, journal = {Geriatr Gerontol Int}, volume = {20 Suppl 2}, pages = {49-56}, abstract = {AIM: Physical inactivity in older adults is linked to increased risk of chronic diseases, disability and various poor health outcomes. As the aging population rises, the prevalence of diseases associated with aging also increases. Regular physical activity in older adults is important to improve overall health and promote healthy aging. This study aimed to determine the prevalence and factors associated with physical inactivity among older adults in Malaysia. METHODS: This study was based on 3969 Malaysian older adults aged ≥60 years who completed the physical activity module in the National Health and Morbidity Survey 2018, a population-based cross-sectional survey. Physical activity was measured using the Global Physical Activity Questionnaire through a face-to-face interview. Participants were classified as physically active or inactive. Associations between physical inactivity, sociodemographic characteristics and a range of selected independent variables were examined using multivariable logistic regression. RESULTS: Overall, three out of 10 (29.8%) Malaysian older adults were physically inactive. Results of multivariable analysis showed that older age group (≥80 years), of Bumiputera Sarawak ethnicity, unemployed/retirees/homemakers, functional limitation, diabetes mellitus and dementia were significantly associated with a higher risk of physical inactivity. Women, with secondary education level and good social support were less likely to be physically inactive. CONCLUSIONS: The present study reported the status of physical inactivity among older adults in Malaysia. There is the need to design effective public health programs and interventions to promote active living and healthy aging among Malaysian older adults, particularly in those at-risk older population subgroups. Geriatr Gerontol Int 2020; 20: 49-56.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN139, title = {Ultrasound-guided central venous vascular access-novel needle navigation technology compared with conventional method: A randomized study}, author = {S. C. Chew and Z. Y. Beh and V. R. Hakumat Rai and M. F. Jamaluddin and C. C. Ng and K. Chinna and M. S. Hasan}, doi = {10.1177/1129729819852057}, issn = {1129-7298}, year = {2020}, date = {2020-01-01}, journal = {J Vasc Access}, volume = {21}, number = {1}, pages = {26-32}, abstract = {PURPOSE: Central venous catheter insertion is a common procedure in the intensive care setting. However, complications persist despite real-time ultrasound guidance. Recent innovation in needle navigation technology using guided positioning system enables the clinician to visualize the needle's real-time position and trajectory as it approaches the target. We hypothesized that the guided positioning system would improve performance time in central venous catheter insertion. METHODS: A prospective randomized study was conducted in a single-center adult intensive care unit. In total, 100 patients were randomized into two groups. These patients underwent internal jugular vein central venous catheter cannulation with ultrasound guidance (short-axis scan, out-of-plane needling approach) in which one group adopted conventional method, while the other group was aided with the guided positioning system. Outcomes were measured by procedural efficacy (success rate, number of attempts, time to successful cannulation), complications, level of operators' experience, and their satisfaction. RESULTS: All patients had successful cannulation on the first attempt except for one case in the conventional group. The median performance time for the guided positioning system method was longer (25.5 vs 15.5 s; p = 0.01). And 86% of the operators had more than 3-year experience in anesthesia. One post-insertion hematoma occurred in the conventional group. Only 88% of the operators using the guided positioning system method were satisfied compared to 100% in the conventional group. CONCLUSION: Ultrasound-guided central venous catheter insertion via internal jugular vein was a safe procedure in both conventional and guided positioning system methods. The guided positioning system did not confer additional benefit but was associated with slower performance time and lower satisfaction level among the experienced operators.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN106, title = {Psychometric properties of the Malay version of the diabetes empowerment scale among hospital Serdang type 2 diabetes mellitus patients using exploratory factor analysis}, author = {S. M. Ching and A. Yee and P. Y. Lee and V. Ramachandran and K. M. Shum and N. F. Ismael and W. A. Wan Sulaiman and F. K. Hoo and Y. L. Foo and K. W. Lee and M. Danaee and K. A. Tan}, doi = {10.1186/s12955-020-1280-0}, issn = {1477-7525}, year = {2020}, date = {2020-01-01}, journal = {Health Qual Life Outcomes}, volume = {18}, number = {1}, pages = {23}, abstract = {BACKGROUND: This study was initiated to examine the psychometric components of the Diabetes Empowerment Scale (DES) by translating and validating the scale into the Malay language (DES-M) which is the main language spoken in Malaysia. This study can determine the level of empowerment among diabetic patients towards diabetes management. In addition, the reliability and validity of the DES-M was also demonstrated. METHODS: A total of 151 patients with type 2 diabetes mellitus were recruited (between June 2016 and October 2016) to complete sets of questionnaires, which were DES-M, the Malay versions of the Diabetes Quality of Life (DQOL) for Adults and Summary of Diabetes Self Care Activities Questionnaire (SDSCA). Confirmatory and Exploratory factor analysis (CFA and EFA) were carried out to determine the factor structures of the DES-M. RESULTS: There were 100 males and 51 females with ages ranging from 19 to 81 years old (55 ± 13) included in this study. The instrument displayed good internal consistency (Cronbach's α =0.920) and the respective coefficients ranged from 0.65-0.84. Discriminant validity showed adequate correlations ranged from 0.257-0.744. Concurrent validity with SDSCA (Pearson's correlation = 0.313}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN3, title = {Establishment of a hospital-based health care workers surveillance programme to keep them safe during the COVID-19 pandemic}, author = {D. W. Chong and V. J. Jayaraj and S. Rampal and M. A. Said and N. D. N. Farid and R. A. Zaki and N. N. Hairi and V. C. Hoe and M. Isahak and S. Ponnampalavanar and S. F. S. Omar and I. C. Sam and N. Hasnan and H. C. Ong and A. Kamarulzaman and C. W. Ng}, doi = {10.7189/jogh.10.0203100}, issn = {2047-2978 (Print) 2047-2978}, year = {2020}, date = {2020-01-01}, journal = {J Glob Health}, volume = {10}, number = {2}, pages = {0203100}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN138, title = {Achieving cost-efficient management of drug supply via economic order quantity and minimum-maximum stock level}, author = {E. K. Dewi and M. Dahlui and D. Chalidyanto and T. N. Rochmah}, doi = {10.1080/14737167.2019.1633308}, issn = {1473-7167}, year = {2020}, date = {2020-01-01}, journal = {Expert Rev Pharmacoecon Outcomes Res}, volume = {20}, number = {3}, pages = {289-294}, abstract = {BACKGROUND: A good drug inventory planning system is important for an efficient budgeting, procurement, and cost control of drugs. When stagnant drugs in the inventory are too much, wastage due to expired and spoiled drugs could occur. These will not only cause loss of income but could also jeopardize healthcare service delivery. RESEARCH DESIGN AND METHODS: This study aimed to determine the most efficient and effective management of stagnant and shortage drugs by comparing three pharmacy logistic methods; the economic order quantity (EOQ), minimum-maximum stock level (MMSL), and the traditional consumption of drug inventory, at RA Basoeni Hospital, Mojokerto. Drug inventory was analyzed to calculate the opportunity loss, opportunity cost, and proportions of both stagnant and shortage drugs. RESULTS: We found that EOQ and MMSL performed best for control of stagnant drugs and shortage drugs, respectively. Both methods had proved as effective pharmacy logistic planning. In addition, EOQ produced the lowest opportunity cost for stagnant drugs besides the lowest opportunity loss for shortage drugs. CONCLUSION: The study concluded that EOQ is the most effective and efficient method to manage stagnant and shortage drugs at hospital pharmacy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN118, title = {Fine-mapping of 150 breast cancer risk regions identifies 191 likely target genes}, author = {L. Fachal and H. Aschard and J. Beesley and D. R. Barnes and J. Allen and S. Kar and K. A. Pooley and J. Dennis and K. Michailidou and C. Turman and P. Soucy and A. Lema\c{c}on and M. Lush and J. P. Tyrer and M. Ghoussaini and M. Moradi Marjaneh and X. Jiang and S. Agata and K. Aittom\"{a}ki and M. R. Alonso and I. L. Andrulis and H. Anton-Culver and N. N. Antonenkova and A. Arason and V. Arndt and K. J. Aronson and B. K. Arun and B. Auber and P. L. Auer and J. Azzollini and J. Balma\~{n}a and R. B. Barkardottir and D. Barrowdale and A. Beeghly-Fadiel and J. Benitez and M. Bermisheva and K. Bia\lkowska and A. M. Blanco and C. Blomqvist and W. Blot and N. V. Bogdanova and S. E. Bojesen and M. K. Bolla and B. Bonanni and A. Borg and K. Bosse and H. Brauch and H. Brenner and I. Briceno and I. W. Brock and A. Brooks-Wilson and T. Br\"{u}ning and B. Burwinkel and S. S. Buys and Q. Cai and T. Cald\'{e}s and M. A. Caligo and N. J. Camp and I. Campbell and F. Canzian and J. S. Carroll and B. D. Carter and J. E. Castelao and J. Chiquette and H. Christiansen and W. K. Chung and K. B. M. Claes and C. L. Clarke and J. M. Coll\'{e}e and S. Cornelissen and F. J. Couch and A. Cox and S. S. Cross and C. Cybulski and K. Czene and M. B. Daly and M. Hoya and P. Devilee and O. Diez and Y. C. Ding and G. S. Dite and S. M. Domchek and T. D\"{o}rk and I. Dos-Santos-Silva and A. Droit and S. Dubois and M. Dumont and M. Duran and L. Durcan and M. Dwek and D. M. Eccles and C. Engel and M. Eriksson and D. G. Evans and P. A. Fasching and O. Fletcher and G. Floris and H. Flyger and L. Foretova and W. D. Foulkes and others}, doi = {10.1038/s41588-019-0537-1}, issn = {1061-4036 (Print) 1061-4036}, year = {2020}, date = {2020-01-01}, journal = {Nat Genet}, volume = {52}, number = {1}, pages = {56-73}, abstract = {Genome-wide association studies have identified breast cancer risk variants in over 150 genomic regions, but the mechanisms underlying risk remain largely unknown. These regions were explored by combining association analysis with in silico genomic feature annotations. We defined 205 independent risk-associated signals with the set of credible causal variants in each one. In parallel, we used a Bayesian approach (PAINTOR) that combines genetic association, linkage disequilibrium and enriched genomic features to determine variants with high posterior probabilities of being causal. Potentially causal variants were significantly over-represented in active gene regulatory regions and transcription factor binding sites. We applied our INQUSIT pipeline for prioritizing genes as targets of those potentially causal variants, using gene expression (expression quantitative trait loci), chromatin interaction and functional annotations. Known cancer drivers, transcription factors and genes in the developmental, apoptosis, immune system and DNA integrity checkpoint gene ontology pathways were over-represented among the highest-confidence target genes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN2, title = {Willingness to Use Pre-Exposure Prophylaxis (PrEP) for HIV Prevention and PrEP Implementation Preferences Among Transgender Women in Malaysia}, author = {J. M. Galka and M. Wang and I. Azwa and B. Gibson and S. H. Lim and R. Shrestha and J. A. Wickersham}, doi = {10.1089/trgh.2020.0003}, issn = {2688-4887 (Print) 2380-193x}, year = {2020}, date = {2020-01-01}, journal = {Transgend Health}, volume = {5}, number = {4}, pages = {258-266}, abstract = {Introduction: Transgender women (TW) face one of the highest HIV burdens worldwide. In Malaysia, 12.4% of TW are HIV infected, ∼30-fold higher than in the Malaysian adult population. Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy, however, little is known about TW's willingness to use PrEP or their preferences for receiving PrEP. This study examined the correlates of Malaysian TW's willingness to use PrEP and their attitudes and preferences related to delivery of PrEP and PrEP-related care. Methods: Between June and August 2017, 361 TW in Malaysia completed an online survey about their knowledge of and willingness to use PrEP for HIV prevention. Results: Only 20.2% of participants had ever previously heard of PrEP and none were currently taking PrEP. The majority (82.5%) expressed high willingness to take PrEP and most participants met the World Health Organization (WHO) indication for PrEP (82.3%). In the multivariate model, lifetime hormone use, prior postexposure prophylaxis use, and having completed a high school education were associated with higher willingness to use PrEP, while injection drug use, older age, and Chinese ethnicity were associated with lower PrEP willingness. Conclusion: TW in Malaysia are highly willing to use PrEP for HIV prevention. Differences in willingness to use PrEP identified by education, ethnicity, substance abuse, and age suggest different strategies may be needed to scale-up PrEP for this diverse community of TW.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN77, title = {Association of Circulating Vitamin D With Colorectal Cancer Depends on Vitamin D-Binding Protein Isoforms: A Pooled, Nested, Case-Control Study}, author = {D. C. Gibbs and M. Song and M. L. McCullough and C. Y. Um and R. M. Bostick and K. Wu and W. D. Flanders and E. Giovannucci and M. Jenab and M. Brustad and A. Tj\onneland and A. Perez-Cornago and A. Trichopoulou and K. K. Tsilidis and J. Hultdin and A. Barricarte Gurrea and B. Bueno-de-Mesquita and Y. Mahamat-Saleh and T. K\"{u}hn and M. J. Gunter and E. Weiderpass and V. Fedirko}, doi = {10.1093/jncics/pkz083}, issn = {2515-5091}, year = {2020}, date = {2020-01-01}, journal = {JNCI Cancer Spectr}, volume = {4}, number = {1}, pages = {pkz083}, abstract = {BACKGROUND: Higher circulating 25-hydroxyvitamin-D [25(OH)D] concentrations are consistently inversely associated with colorectal cancer (CRC) risk in observational studies. However, it is unknown whether this association depends on the functional GC-rs4588*A (Thr436Lys) variant encoding the vitamin D-binding protein-2 (DBP2) isoform, which may affect vitamin D status and bioavailability. METHODS: We analyzed data from 1710 incident CRC cases and 1649 incidence-density-matched controls nested within three prospective cohorts of mostly Caucasians. Study-specific incidence rate ratios (RRs) for associations of prediagnostic, season-standardized 25(OH)D concentrations according to DBP2 isoform with CRC were estimated using multivariable unconditional logistic regression and were pooled using fixed-effects models. All statistical significance tests were two-sided. RESULTS: The odds of having 25(OH)D concentrations less than 50 nmol/L (considered insufficient by the Institute of Medicine) were 43% higher for each DBP2-encoding variant (rs4588*A) inherited (per DBP2 odds ratio [OR] = 1.43, 95% confidence interval [CI] = 1.27 to 1.62, P (trend) = 1.2 × 10(-8)). The association of 25(OH)D concentrations with CRC risk differed by DBP2: 25(OH)D concentrations considered sufficient (≥ 50 nmol/L), relative to deficient (\< 30 nmol/L), were associated with a 53% lower CRC risk among individuals with the DBP2 isoform (RR = 0.47, 95% CI = 0.33 to 0.67), but with a non-statistically significant 12% lower risk among individuals without it (RR = 0.88, 95% CI = 0.61 to 1.27) (P (heterogeneity) = .01). CONCLUSIONS: Our results suggest that the 25(OH)D-CRC association may differ by DBP isoform, and those with a DBP2-encoding genotype linked to vitamin D insufficiency may particularly benefit from adequate 25(OH)D for CRC prevention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN114, title = {Nutrient-wide association study of 92 foods and nutrients and breast cancer risk}, author = {A. K. Heath and D. C. Muller and P. A. Brandt and N. Papadimitriou and E. Critselis and M. Gunter and P. Vineis and E. Weiderpass and G. Fagherazzi and H. Boeing and P. Ferrari and A. Olsen and A. Tj\onneland and P. Arveux and M. C. Boutron-Ruault and F. R. Mancini and T. K\"{u}hn and R. Turzanski-Fortner and M. B. Schulze and A. Karakatsani and P. Thriskos and A. Trichopoulou and G. Masala and P. Contiero and F. Ricceri and S. Panico and B. Bueno-de-Mesquita and M. F. Bakker and C. H. Gils and K. S. Olsen and G. Skeie and C. Lasheras and A. Agudo and M. Rodr\'{i}guez-Barranco and M. J. S\'{a}nchez and P. Amiano and M. D. Chirlaque and A. Barricarte and I. Drake and U. Ericson and I. Johansson and A. Winkvist and T. Key and H. Freisling and M. His and I. Huybrechts and S. Christakoudi and M. Ellingjord-Dale and E. Riboli and K. K. Tsilidis and I. Tzoulaki}, doi = {10.1186/s13058-019-1244-7}, issn = {1465-5411 (Print) 1465-5411}, year = {2020}, date = {2020-01-01}, journal = {Breast Cancer Res}, volume = {22}, number = {1}, pages = {5}, abstract = {BACKGROUND: Several dietary factors have been reported to be associated with risk of breast cancer, but to date, unequivocal evidence only exists for alcohol consumption. We sought to systematically assess the association between intake of 92 foods and nutrients and breast cancer risk using a nutrient-wide association study. METHODS: Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression was used to quantify the association between each food/nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to be replicated in the independent Netherlands Cohort Study (NLCS). RESULTS: Six foods and nutrients were identified as associated with risk of breast cancer in the EPIC study (10,979 cases). Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% CI 1.03-1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03-1.06 and 1.04, 95% CI 1.02-1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94-0.98; 0.96, 95% CI 0.94-0.99; and 0.96, 95% CI 0.95-0.98, respectively). When evaluated in the NLCS (2368 cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk in the NLCS. CONCLUSIONS: Our findings confirm a positive association of alcohol consumption and suggest an inverse association of dietary fibre and possibly fruit intake with breast cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN84, title = {Fruit consumption and the risk of bladder cancer: A pooled analysis by the Bladder Cancer Epidemiology and Nutritional Determinants Study}, author = {S. H. J. Jochems and R. C. Reulen and F. H. M. Osch and W. J. A. Witlox and M. E. Goossens and M. Brinkman and G. G. Giles and R. L. Milne and P. A. Brandt and E. White and E. Weiderpass and I. Huybrechts and B. H\'{e}mon and A. Agudo and B. Bueno-de-Mesquita and K. K. Cheng and F. J. Schooten and R. T. Bryan and A. Wesselius and M. P. Zeegers}, doi = {10.1002/ijc.33008}, issn = {0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {147}, number = {8}, pages = {2091-2100}, abstract = {While the association between fruit consumption and bladder cancer risk has been extensively reported, studies have had inadequate statistical power to investigate associations between types of fruit and bladder cancer risk satisfactorily. Fruit consumption in relation to bladder cancer risk was investigated by pooling individual data from 13 cohort studies. Cox regression models with attained age as time scale were used to estimate hazard ratios (HRs) for intakes of total fruit and citrus fruits, soft fruits, stone fruits, tropical fruits, pome fruits and fruit products. Analyses were stratified by sex, smoking status and bladder cancer subtype. During on average 11.2 years of follow-up, 2836 individuals developed incident bladder cancer. Increasing fruit consumption (by 100 g/day) was inversely associated with the risk of bladder cancer in women (HR = 0.92; 95% CI 0.85-0.99). Although in women the association with fruit consumption was most evident for higher-risk nonmuscle invasive bladder cancer (NMIBC; HR = 0.72; 95% CI 0.56-0.92), the test for heterogeneity by bladder cancer subtype was nonsignificant (P-heterogeneity = .14). Increasing fruit consumption (by 100 g/day) was not associated with bladder cancer risk in men (HR = 0.99; 95% CI 0.94-1.03), never smokers (HR = 0.96; 95% CI 0.88-1.05), former smokers (HR = 0.98; 95% CI 0.92-1.05) or current smokers (HR = 0.95; 95% CI 0.89-1.01). The consumption of any type of fruit was not found to be associated with bladder cancer risk (P values \> .05). Our study supports no evidence that the consumption of specific types of fruit reduces the risk of bladder cancer. However, increasing total fruit consumption may reduce bladder cancer risk in women.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN95, title = {Group sex, suicidality and online partners: implications for HIV and suicide prevention: a short report}, author = {Y. Kongjareon and N. Samoh and S. H. Lim and P. Peerawaranun and K. J. Jonas and T. E. Guadamuz}, doi = {10.1080/09540121.2020.1734174}, issn = {0954-0121 (Print) 0954-0121}, year = {2020}, date = {2020-01-01}, journal = {AIDS Care}, volume = {32}, number = {8}, pages = {954-958}, abstract = {HIV-related factors and suicide-risk status were assessed among YMSM aged 18-24 years recruited through various MSM-related online social apps in Bangkok (N = 1394). The online survey assessed demographic characteristics, sexual behaviours and suicide-risk status. Measure of suicide risk was taken from the Suicidal Behaviors Questionnaire-Revised (cut-off score of seven or higher). Among participants, 249 (17.9%) reported suicide-risk. In multivariable logistic regression, correlates of suicide-risk status included having sometimes or often ever participated in group sex (AOR=1.58, 95% CI: 1.17-2.14), having received money or opportunities for sex (AOR=1.54, 95% CI: 1.09-2.17), often seeking partners online (AOR=1.59, 95% CI: 1.05-2.39), inconsistent condom use (AOR=1.67, 95% CI: 1.26-2.21), and self-assessed as having "medium" or "high" HIV risk (AOR=2.53, 95% CI: 1.61-3.98 and AOR=3.35, 95% CI: 1.92-5.82, respectively). Findings suggest that HIV risk behaviours shown by YMSM are significantly associated with higher risk of suicide.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN5, title = {Strengthening the migrant-friendliness of Thai health services through interpretation and cultural mediation: a system analysis}, author = {H. Kosiyaporn and S. Julchoo and M. Phaiyarom and P. Sinam and W. Kunpeuk and N. Pudpong and P. Allotey and Z. X. Chan and T. Loganathan and N. Pocock and R. Suphanchaimat}, doi = {10.1186/s41256-020-00181-0}, issn = {2397-0642}, year = {2020}, date = {2020-01-01}, journal = {Glob Health Res Policy}, volume = {5}, number = {1}, pages = {53}, abstract = {BACKGROUND: In addition to healthcare entitlements, 'migrant-friendly health services' in Thailand include interpretation and cultural mediation services which aim to reduce language and cultural barriers between health personnel and migrants. Although the Thai Government started implementing these services in 2003, challenges in providing them still remain. This study aims to analyse the health system functions which support the interpretation and cultural mediation services of migrant health worker (MHW) and migrant health volunteer (MHV) programmes in Thailand. METHODS: In-depth interviews were conducted in two migrant-populated provinces using purposive and snowball sampling. A total of fifty key informants were recruited, including MHWs, MHWs, health professionals, non-governmental organisation (NGO) staff and policy stakeholders. Data were triangulated using information from policy documents. The deductive thematic analysis was classified into three main themes of evolving structure of MHW and MHV programmes, roles and responsibilities of MHWs and MHVs, and supporting systems. RESULTS: The introduction of the MHW and MHV programmes was one of the most prominent steps taken to improve the migrant-friendliness of Thai health services. MHWs mainly served as interpreters in public facilities, while MHVs served as cultural mediators in migrant communities. Operational challenges in providing services included insufficient budgets for employment and training, diverse training curricula, and lack of legal provisions to sustain the MHW and MHV programmes. CONCLUSION: Interpretation and cultural mediation services are hugely beneficial in addressing the health needs of migrants. To ensure the sustainability of current service provision, clear policy regulation and standardised training courses should be in place, alongside adequate and sustainable financial support from central government, NGOs, employers and migrant workers themselves. Moreover, regular monitoring and evaluation of the quality of services are recommended. Finally, a lead agency should be mandated to collaborate with stakeholders in planning the overall structure and resource allocation for the programmes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN122, title = {From Evidence to Policy: Economic Evaluations of Healthcare in Malaysia: A Systematic Review}, author = {K. N. Ku Abd Rahim and H. F. Kamaruzaman and M. Dahlui and S. E. Wan Puteh}, doi = {10.1016/j.vhri.2019.09.002}, issn = {2212-1099}, year = {2020}, date = {2020-01-01}, journal = {Value Health Reg Issues}, volume = {21}, pages = {91-99}, abstract = {OBJECTIVE: To identify and describe the various economic evaluation studies in Malaysia and to determine the range of incremental cost-effectiveness ratios (ICERs) as reported in these studies. METHODS: A comprehensive search of the scientific electronic databases was conducted (Medline, EBM Reviews, Embase, and hand search) to identify all published economic evaluation studies related to Malaysian healthcare. Two researchers assessed the quality of selected studies using the Critical Appraisal Skills Programme (CASP) checklist and Quality of Health Economic Studies instrument. The assessment was also reviewed by expert members of the Technical Advisory Committee of Health Technology Economic Evaluations (TACHTEE). RESULTS: A total of 64 full-text articles were assessed for eligibility and included in this systematic review. Thirty studies were partial economic evaluations; the full economic evaluations included 17 cost-effectiveness analyses and 17 cost-utility analyses. From all the reported ICERs, the majority (68%) were categorized as highly cost-effective (ICER of less than 1 gross domestic product (GDP) per capita per quality-adjusted life-years or disability-adjusted life-years gained). CONCLUSION: This review identifies information gaps and loopholes in health economics research in Malaysia. Additionally, this study provides the information that the majority of published interventions in Malaysia fell within the cost-effectiveness threshold of 1 GDP per capita per quality-adjusted life-years or disability-adjusted life-years gained.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN11, title = {Understanding COVID-19 vaccine demand and hesitancy: A nationwide online survey in China}, author = {Y. Lin and Z. Hu and Q. Zhao and H. Alias and M. Danaee and L. P. Wong}, doi = {10.1371/journal.pntd.0008961}, issn = {1935-2727 (Print) 1935-2727}, year = {2020}, date = {2020-01-01}, journal = {PLoS Negl Trop Dis}, volume = {14}, number = {12}, pages = {e0008961}, abstract = {BACKGROUND: This study attempts to understand coronavirus disease 2019 (COVID-19) vaccine demand and hesitancy by assessing the public's vaccination intention and willingness-to-pay (WTP). Confidence in COVID-19 vaccines produced in China and preference for domestically-made or foreign-made vaccines was also investigated. METHODS: A nationwide cross-sectional, self-administered online survey was conducted on 1-19 May 2020. The health belief model (HBM) was used as a theoretical framework for understanding COVID-19 vaccination intent and WTP. RESULTS: A total of 3,541 complete responses were received. The majority reported a probably yes intent (54.6%), followed by a definite yes intent (28.7%). The perception that vaccination decreases the chances of getting COVID-19 under the perceived benefit construct (OR = 3.14, 95% CI 2.05-4.83) and not being concerned about the efficacy of new COVID-19 vaccines under the perceived barriers construct (OR = 1.65, 95% CI 1.31-2.09) were found to have the highest significant odds of a definite intention to take the COVID-19 vaccine. The median (interquartile range [IQR]) of WTP for COVID-19 vaccine was CNY¥200/US$28 (IQR CNY¥100-500/USD$14-72). The highest marginal WTP for the vaccine was influenced by socio-economic factors. The majority were confident (48.7%) and completely confident (46.1%) in domestically-made COVID-19 vaccine. 64.2% reported a preference for a domestically-made over foreign-made COVID-19 vaccine. CONCLUSIONS: The findings demonstrate the utility of HBM constructs in understanding COVID-19 vaccination intent and WTP. It is important to improve health promotion and reduce the barriers to COVID-19 vaccination.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN13, title = {Healthcare financing and social protection policies for migrant workers in Malaysia}, author = {T. Loganathan and Z. X. Chan and N. S. Pocock}, doi = {10.1371/journal.pone.0243629}, issn = {1932-6203}, year = {2020}, date = {2020-01-01}, journal = {PLoS One}, volume = {15}, number = {12}, pages = {e0243629}, abstract = {BACKGROUND: For Malaysia, a nation highly dependent on migrant labour, the large non-citizen workforce presents a unique health system challenge. Although documented migrant workers are covered by mandatory healthcare insurance (SPIKPA), financial constraints remain a major barrier for non-citizen healthcare access. Malaysia recently extended protection for migrant workers under the national social security scheme (SOCSO), previously exclusive to citizens. This study aims to evaluate healthcare financing and social security policies for migrant workers to identify policy gaps and opportunities for intervention. METHODS: A total of 37 in-depth interviews were conducted of 44 stakeholders from July 2018 to July 2019. A mixed-methods analysis combining major themes from qualitative interviews with policy document reviews was conducted. Descriptive analysis of publicly available secondary data, namely revenues collected at government healthcare facilities, was conducted to contextualise the policy review and qualitative findings. RESULTS: We found that migrant workers and employers were unaware of SPIKPA enrolment and entitlements. Higher fees for non-citizens result in delayed care-seeking. While the Malaysian government nearly doubled non-citizen healthcare fees revenues from RM 104 to 182 million (USD 26 to 45 million) between 2014 to 2018, outstanding revenues tripled from RM 16 to 50 million (USD 4 to 12 million) in the same period. SPIKPA coverage is likely inadequate in providing financial risk protection to migrant workers, especially with increased non-citizens fees at public hospitals. Undocumented workers and other migrant populations excluded from SPIKPA contribution to unpaid fees revenues are unknown. Problems described with the previous Foreign Workers Compensation Scheme (FWCS), could be partially addressed by SOCSO, in theory. Nevertheless, questions remain on the feasibility of implementing elements of SOCSO, such as recurring payments to workers and next-of-kin overseas. CONCLUSION: Malaysia is moving towards migrant inclusion with the provision of SOCSO for documented migrant workers, but more needs to be done. Here we suggest the expansion of the SPIKPA insurance scheme to include all migrant populations, while broadening its scope towards more comprehensive coverage, including essential primary care.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN14, title = {Healthcare for migrant workers in destination countries: a comparative qualitative study of China and Malaysia}, author = {T. Loganathan and D. Rui and N. S. Pocock}, doi = {10.1136/bmjopen-2020-039800}, issn = {2044-6055}, year = {2020}, date = {2020-01-01}, journal = {BMJ Open}, volume = {10}, number = {12}, pages = {e039800}, abstract = {OBJECTIVES: This paper explores policies addressing migrant worker's health and barriers to healthcare access in two middle-income, destination countries in Asia with cross-border migration to Yunnan province, China and international migration to Malaysia. DESIGN: Qualitative interviews were conducted in Rui Li City and Tenchong County in Yunnan Province, China (n=23) and Kuala Lumpur, Malaysia (n=44), along with review of policy documents. Data were thematically analysed. PARTICIPANTS: Participants were migrant workers and key stakeholders with expertise in migrant issues including representatives from international organisations, local civil society organisations, government agencies, medical professionals, academia and trade unions. RESULTS: Migrant health policies at destination countries were predominantly protectionist, concerned with preventing transmission of communicable disease and the excessive burden on health systems. In China, foreign wives were entitled to state-provided maternal health services while female migrant workers had to pay out-of-pocket and often returned to Myanmar for deliveries. In Malaysia, immigration policies prohibit migrant workers from pregnancy, however, women do deliver at healthcare facilities. Mandatory HIV testing was imposed on migrants in both countries, where it was unclear whether and how informed consent was obtained from migrants. Migrants who did not pass mandatory health screenings in Malaysia would runaway rather than be deported and become undocumented in the process. Excessive attention on migrant workers with communicable disease control campaigns in China resulted in inadvertent stigmatisation. Language and financial barriers frustrated access to care in both countries. Reported conditions of overcrowding and inadequate healthcare access at immigration detention centres raise public health concern. CONCLUSIONS: This study's findings inform suggestions to mainstream the protection of migrant workers' health within national health policies in two middle-income destination countries, to ensure that health systems are responsive to migrants' needs as well as to strengthen bilateral and regional cooperation towards ensuring better migration management.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN9, title = {Social support among older adults in Malaysia}, author = {M. A. Mahmud and M. Hazrin and E. N. Muhammad and M. F. Mohd Hisyam and S. M. Awaludin and M. A. Abdul Razak and N. A. Mahmud and N. A. Mohamad and N. N. Mohd Hairi and C. Wan Yuen}, doi = {10.1111/ggi.14033}, issn = {1447-0594}, year = {2020}, date = {2020-01-01}, journal = {Geriatr Gerontol Int}, volume = {20 Suppl 2}, pages = {63-67}, abstract = {AIM: This study aimed to determine the factors that influence perceived social support among older adults in Malaysia. METHODS: We used the 11-item Duke Social Support Index to assess perceived social support through a face-to-face interview. Higher scores indicate better social support. Linear regression analysis was carried out to determine the factors that influence perceived social support by adapting the conceptual model of social support determinants and its impact on health. RESULTS: A total of 3959 respondents aged ≥60 years completed the Duke Social Support Index. The estimated mean Duke Social Support Index score was 27.65 (95% CI 27.36-27.95). Adjusted for confounders, the factors found to be significantly associated with social support among older adults were monthly income below RM1000 (-0.8502, 95% CI -1.3523, -0.3481), being single (-0.5360, 95% CI -0.8430, -0.2290), no depression/normal (2.2801, 95% CI 1.6666-2.8937), absence of activities of daily living (0.9854, 95% CI 0.5599-1.4109) and dependency in instrumental activities of daily living (-0.3655, 95% CI -0.9811, -0.3259). CONCLUSION: This study found that low income, being single, no depression, absence of activities of daily living and dependency in instrumental activities of daily living were important factors related to perceived social support among Malaysian older adults. Geriatr Gerontol Int 2020; 20: 63-67.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN125, title = {Online STI information seeking behaviour and condom use intentions among young Facebook users in Malaysia}, author = {S. M. Mohamad Shakir and L. P. Wong and K. Lim Abdullah and P. Adam}, doi = {10.1093/heapro/daz108}, issn = {0957-4824}, year = {2020}, date = {2020-01-01}, journal = {Health Promot Int}, volume = {35}, number = {5}, pages = {1116-1124}, abstract = {The Internet has opened pathways for youth to find sexual health information which was not easily available to them in the past. Studies have shown that seeking sexual health information online may potentially influence an individuals' decision-making to change their sexual health behaviours. However, there is a gap in research on the associations of seeking online sexually transmitted infection (STI) information with STI prevention among young people, particularly in Malaysia. This study investigated the associations of seeking STI information online with the intentions of condom use among young adult online users in Malaysia. A cross-sectional online survey was conducted among Malaysian youth aged 18-25 years old who were recruited through Facebook. In total, 1530 respondents completed the survey, identifying 874 respondents who had sought STI information online. The majority of respondents had intentions to use condoms as protection against STI. Respondents who sought online STI information were significantly more likely to have the intention to use condoms compared to respondents who did not seek online STI information (OR = 1.33, 95% CI = 1.01-1.76}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN104, title = {Bacterial pneumonia and its associated factors in children from a developing country: A prospective cohort study}, author = {A. M. Nathan and C. S. J. Teh and K. A. Jabar and B. T. Teoh and A. Tangaperumal and C. Westerhout and R. Zaki and K. P. Eg and S. Thavagnanam and J. A. Bruyne}, doi = {10.1371/journal.pone.0228056}, issn = {1932-6203}, year = {2020}, date = {2020-01-01}, journal = {PLoS One}, volume = {15}, number = {2}, pages = {e0228056}, abstract = {INTRODUCTION: Pneumonia in children is a common disease yet determining its aetiology remains elusive. OBJECTIVES: To determine the a) aetiology, b) factors associated with bacterial pneumonia and c) association between co-infections (bacteria + virus) and severity of disease, in children admitted with severe pneumonia. METHODS: A prospective cohort study involving children aged 1-month to 5-years admitted with very severe pneumonia, as per the WHO definition, over 2 years. Induced sputum and blood obtained within 24 hrs of admission were examined via PCR, immunofluorescence and culture to detect 17 bacteria/viruses. A designated radiologist read the chest radiographs. RESULTS: Three hundred patients with a mean (SD) age of 14 (±15) months old were recruited. Significant pathogens were detected in 62% of patients (n = 186). Viruses alone were detected in 23.7% (n = 71) with rhinovirus (31%), human metapneumovirus (HMP) [22.5%] and respiratory syncytial virus (RSV) [16.9%] being the commonest. Bacteria alone was detected in 25% (n = 75) with Haemophilus influenzae (29.3%), Staphylococcus aureus (24%) and Streptococcus pneumoniae (22.7%) being the commonest. Co-infections were seen in 13.3% (n = 40) of patients. Male gender (AdjOR 1.84 [95% CI 1.10, 3.05]) and presence of crepitations (AdjOR 2.27 [95% CI 1.12, 4.60]) were associated with bacterial infection. C-reactive protein (CRP) [p = 0.007]) was significantly higher in patients with co-infections but duration of hospitalization (p = 0.77) and requirement for supplemental respiratory support (p = 0.26) were not associated with co-infection. CONCLUSIONS: Bacteria remain an important cause of very severe pneumonia in developing countries with one in four children admitted isolating bacteria alone. Male gender and presence of crepitations were significantly associated with bacterial aetiology. Co-infection was associated with a higher CRP but no other parameters of severe clinical illness.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN85, title = {Barriers to implementing a national health screening program for men in Malaysia: An online survey of healthcare providers}, author = {C. J. Ng and C. H. Teo and K. M. Ang and Y. L. Kok and K. Ashraf and H. L. Leong and S. W. Taher and S. Z. Mohd and Z. F. Zakaria and P. F. Wong and C. P. Hor and T. A. Ong and H. Hussain and P. V and C. W. Ng and K. Agamutu and M. A. Abd Razak}, issn = {1985-207X (Print) 1985-2274}, year = {2020}, date = {2020-01-01}, journal = {Malays Fam Physician}, volume = {15}, number = {1}, pages = {6-14}, abstract = {INTRODUCTION: This study aimed to determine the views and practices of healthcare providers and barriers they encountered when implementing the national health screening program for men in a public primary care setting in Malaysia. METHODS: An online survey was conducted among healthcare providers across public health clinics in Malaysia. All family medicine specialists, medical officers, nurses and assistant medical officers involved in the screening program for adult men were invited to answer a 51-item questionnaire via email or WhatsApp. The questionnaire comprised five sections: participants' socio-demographic information, current screening practices, barriers and facilitators to using the screening tool, and views on the content and format of the screening tool. RESULTS: A total of 231 healthcare providers from 129 health clinics participated in this survey. Among them, 37.44% perceived the implementation of the screening program as a "top-down decision." Although 37.44% found the screening tool for adult men "useful," some felt that it was "time consuming" to fill out (38.2%) and "lengthy" (28.3%). In addition, 'adult men refuse to answer' (24.1%) was cited as the most common patient-related barrier. CONCLUSIONS: This study provided useful insights into the challenges encountered by the public healthcare providers when implementing a national screening program for men. The screening tool for adult men should be revised to make it more user-friendly. Further studies should explore the reasons why men were reluctant to participate in health screenings, thus enhancing the implementation of screening programs in primary care.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN82, title = {Association of co-occurring psychosocial health conditions and HIV infection among MSM in Malaysia: Implication of a syndemic effect}, author = {R. X. Ng and T. E. Guadamuz and M. Akbar and A. Kamarulzaman and S. H. Lim}, doi = {10.1177/0956462420913444}, issn = {0956-4624}, year = {2020}, date = {2020-01-01}, journal = {Int J STD AIDS}, volume = {31}, number = {6}, pages = {568-578}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN140, title = {Consumption of nuts and seeds and pancreatic ductal adenocarcinoma risk in the European Prospective Investigation into Cancer and Nutrition}, author = {M. Ob\'{o}n-Santacana and L. Luj\'{a}n-Barroso and H. Freisling and S. Naudin and M. C. Boutron-Ruault and F. R. Mancini and V. Rebours and T. K\"{u}hn and V. Katzke and H. Boeing and A. Tj\onneland and A. Olsen and K. Overvad and C. Lasheras and M. Rodr\'{i}guez-Barranco and P. Amiano and C. Santiuste and E. Ardanaz and K. T. Khaw and N. J. Wareham and J. A. Schmidt and D. Aune and A. Trichopoulou and P. Thriskos and E. Peppa and G. Masala and S. Grioni and R. Tumino and S. Panico and B. Bueno-de-Mesquita and V. Sciannameo and R. Vermeulen and E. Sonestedt and M. Sund and E. Weiderpass and G. Skeie and C. A. Gonz\'{a}lez and E. Riboli and E. J. Duell}, doi = {10.1002/ijc.32415}, issn = {0020-7136 (Print) 0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {146}, number = {1}, pages = {76-84}, abstract = {Four epidemiologic studies have assessed the association between nut intake and pancreatic cancer risk with contradictory results. The present study aims to investigate the relation between nut intake (including seeds) and pancreatic ductal adenocarcinoma (PDAC) risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Cox proportional hazards models were used to estimate hazards ratio (HR) and 95% confidence intervals (95% CI) for nut intake and PDAC risk. Information on intake of nuts was obtained from the EPIC country-specific dietary questionnaires. After a mean follow-up of 14 years, 476,160 participants were eligible for the present study and included 1,283 PDAC cases. No association was observed between consumption of nuts and PDAC risk (highest intake vs nonconsumers: HR, 0.89; 95% CI, 0.72-1.10; p-trend = 0.70). Furthermore, no evidence for effect-measure modification was observed when different subgroups were analyzed. Overall, in EPIC, the highest intake of nuts was not statistically significantly associated with PDAC risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN145, title = {Intake of individual fatty acids and risk of prostate cancer in the European prospective investigation into cancer and nutrition}, author = {A. Perez-Cornago and I. Huybrechts and P. N. Appleby and J. A. Schmidt and F. L. Crowe and K. Overvad and A. Tj\onneland and T. K\"{u}hn and V. Katzke and A. Trichopoulou and A. Karakatsani and E. Peppa and S. Grioni and D. Palli and C. Sacerdote and R. Tumino and H. B. Bueno-de-Mesquita and N. Larra\~{n}aga and M. J. S\'{a}nchez and J. R. Quir\'{o}s and E. Ardanaz and M. D. Chirlaque and A. Agudo and A. Bjartell and P. Wallstr\"{o}m and V. Chajes and K. K. Tsilidis and D. Aune and E. Riboli and R. C. Travis and T. J. Key}, doi = {10.1002/ijc.32233}, issn = {0020-7136 (Print) 0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {146}, number = {1}, pages = {44-57}, abstract = {The associations of individual dietary fatty acids with prostate cancer risk have not been examined comprehensively. We examined the prospective association of individual dietary fatty acids with prostate cancer risk overall, by tumor subtypes, and prostate cancer death. 142,239 men from the European Prospective Investigation into Cancer and Nutrition who were free from cancer at recruitment were included. Dietary intakes of individual fatty acids were estimated using center-specific validated dietary questionnaires at baseline and calibrated with 24-h recalls. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average follow-up of 13.9 years, 7,036 prostate cancer cases and 936 prostate cancer deaths were ascertained. Intakes of individual fatty acids were not related to overall prostate cancer risk. There was evidence of heterogeneity in the association of some short chain saturated fatty acids with prostate cancer risk by tumor stage (p(heterogeneity) \< 0.015), with a positive association with risk of advanced stage disease for butyric acid (4:0; HR(1SD) = 1.08; 95%CI = 1.01-1.15; p-trend = 0.026). There were no associations with fatal prostate cancer, with the exception of a slightly higher risk for those who consumed more eicosenoic acid (22:1n-9c; HR(1SD) = 1.05; 1.00-1.11; p-trend = 0.048) and eicosapentaenoic acid (20:5n-3c; HR(1SD) = 1.07; 1.00-1.14; p-trend = 0.045). There was no evidence that dietary intakes of individual fatty acids were associated with overall prostate cancer risk. However, a higher intake of butyric acid might be associated with a higher risk of advanced, whereas intakes of eicosenoic and eicosapentaenoic acids might be positively associated with fatal prostate cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN119, title = {Biochar amendment improves alpine meadows growth and soil health in Tibetan plateau over a three year period}, author = {M. K. Rafiq and Y. Bai and R. Aziz and M. T. Rafiq and O. Ma\v{s}ek and R. T. Bachmann and S. Joseph and M. Shahbaz and A. Qayyum and Z. Shang and M. Danaee and R. Long}, doi = {10.1016/j.scitotenv.2019.135296}, issn = {0048-9697}, year = {2020}, date = {2020-01-01}, journal = {Sci Total Environ}, volume = {717}, pages = {135296}, abstract = {Previous biochar research has primarily focused on agricultural annual cropping systems with very little attention given to highly fragile, complex and diverse natural alpine grassland ecosystems. The present study investigated the effect of biochar on the growth of alpine meadows and soil health. This study was conducted in the Qinghai Tibetan Plateau over a three year period to investigate the effect of three rice husk biochar application rates alone and combination with high and low NPK fertilizer dosages on alpine meadow productivity, soil microbial diversity as well as pH, carbon and nitrogen content at 0-10 cm and 10-20 cm depth. At the end of the 3rd year soil samples were analysed and assessed by combined analysis of variance. The results showed that biochar application in combination with nitrogen (N), phosphorus (P) and potassium (K) fertilizer had a significant increase in fresh and dry biomass during the second and third year of the study as compared to control and alone biochar application (p ≤ 0.05). Biochar alone and in combination with NPK fertilizer resulted in a significant increase in the soil pH and carbon contents of the soil. XPS results, the SEM imaging and EDS analysis of aged biochar demonstrated that the biochar has undergone complex changes over the 3 years as compared to fresh biochar. This research suggests that biochar has positive effect on alpine meadow growth and soil health and may be an effective tool for alpine meadow restoration.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN79, title = {Defending against the Novel Coronavirus (COVID-19) outbreak: How can the Internet of Things (IoT) help to save the world?}, author = {M. S. Rahman and N. C. Peeri and N. Shrestha and R. Zaki and U. Haque and S. H. A. Hamid}, doi = {10.1016/j.hlpt.2020.04.005}, issn = {2211-8837 (Print) 2211-8837}, year = {2020}, date = {2020-01-01}, journal = {Health Policy Technol}, volume = {9}, number = {2}, pages = {136-138}, abstract = {•IoT within infectious disease epidemiology is an emerging field of research, however the ubiquitous availability of smart technologies, as well as increased risks of infectious disease spread through the globalization and interconnectedness of the world necessitates its use for predicting, preventing and controlling emerging infectious diseases.•Considering the present situation in China, IoT based smart disease surveillance systems have the potential to be a major breakthrough in efforts to control the current pandemic. With much of the infrastructure itself in place already (i.e. smartphones, wearable technologies, internet access) the role this technology can have in limiting the spread of the pandemic involves only the collection and analysis of data already gathered.•More research must be carried out for the development of automated and effective alert systems to provide early and timely detection of outbreaks of such diseases in order to reduce morbidity mortality and prevent global spread.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN86, title = {Contributing risk factors towards the prevalence of multidrug-resistant tuberculosis in Malaysia: A systematic review}, author = {M. Rajendran and R. A. Zaki and N. Aghamohammadi}, doi = {10.1016/j.tube.2020.101925}, issn = {1472-9792}, year = {2020}, date = {2020-01-01}, journal = {Tuberculosis (Edinb)}, volume = {122}, pages = {101925}, abstract = {Multidrug-resistant tuberculosis (MDR-TB) is one of the causes of morbidity and mortality, among tuberculosis (TB) patients in Malaysia. The purpose of this study was to determine the contributing risk factors to the prevalence of (MDR-TB). Based on systematic review of the literatures, the prevalence of (MDR-TB) and associated risk factors in Malaysia were studied. A comprehensive search of Scopus, Science direct, PubMed, DOAJ, CINAHL Plus, MyJournal, BIREME, BMC Public Health, Medline, CAB, and WoS databases were done among the articles published from 31st January 2009 to 31st December 2018, by using medical subject heading (MeSH) key terms. In conducting this study, a total of 121 papers were reviewed and 23 research papers were chosen, because, they met the specific inclusion criteria. In this study, gender, age, marital status, ethnicity, homeless status, living in urban area and history of imprisonment were evaluated as demographic factors, while educational level and employment were evaluated as socioeconomic factors. Smoking, diabetes mellitus, drug abuse and alcohol consumption were evaluated as behavioral and co-morbidities factors. All the studies chosen as eligible to be included in this study were found to be significantly associated with the risk factors for the prevalence of (MDR-TB). It was also discovered that, lack of adequate knowledge among the community and (TB) patients might increase the progression of (MDR-TB) infection in Malaysia. Thus, carried out a systematic review provided a comprehensive assessment of the (MDR-TB) which might be useful for policy makers, health experts and researchers to implement appropriate strategies for (TB) infected population in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN6, title = {Motivations and built environment factors associated with campus walkability in the tropical settings}, author = {L. Ramakreshnan and C. S. Fong and N. M. Sulaiman and N. Aghamohammadi}, doi = {10.1016/j.scitotenv.2020.141457}, issn = {0048-9697}, year = {2020}, date = {2020-01-01}, journal = {Sci Total Environ}, volume = {749}, pages = {141457}, abstract = {Recognizing and mainstreaming pertinent walkability elements into the university campus planning is crucial to materialise green mandates of the campus, while enhancing social and economic sustainability. In one of such attempts, this transverse study investigated the walking motivations, built environment factors associated with campus walkability and the relative importance of the studied built environment factors in reference to the sociodemographic attributes from the viewpoint of the campus community in a tropical university campus in Kuala Lumpur, Malaysia. An online survey using a structured questionnaire was conducted between May and September 2019. The built environment factors associated with campus walkability were expressed and ranked as adjusted scores (AS). Meanwhile, multivariable logistic regression was deployed to examine the relative importance of the studied built environment factors in reference to the sociodemographic attributes of the campus community. Among 504 total responses acquired, proximity between complementary land uses (90.7%) was reported as the main motivation for walking. On the other hand, street connectivity and accessibility (AS: 97.62%) was described as the most opted built environment factor, followed by land use (AS: 96.76%), pedestrian infrastructure (AS: 94.25%), walking experience (AS: 87.07%), traffic safety (AS: 85.28%) and campus neighbourhood (AS: 59.62%), respectively. Among the sociodemographic attributes, no regular monthly income (OR = 3.162; 95% CI = 1.165-8.379; p \< 0.05) and willingness to walk more than 60 min inside the campus per day (OR = 0.418; 95% CI = 0.243-0.720; p \< 0.05) were significantly associated with the expression of higher importance towards the reported built environment factors in the multivariate analysis. In brief, the findings of this study were envisaged to elicit valuable empirical evidence for informed interventions and strengthening campus sustainable mobility policies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN75, title = {The Predictive Factors for Severe Leptospirosis Cases in Kedah}, author = {R. S. Sandhu and H. B. Ismail and M. H. B. Ja'afar and S. Rampal}, doi = {10.3390/tropicalmed5020079}, issn = {2414-6366}, year = {2020}, date = {2020-01-01}, journal = {Trop Med Infect Dis}, volume = {5}, number = {2}, abstract = {Over the past decade, increased awareness about leptospirosis disease in developing and industrialized countries has resulted in increased numbers of leptospirosis cases being reported worldwide. About 5% to 15% of leptospirosis patients end up with severe forms of the disease. Complication due to leptospirosis requires monitoring, specific treatments, and intensive care admission, thus increasing the cost of treating severe leptospirosis cases. Currently, we have data on incident and mortality rates, but we do not have data on the number of patients with severe form of leptospirosis or how many patients have complications, and whether or not these complications were resolved. Therefore, we carried out this study to determine the predictive factors for severe leptospirosis cases in Kedah. We conducted a cross-sectional study. The data of patients diagnosed with leptospirosis were obtained from the surveillance unit, Kedah Health Department, through the e-notification system. These data were then sorted according to the hospitals where the patients were admitted. The patients' medical records were collected, and their information was obtained using a checklist. A total of 456 confirmed leptospirosis cases were included in the study, with 199 patients classified as severe cases and 257 patients as mild cases, based on the Malaysian leptospirosis guidelines. Most patients were male (71.5%) with a mean SD age of 36.62 ± 20.75 years. The predictive factors for severe leptospirosis include abnormal lung sounds (OR: 3.07 [CI 1.58-6.00]), hepatomegaly (OR: 7.14 [1.10-45.98]), hypotension (OR: 2.16 [1.08-4.34]), leukocytosis (OR: 2.12 [1.37-3.29]), low hematocrit (OR: 2.33 [1.43-3.81]), and increased alanine aminotransferase (SGPT ALT) (OR: 2.12 [1.36-3.30]). In conclusion, knowing these predictive factors will help clinicians identify severe leptospirosis cases earlier and develop their treatment plans accordingly, to reduce the complications and death from severe leptospirosis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN142, title = {Anthropometric and reproductive factors and risk of esophageal and gastric cancer by subtype and subsite: Results from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort}, author = {H. Sanikini and D. C. Muller and M. Sophiea and S. Rinaldi and A. Agudo and E. J. Duell and E. Weiderpass and K. Overvad and A. Tj\onneland and J. Halkjaer and M. C. Boutron-Ruault and F. Carbonnel and I. Cervenka and H. Boeing and R. Kaaks and T. K\"{u}hn and A. Trichopoulou and G. Martimianaki and A. Karakatsani and V. Pala and D. Palli and A. Mattiello and R. Tumino and C. Sacerdote and G. Skeie and C. Rylander and M. D. Chirlaque L\'{o}pez and M. J. S\'{a}nchez and E. Ardanaz and S. Regn\'{e}r and T. Stocks and B. Bueno-de-Mesquita and R. C. H. Vermeulen and D. Aune and T. Y. N. Tong and N. Kliemann and N. Murphy and M. Chadeau-Hyam and M. J. Gunter and A. J. Cross}, doi = {10.1002/ijc.32386}, issn = {0020-7136 (Print) 0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {146}, number = {4}, pages = {929-942}, abstract = {Obesity has been associated with upper gastrointestinal cancers; however, there are limited prospective data on associations by subtype/subsite. Obesity can impact hormonal factors, which have been hypothesized to play a role in these cancers. We investigated anthropometric and reproductive factors in relation to esophageal and gastric cancer by subtype and subsite for 476,160 participants from the European Prospective Investigation into Cancer and Nutrition cohort. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox models. During a mean follow-up of 14 years, 220 esophageal adenocarcinomas (EA), 195 esophageal squamous cell carcinomas, 243 gastric cardia (GC) and 373 gastric noncardia (GNC) cancers were diagnosed. Body mass index (BMI) was associated with EA in men (BMI ≥30 vs. 18.5-25 kg/m(2) : HR = 1.94, 95% CI: 1.25-3.03) and women (HR = 2.66, 95% CI: 1.15-6.19); however, adjustment for waist-to-hip ratio (WHR) attenuated these associations. After mutual adjustment for BMI and HC, respectively, WHR and waist circumference (WC) were associated with EA in men (HR = 3.47, 95% CI: 1.99-6.06 for WHR \>0.96 vs. \<0.91; HR = 2.67, 95% CI: 1.52-4.72 for WC \>98 vs. \<90 cm) and women (HR = 4.40, 95% CI: 1.35-14.33 for WHR \>0.82 vs. \<0.76; HR = 5.67, 95% CI: 1.76-18.26 for WC \>84 vs. \<74 cm). WHR was also positively associated with GC in women, and WC was positively associated with GC in men. Inverse associations were observed between parity and EA (HR = 0.38, 95% CI: 0.14-0.99; \>2 vs. 0) and age at first pregnancy and GNC (HR = 0.54, 95% CI: 0.32-0.91; \>26 vs. \<22 years); whereas bilateral ovariectomy was positively associated with GNC (HR = 1.87, 95% CI: 1.04-3.36). These findings support a role for hormonal pathways in upper gastrointestinal cancers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN88, title = {Cancer symptom and risk factor awareness in Malaysia: findings from a nationwide cross-sectional study}, author = {D. Schliemann and R. Ismail and M. Donnelly and C. R. Cardwell and T. T. Su}, doi = {10.1186/s12889-020-08581-0}, issn = {1471-2458}, year = {2020}, date = {2020-01-01}, journal = {BMC Public Health}, volume = {20}, number = {1}, pages = {464}, abstract = {BACKGROUND: Cancer incidence in Malaysia is expected to double by 2040. Understanding cancer awareness is important in order to tailor preventative efforts and reduce the cancer burden. The objective of this research was to assess nationwide awareness about the signs and symptoms as well as risk factors for various cancers in Malaysia and identify socio-demographic factors associated with awareness. METHODS: This cross-sectional study was conducted from March-November 2014 in the form of a telephone survey. Participants aged 40 years and above were randomly selected across Malaysia and interviewed using the validated Awareness Beliefs about Cancer (ABC) measurement tool. Linear regression was conducted to test the association between symptom and risk factor recognition and socio-demographic variables. RESULTS: A sample of 1895 participants completed the survey. On average, participants recognised 5.8 (SD 3.2) out of 11 symptoms and 7.5 (SD 2.7) out of 12 risk factors. The most commonly recognised symptom was 'lump or swelling' (74.5%) and the most commonly recognised risk factor was 'smoking' (88.7%). Factors associated with prompted awareness were age, ethnicity, education and smoking status. CONCLUSION: Recognition of symptom and risk factors for most cancers was relatively low across Malaysia compared to previous studies in high-income countries and to studies conducted in Malaysia. There is a need to conduct regular public health campaigns and interventions designed to improve cancer awareness and knowledge as a first step towards increasing the early detection of cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN144, title = {Patterns in metabolite profile are associated with risk of more aggressive prostate cancer: A prospective study of 3,057 matched case-control sets from EPIC}, author = {J. A. Schmidt and G. K. Fensom and S. Rinaldi and A. Scalbert and P. N. Appleby and D. Achaintre and A. Gicquiau and M. J. Gunter and P. Ferrari and R. Kaaks and T. K\"{u}hn and H. Boeing and A. Trichopoulou and A. Karakatsani and E. Peppa and D. Palli and S. Sieri and R. Tumino and B. Bueno-de-Mesquita and A. Agudo and M. J. S\'{a}nchez and M. D. Chirlaque and E. Ardanaz and N. Larra\~{n}aga and A. Perez-Cornago and N. Assi and E. Riboli and K. K. Tsilidis and T. J. Key and R. C. Travis}, doi = {10.1002/ijc.32314}, issn = {0020-7136 (Print) 0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {146}, number = {3}, pages = {720-730}, abstract = {Metabolomics may reveal novel insights into the etiology of prostate cancer, for which few risk factors are established. We investigated the association between patterns in baseline plasma metabolite profile and subsequent prostate cancer risk, using data from 3,057 matched case-control sets from the European Prospective Investigation into Cancer and Nutrition (EPIC). We measured 119 metabolite concentrations in plasma samples, collected on average 9.4 years before diagnosis, by mass spectrometry (AbsoluteIDQ p180 Kit, Biocrates Life Sciences AG). Metabolite patterns were identified using treelet transform, a statistical method for identification of groups of correlated metabolites. Associations of metabolite patterns with prostate cancer risk (OR(1SD) ) were estimated by conditional logistic regression. Supplementary analyses were conducted for metabolite patterns derived using principal component analysis and for individual metabolites. Men with metabolite profiles characterized by higher concentrations of either phosphatidylcholines or hydroxysphingomyelins (OR(1SD) = 0.77, 95% confidence interval 0.66-0.89), acylcarnitines C18:1 and C18:2, glutamate, ornithine and taurine (OR(1SD) = 0.72, 0.57-0.90), or lysophosphatidylcholines (OR(1SD) = 0.81, 0.69-0.95) had lower risk of advanced stage prostate cancer at diagnosis, with no evidence of heterogeneity by follow-up time. Similar associations were observed for the two former patterns with aggressive disease risk (the more aggressive subset of advanced stage), while the latter pattern was inversely related to risk of prostate cancer death (OR(1SD) = 0.77, 0.61-0.96). No associations were observed for prostate cancer overall or less aggressive tumor subtypes. In conclusion, metabolite patterns may be related to lower risk of more aggressive prostate tumors and prostate cancer death, and might be relevant to etiology of advanced stage prostate cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16, title = {Using individual stated-preferences to optimize HIV self-testing service delivery among men who have sex with men (MSM) in Malaysia: results from a conjoint-based analysis}, author = {R. Shrestha and H. Alias and L. P. Wong and F. L. Altice and S. H. Lim}, doi = {10.1186/s12889-020-09832-w}, issn = {1471-2458}, year = {2020}, date = {2020-01-01}, journal = {BMC Public Health}, volume = {20}, number = {1}, pages = {1777}, abstract = {BACKGROUND: HIV self-testing (HIVST) has the potential to improve HIV testing uptake and frequency for key populations like MSM who experience multiple barriers accessing clinic-based HIV testing. In the absence of HIVST in Malaysia, there is no guidance to inform HIVST delivery. This study investigated the acceptability of HIVST and preferences about the HIVST service delivery approaches using a standardized stated preference method. METHODS: A cross-sectional online survey conducted between January and April 2019 assessed the interest in HIVST in 544 MSM in Malaysia. Participants ranked eight hypothetical HIVST service delivery program elements with varied combinations of six, two-level HIVST service delivery program attributes (cost, privacy, accuracy, kit collection site, kit type, and testing support). SPSS conjoint procedure was used to estimate the relative importance of each attribute and preference across eight possible HIVST service delivery programs. RESULTS: Overall, 70.4% had previously tested for HIV, and of those, 64.0% had done so in the past 6 months (45.0% of all participants). Of all the participants, 25.2% reported having used HIVST previously. The acceptability for HIVST service delivery models ranged from 44.9 to 77.1%, with mean acceptability of 56.2% across the eight hypothetical HIVST distribution scenarios. The HIVST service delivery scenario with the highest acceptability had the following attributes: no cost (free), anonymity (name not required), 99-100% accuracy, home-delivered, fingerstick, and testing support using telephone hotline or texting. HIVST cost was the most important attribute (relative importance score: RIS = 19.30) associated with acceptability, followed by anonymity (RIS = 18.41), accuracy (RIS = 17.33), kit delivery (RIS = 16.99), fingerstick kit (RIS = 15.86), and support (RIS = 12.08). CONCLUSIONS: Acceptability for HIVST in Malaysian MSM was high but differed markedly by a number of HIVST delivery scenarios and attributes. These findings could be relevant as the Malaysian Ministry of Health is in the process of developing a regulatory framework for ensuring the quality of kits, as well as policies supporting safe use while broader implementation under national AIDS programs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN8, title = {Elder abuse: Nationwide findings among community-dwelling Malaysian older persons}, author = {R. Sooryanarayana and S. S. Ganapathy and N. I. Wong and A. Rosman and W. Y. Choo and N. N. Hairi}, doi = {10.1111/ggi.13989}, issn = {1447-0594}, year = {2020}, date = {2020-01-01}, journal = {Geriatr Gerontol Int}, volume = {20 Suppl 2}, pages = {85-91}, abstract = {AIM: Elder abuse is a significant public health problem. This study aims to estimate its prevalence and associated factors, using representative national Malaysian data. METHODS: A nationwide population-based survey involving 3977 community-dwelling older persons aged ≥60 years was conducted via face-to-face interview, of whom 3466 older persons were eligible for screening using a locally validated tool. Elder abuse was defined as any one occurrence of neglect, financial, psychological, physical or sexual abuse perpetrated by someone in a position of trust that was experienced in the past 12 months. RESULTS: About 9.0% of older persons in Malaysia have experienced elder abuse in the past 12 months, with neglect being the commonest type experienced (7.5%; 95% confidence interval [CI]: 5.54, 10.07). There is no significant difference by age group and geographical location. Males (adjusted odds ratio [aOR] 1.7; 95% CI: 1.06, 2.60), poorer social support (aOR 5.0; 95% CI: 2.25, 11.22), dependency in activities of daily living (aOR 2.1; 95% CI: 1.23, 3.44) and a previous history of abuse (aOR 10.1; 95% CI: 4.50, 22.86) show higher odds of experiencing elder abuse. Almost 5% of abused older persons reported experiencing multiple types of abuse. Reporting is low at 19.3% with none reporting to healthcare personnel. CONCLUSIONS: The prevalence of elder abuse in this study is lower than global estimates, but similar to local studies. Preventive measures and programs are crucial to overcoming elder abuse and need to be carried out at multiple levels - the individual, community, healthcare and other stakeholders. Geriatr Gerontol Int 2020; 20: 85-91.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN105, title = {Seeking medical help for cancer among urban dwellers in Malaysia-Emotional barriers and awareness of cancer symptoms}, author = {T. T. Su and M. Azzani and M. Donnelly and H. A. Majid}, doi = {10.1111/ecc.13232}, issn = {0961-5423}, year = {2020}, date = {2020-01-01}, journal = {Eur J Cancer Care (Engl)}, volume = {29}, number = {4}, pages = {e13232}, abstract = {OBJECTIVES: The main aims of the study were to identify barriers to seeking help for cancer, appraise demographic and socio-economic differences in relation to barriers and evaluate the association between barriers and cancer symptoms awareness and delayed help-seeking. METHODS: A total of 2,360 adults (18 years and above) from randomly selected households in metropolitan Kuala Lumpur completed face-to-face interviews with trained research assistants that incorporated the validated Malay version of the Cancer Awareness Measure (CAM). Logistic regression was the main statistical technique that was used to investigate the study objectives and relationships (noted above). RESULTS: The most commonly reported barriers to help-seeking were emotional barriers. The probability of delaying seeking help was 49% higher in participants who reported emotional barriers (OR = 1.49; CI: 1.32-1.68; p \< .001); and each unit rise in the cancer symptom awareness score was associated with a reduced likelihood of 29% in help-seeking delay (OR = 0.71; 95% CI: 0.68-0.74; p \< .001). CONCLUSIONS: Our study presents clear evidence of the relationship between cancer awareness and help-seeking; and the need for, and potential positive impact of, providing cancer awareness-raising programmes. Cancer health education campaigns or programme should address emotional barriers and encourage early seeking help.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN4, title = {COVID-19 handling report for pre-case, case (pre-hospital and hospital), and post-case phases in the elderly as vulnerable populations in 6 Asia Pacific countries}, author = {I. H. Susilowati and H. Nakatani and S. Nugraha and S. Pengpid and W. Keawpan and B. P. Hasiholan and N. P. Toai and A. Abdeali and M. Isahak and S. Kamso}, doi = {10.35772/ghm.2020.01061}, issn = {2434-9186 (Print) 2434-9186}, year = {2020}, date = {2020-01-01}, journal = {Glob Health Med}, volume = {2}, number = {6}, pages = {350-359}, abstract = {In this current COVID-19 pandemic, the elderly (60 years and over) are more vulnerable populations to be infected and become victims. In a disaster cycle, the various parts are usually divided into three stages, consisting of the pre-impact stage, the trans-impact stage, and the post-impact stage. It is necessary to explain how to handle the COVID-19 disaster for the elderly at each step (explain the meaning of pre-case, case (pre-hospital and hospital), and post-case phases, respectively). This paper presents the handling of COVID-19 for elderly in pre-case, case, and post-case phases in six Asia-Pacific countries (Indonesia, Thailand, Singapore, Malaysia, Vietnam, and Japan). The data and information come from COVID-19 official websites of each country, including information from World Health Organization (WHO), United States Centers for Disease Control and Prevention (CDC), mass media, and professional associations. The handling of COVID-19 in the pre-case phase has been done correctly for the elderly, especially in Indonesia, Japan, Thailand, and Singapore. In the case phase (pre-hospital and hospital), only Indonesia, Japan, and Thailand have followed special handling protocols for the elderly, particularly for those who have comorbidities and respiratory diseases. For the post-case phase, all countries have the same treatment protocol for all age groups, with none specific for the elderly.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN102, title = {Response to Validity and Reliability of a Nutrition Screening Tool in Identifying Malnutrition Among Hospitalized Adult Patients}, author = {P. C. Tah and C. C. Kee and H. A. Majid}, doi = {10.1002/ncp.10457}, issn = {0884-5336}, year = {2020}, date = {2020-01-01}, journal = {Nutr Clin Pract}, volume = {35}, number = {2}, pages = {365}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN93, title = {A Single-Center Prospective Observational Study Comparing Resting Energy Expenditure in Different Phases of Critical Illness: Indirect Calorimetry Versus Predictive Equations}, author = {P. C. Tah and Z. Y. Lee and B. K. Poh and H. Abdul Majid and V. R. Hakumat-Rai and M. B. Mat Nor and C. C. Kee and M. Kamarul Zaman and M. S. Hasan}, doi = {10.1097/ccm.0000000000004282}, issn = {0090-3493}, year = {2020}, date = {2020-01-01}, journal = {Crit Care Med}, volume = {48}, number = {5}, pages = {e380-e390}, abstract = {OBJECTIVES: Several predictive equations have been developed for estimation of resting energy expenditure, but no study has been done to compare predictive equations against indirect calorimetry among critically ill patients at different phases of critical illness. This study aimed to determine the degree of agreement and accuracy of predictive equations among ICU patients during acute phase (≤ 5 d), late phase (6-10 d), and chronic phase (≥ 11 d). DESIGN: This was a single-center prospective observational study that compared resting energy expenditure estimated by 15 commonly used predictive equations against resting energy expenditure measured by indirect calorimetry at different phases. Degree of agreement between resting energy expenditure calculated by predictive equations and resting energy expenditure measured by indirect calorimetry was analyzed using intraclass correlation coefficient and Bland-Altman analyses. Resting energy expenditure values calculated from predictive equations differing by ± 10% from resting energy expenditure measured by indirect calorimetry was used to assess accuracy. A score ranking method was developed to determine the best predictive equations. SETTING: General Intensive Care Unit, University of Malaya Medical Centre. PATIENTS: Mechanically ventilated critically ill patients. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Indirect calorimetry was measured thrice during acute, late, and chronic phases among 305, 180, and 91 ICU patients, respectively. There were significant differences (F= 3.447; p = 0.034) in mean resting energy expenditure measured by indirect calorimetry among the three phases. Pairwise comparison showed mean resting energy expenditure measured by indirect calorimetry in late phase (1,878 ± 517 kcal) was significantly higher than during acute phase (1,765 ± 456 kcal) (p = 0.037). The predictive equations with the best agreement and accuracy for acute phase was Swinamer (1990), for late phase was Brandi (1999) and Swinamer (1990), and for chronic phase was Swinamer (1990). None of the resting energy expenditure calculated from predictive equations showed very good agreement or accuracy. CONCLUSIONS: Predictive equations tend to either over- or underestimate resting energy expenditure at different phases. Predictive equations with "dynamic" variables and respiratory data had better agreement with resting energy expenditure measured by indirect calorimetry compared with predictive equations developed for healthy adults or predictive equations based on "static" variables. Although none of the resting energy expenditure calculated from predictive equations had very good agreement, Swinamer (1990) appears to provide relatively good agreement across three phases and could be used to predict resting energy expenditure when indirect calorimetry is not available.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN141, title = {Ethnic differences in lifetime cumulative incidence of syncope: the Malaysian elders longitudinal research (MELoR) study}, author = {M. P. Tan and Y. Y. Ho and A. V. Chin and N. Saedon and I. Z. Abidin and K. H. Chee and H. M. Khor and C. H. Goh and N. N. Hairi and S. Othman and S. B. Kamaruzzaman}, doi = {10.1007/s10286-019-00610-2}, issn = {0959-9851}, year = {2020}, date = {2020-01-01}, journal = {Clin Auton Res}, volume = {30}, number = {2}, pages = {121-128}, abstract = {PURPOSE: To determine the lifetime cumulative incidence of syncope, potential ethnic differences and factors associated with syncope using the Malaysian elders longitudinal research (MELoR) study first wave dataset. METHODS: The MELoR study recruited community-dwelling adults aged 55 years and over, selected through stratified random sampling from three parliamentary constituencies. The baseline data collected during the first wave was obtained through face-to-face interviews in participants' homes using computer-assisted questionnaires. During their baseline assessments, participants were asked whether they had ever experienced a blackout in their lifetime and if they had experienced a blackout in the preceding 12 months. RESULTS: Information on blackouts and ethnicity were available for 1530 participants. The weight-adjusted lifetime cumulative incidence of syncope for the overall population aged 55 years and above was 27.7%. The estimated lifetime cumulative incidence according to ethnic groups was 34.6% for Malays, 27.8% for Indians and 23.7% for Chinese. The estimated 12-month incidence of syncope was 6.1% overall, equating to 11.7% for Malays, 8.7 % for Indians and 2.3% for Chinese. Both Malay [odds ratio (OR) 1.46; 95% confidence interval (CI) 1.10-1.95 and OR 3.62, 95% CI 1.96-6.68] and Indian (OR 1.34; 95% CI 1.01-1.80 and OR 3.31, 1.78-6.15) ethnicities were independently associated with lifetime and 12-month cumulative incidence of syncope, respectively, together with falls, dizziness and myocardial infarction. CONCLUSION: Ethnic differences exist for lifetime cumulative incidence of syncope in community-dwelling individuals aged 55 years and over in an urban area in Southeast Asia. Future studies should now seek to determine potential genetic, cultural and lifestyle differences which may predispose to syncope.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15, title = {Income Inequality in Quality of Life among Rural Communities in Malaysia: A Case for Immediate Policy Consideration}, author = {G. Thangiah and M. A. Said and H. A. Majid and D. Reidpath and T. T. Su}, doi = {10.3390/ijerph17238731}, issn = {1661-7827 (Print) 1660-4601}, year = {2020}, date = {2020-01-01}, journal = {Int J Environ Res Public Health}, volume = {17}, number = {23}, abstract = {Quality of life (QOL) is a proxy of health and social well-being. Hence, it is vital to assess QOL as it informs the strategies of policymakers to enhance the living conditions in communities. Rural areas in emerging economies are underserved in terms of modern facilities and technologies, which impact QOL. To address this, this study investigated whether income played a role in the QOL of rural residents within emerging economies using a large survey of Malaysian adults above 18 years old. The study extracted data from a sample of 18,607 respondents of a health and demographic surveillance system survey. A generalized linear model was used to estimate the impact of three income groups, the bottom 40%, middle 40% and top 20%, on perceived QOL, controlling for sociodemographic, chronic disease co-morbidities and mental health status. Results of the study showed a statistically significant association between income and the physical, psychological, social and environmental QOL domains. Using the bottom 40% as a reference category, the middle 40% and top 20% income groups showed a significant and positive association across the four domains of QOL. Hence, intervention programs are necessary to escalate the income levels of rural communities, especially the bottom 40%, to uplift perceived QOL among rural residents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN87, title = {Clustering and Tracking the Stability of Biological CVD Risk Factors in Adolescents: The Malaysian Health and Adolescents Longitudinal Research Team Study (MyHeARTs)}, author = {N. Thangiah and K. Chinna and T. T. Su and M. Y. Jalaludin and N. Al-Sadat and H. A. Majid}, doi = {10.3389/fpubh.2020.00069}, issn = {2296-2565 (Print) 2296-2565}, year = {2020}, date = {2020-01-01}, journal = {Front Public Health}, volume = {8}, pages = {69}, abstract = {Background: Cardiovascular disease (CVD) risk factors tend to cluster and progress from adolescence to young adulthood. Reliable and meaningful clustering of CVD risk factors is essential to circumvent loss of information. Tracking adverse and high-risk profiles of adolescents is hoped to curb CVD progression later in life. The study aims to investigate the clustering of biological CVD risk factor among adolescents in Malaysia and the transitions between clusters over time. Method: The Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs) examined school students aged 13 in 2012 and re-examined them in 2014 and 2016. In a two-stage stratified cluster sampling, 1,361 students were recruited, of which, 1,320 had complete data. In the follow-up, there were 881 and 637 students in 2014 and in 2016, respectively. Pearson's correlation coefficients were used to identify and remove highly correlated CVD risk factors. All risk factors were standardized into z-scores. The hierarchical and non-hierarchical (k-means) cluster analyses were used to classify students into high, medium and low risk clusters in each screening year. The tracking and stability of cluster transitions through cross-classification were enumerated with Pearson's inter-age correlations and percentages. Results: Three significant clusters of high, medium and low risk groups were derived from the clustering of eight biological CVD risk factors. The transitions between risk clusters from one screening year to the other were categorized as either stagnant, improved or adverse. The number of students who had adverse transitions increased from 15.5% (13-15 year) to 19.5% (15-17 year), 13.8 to 18.2% among the girls and 19.9 to 22.8% among the boys. For girls, the number of them who remained at high risk over the two transition periods were about the same (13.6 vs. 13.8%) whereas for boys, the percentage reduced from 14.6 to 12.3%. Conclusion: Over time, more than 12% of adolescents remained in the high risk cluster. There were sizable adverse transitions over time as more adolescents appear to be shifting toward an increased risk of having CVD. Collaborative and constant measures should be taken by parents, school, health promotion boards and policy makers to curb the multiplicative effect of clustering CVD risk factors among adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN80, title = {Determinants of unsuccessful treatment outcomes and mortality among tuberculosis patients in Malaysia: A registry-based cohort study}, author = {P. S. K. Tok and S. M. Liew and L. P. Wong and A. Razali and T. Loganathan and K. Chinna and N. Ismail and N. A. Kadir}, doi = {10.1371/journal.pone.0231986}, issn = {1932-6203}, year = {2020}, date = {2020-01-01}, journal = {PLoS One}, volume = {15}, number = {4}, pages = {e0231986}, abstract = {INTRODUCTION: The monitoring of tuberculosis (TB) treatment outcomes and examination of the factors affecting these outcomes are important for evaluation and feedback of the national TB control program. This study aims to assess the TB treatment outcomes among patients registered in the national TB surveillance database in Malaysia from 2014 until 2017 and identify factors associated with unsuccessful treatment outcomes and all-cause mortality. MATERIALS AND METHODS: Using registry-based secondary data, a retrospective cohort study was conducted. TB patients' sociodemographic characteristics, clinical disease data and treatment outcomes at one-year surveillance were extracted from the database and analyzed. Logistic regression analysis was used to determine factors associated with unsuccessful treatment outcomes and all-cause mortality. RESULTS: A total of 97,505 TB cases (64.3% males) were included in this study. TB treatment success (cases categorized as cured and completed treatment) was observed in 80.7% of the patients. Among the 19.3% patients with unsuccessful treatment outcomes, 10.2% died, 5.3% were lost to follow-up, 3.6% had outcomes not evaluated while the remaining failed treatment. Unsuccessful TB treatment outcomes were found to be associated with older age, males, foreign nationality, urban dwellers, lower education levels, passive detection of TB cases, absence of bacille Calmette-Guerin (BCG) scar, underlying diabetes mellitus, smoking, extrapulmonary TB, history of previous TB treatment, advanced chest radiography findings and human immunodeficiency virus (HIV) infection. Factors found associated with all-cause mortality were similar except for nationality (higher among Malaysians) and place of residence (higher among rural dwellers), while smoking and history of previous TB treatment were not found to be associated with all-cause mortality. CONCLUSIONS: This study identified various sociodemographic characteristics and TB disease-related variables which were associated with unsuccessful TB treatment outcomes and mortality; these can be used to guide measures for risk assessment and stratification of TB patients in future.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN74, title = {Multidimensional social and cultural norms influencing HPV vaccine hesitancy in Asia}, author = {L. P. Wong and P. F. Wong and Mmaa Megat Hashim and L. Han and Y. Lin and Z. Hu and Q. Zhao and G. D. Zimet}, doi = {10.1080/21645515.2020.1756670}, issn = {2164-5515 (Print) 2164-5515}, year = {2020}, date = {2020-01-01}, journal = {Hum Vaccin Immunother}, volume = {16}, number = {7}, pages = {1611-1622}, abstract = {HPV vaccine hesitancy in Asia is unique compared to Western countries due to multidimensional social-cultural norms that influence beliefs regarding vaccination. Reviews on HPV vaccine hesitancy in Asia lack of in-depth discussion regarding the traditional and social-cultural norms dimensions. This paper puts forward opinions in which culture, normative beliefs, and religion influence HPV vaccine hesitancy in Asian countries. Issues surrounding HPV hesitancy among parents, young adult women, adult women, men and the sexual and gender minority people in Asian countries were highlighted. The shortage of HPV vaccine supply would soon be reduced as some Asian countries are on the way to producing the HPV vaccine which production is currently dominated by Western European countries. The culture of favoring imported Western products among many in Asia and in addition to long-existing fake vaccine crisis pose a challenge for the newly emerging HPV vaccine produced in Asia. Some recommendations, research gaps, and future research needs were discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN83, title = {The effects of enhanced primary healthcare interventions on primary care providers' job satisfaction}, author = {W. J. Wong and A. Mohd Norzi and S. H. Ang and C. L. Chan and F. S. A. Jaafar and S. Sivasampu}, doi = {10.1186/s12913-020-05183-9}, issn = {1472-6963}, year = {2020}, date = {2020-01-01}, journal = {BMC Health Serv Res}, volume = {20}, number = {1}, pages = {311}, abstract = {BACKGROUND: In response to the rising burden of cardiovascular risk factors, the Malaysian government has implemented Enhanced Primary Healthcare (EnPHC) interventions in July 2017 at public clinic level to improve management and clinical outcomes of type 2 diabetes and hypertensive patients. Healthcare providers (HCPs) play crucial roles in healthcare service delivery and health system reform can influence HCPs' job satisfaction. However, studies evaluating HCPs' job satisfaction following primary care transformation remain scarce in low- and middle-income countries. This study aims to evaluate the effects of EnPHC interventions on HCPs' job satisfaction. METHODS: This is a quasi-experimental study conducted in 20 intervention and 20 matched control clinics. We surveyed all HCPs who were directly involved in patient management. A self-administered questionnaire which included six questions on job satisfaction were assessed on a scale of 1-4 at baseline (April and May 2017) and post-intervention phase (March and April 2019). Unadjusted intervention effect was calculated based on absolute differences in mean scores between intervention and control groups after implementation. Difference-in-differences analysis was used in the multivariable linear regression model and adjusted for providers and clinics characteristics to detect changes in job satisfaction following EnPHC interventions. A negative estimate indicates relative decrease in job satisfaction in the intervention group compared with control group. RESULTS: A total of 1042 and 1215 HCPs responded at baseline and post-intervention respectively. At post-intervention, the intervention group reported higher level of stress with adjusted differences of - 0.139 (95% CI -0.266,-0.012; p = 0.032). Nurses, being the largest workforce in public clinics were the only group experiencing dissatisfaction at post-intervention. In subgroup analysis, nurses from intervention group experienced increase in work stress following EnPHC interventions with adjusted differences of - 0.223 (95% CI -0.419,-0.026; p = 0.026). Additionally, the same group were less likely to perceive their profession as well-respected at post-intervention (β = - 0.175; 95% CI -0.331,-0.019; p = 0.027). CONCLUSIONS: Our findings suggest that EnPHC interventions had resulted in some untoward effect on HCPs' job satisfaction. Job dissatisfaction can have detrimental effects on the organisation and healthcare system. Therefore, provider experience and well-being should be considered before introducing healthcare delivery reforms to avoid overburdening of HCPs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN133, title = {Polyphenol intake and differentiated thyroid cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort}, author = {R. Zamora-Ros and V. Cayssials and S. Franceschi and C. Kyr\o and E. Weiderpass and J. Hennings and M. Sandstr\"{o}m and A. Tj\onneland and A. Olsen and K. Overvad and M. C. Boutron-Ruault and T. Truong and F. R. Mancini and V. Katzke and T. K\"{u}hn and H. Boeing and A. Trichopoulou and A. Karakatsani and G. Martimianaki and D. Palli and V. Krogh and S. Panico and R. Tumino and C. Sacerdote and C. Lasheras and M. Rodr\'{i}guez-Barranco and P. Amiano and S. M. Colorado-Yohar and E. Ardanaz and M. Almquist and U. Ericson and H. B. Bueno-de-Mesquita and R. Vermeulen and J. A. Schmidt and G. Byrnes and A. Scalbert and A. Agudo and S. Rinaldi}, doi = {10.1002/ijc.32589}, issn = {0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {146}, number = {7}, pages = {1841-1850}, abstract = {Polyphenols are bioactive compounds with several anticarcinogenic activities; however, human data regarding associations with thyroid cancer (TC) is still negligible. Our aim was to evaluate the association between intakes of total, classes and subclasses of polyphenols and risk of differentiated TC and its main subtypes, papillary and follicular, in a European population. The European Prospective Investigation into Cancer and Nutrition cohort included 476,108 men and women from 10 European countries. During a mean follow-up of 14 years, there were 748 incident differentiated TC cases, including 601 papillary and 109 follicular tumors. Polyphenol intake was estimated at baseline using validated center/country-specific dietary questionnaires and the Phenol-Explorer database. In multivariable-adjusted Cox regression models, no association between total polyphenol and the risks of overall differentiated TC (HR(Q4 vs. Q1) = 0.99, 95% confidence interval [CI] 0.77-1.29), papillary (HR(Q4 vs. Q1) = 1.06, 95% CI 0.80-1.41) or follicular TC (HR(Q4 vs. Q1) = 1.10, 95% CI 0.55-2.22) were found. No associations were observed either for flavonoids, phenolic acids or the rest of classes and subclasses of polyphenols. After stratification by body mass index (BMI), an inverse association between the intake of polyphenols (p-trend = 0.019) and phenolic acids (p-trend = 0.007) and differentiated TC risk in subjects with BMI ≥ 25 was observed. In conclusion, our study showed no associations between dietary polyphenol intake and differentiated TC risk; although further studies are warranted to investigate the potential protective associations in overweight and obese individuals.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN17, title = {Clinical Symptoms of Arboviruses in Mexico}, author = {S. Ananth and N. Shrestha and C. Ja Trevi\~{n}o and U. S. Nguyen and U. Haque and A. Angulo-Molina and U. A. Lopez-Lemus and J. Lubinda and R. M. Sharif and R. A. Zaki and R. M. S\'{a}nchez Casas and D. Cervantes and R. Nandy}, doi = {10.3390/pathogens9110964}, issn = {2076-0817 (Print) 2076-0817}, year = {2020}, date = {2020-01-01}, journal = {Pathogens}, volume = {9}, number = {11}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Arboviruses such as Chikungunya (CHIKV), Dengue (DENV), and Zika virus (ZIKV) have emerged as a significant public health concern in Mexico. The existing literature lacks evidence regarding the dispersion of arboviruses, thereby limiting public health policy's ability to integrate the diagnosis, management, and prevention. This study seeks to reveal the clinical symptoms of CHIK, DENV, and ZIKV by age group, region, sex, and time across Mexico. The confirmed cases of CHIKV, DENV, and ZIKV were compiled from January 2012 to March 2020. Demographic characteristics analyzed significant clinical symptoms of confirmed cases. Multinomial logistic regression was used to assess the association between clinical symptoms and geographical regions. Females and individuals aged 15 and older had higher rates of reported significant symptoms across all three arboviruses. DENV showed a temporal variation of symptoms by regions 3 and 5, whereas ZIKV presented temporal variables in regions 2 and 4. This study revealed unique and overlapping symptoms between CHIKV, DENV, and ZIKV. However, the differentiation of CHIKV, DENV, and ZIKV is difficult, and diagnostic facilities are not available in rural areas. There is a need for adequately trained healthcare staff alongside well-equipped lab facilities, including hematological tests and imaging facilities.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN98, title = {A Review of Published Literature Regarding Health Issues of Coastal Communities in Sabah, Malaysia}, author = {A. Azzeri and G. H. Ching and H. Jaafar and M. I. Mohd Noor and N. A. Razi and A. Y. Then and J. Suhaimi and F. Kari and M. Dahlui}, doi = {10.3390/ijerph17051533}, issn = {1661-7827 (Print) 1660-4601}, year = {2020}, date = {2020-01-01}, journal = {Int J Environ Res Public Health}, volume = {17}, number = {5}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Several of the coastal zones in Sabah, Malaysia, are isolated and inaccessible. This study aimed to review the published literature on the health status of the coastal communities in Sabah. The following four main health issues were found: (i) malaria, (ii) tuberculosis (TB), (iii) seafood poisoning, and (iv) antenatal problems. Factors associated with the risk of acquiring malarial infection in the studied coastal area were advanced age, male sex, farming as an occupation, history of travel outside the village, and rainy seasons. TB infection was primarily observed in adult men. Seafood poisoning was significantly common in Sabah. Studies have reported that tetrodotoxin and paralytic shellfish poisoning were commonly reported (30-60 cases annually). Several pregnant women in the coastal community had insufficient knowledge of the national antenatal care programme. Nonetheless, 99% of them received antenatal care at public healthcare facilities with 92% of them undergoing safe delivery. Nevertheless, a majority of the pregnant women had iodine deficiency due to low iodised salt intake. Findings from this review highlighted that the coastal communities in Sabah are experiencing significant health problems. Specific attention is required to significantly enhance the health and well-being of the individuals living in the coastal communities in Sabah.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN57, title = {Intake of Common Alcoholic and Non-Alcoholic Beverages and Breast Cancer Risk among Japanese Women: Findings from the Japan Collaborative Cohort Study}, author = {S. Sinnadurai and S. Okabayashi and T. Kawamura and M. Mori and N. Bhoo-Pathy and N. Aishah Taib and S. Ukawa and A. Tamakoshi and Group The Jacc Study}, doi = {10.31557/apjcp.2020.21.6.1701}, issn = {1513-7368 (Print) 1513-7368}, year = {2020}, date = {2020-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {21}, number = {6}, pages = {1701-1707}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {This study investigated the association between intake of common alcoholic and non-alcoholic beverages and breast cancer risk among Japanese women. This study included 33,396 Japanese women aged 40-79 years from 24 areas in Japan from the Collaborative Cohort study. During the follow-up period (≥20 years), 245 incidents or mortal breast cancers were documented. Multivariable logistic regression analysis was performed to assess the independent association between breast cancer risk and the intake of Japanese green tea, coffee, and alcohol. Japanese green tea was the most commonly consumed non-alcoholic beverage (81.6% of participants), followed by coffee (34.7%) and alcohol (23.6%). No significant associations were identified between the intake of green tea and coffee with breast cancer risk (odds ratio OR 1.15, 95% confidence interval [CI] 0.82-1.60, and OR 0.84, 95% CI 0.64-1.10, respectively). Alcohol intake was associated with significant breast cancer risk (OR 1.46, 95% CI 1.11-1.92), and even infrequent alcohol consumption (.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN28, title = {Clinical inertia in type 2 diabetes management in a middle-income country: A retrospective cohort study}, author = {K. S. Wan and F. M. Moy and K. Mohd Yusof and F. I. Mustapha and Z. Mohd Ali and N. N. Hairi}, doi = {10.1371/journal.pone.0240531}, issn = {1932-6203}, year = {2020}, date = {2020-01-01}, journal = {PLoS One}, volume = {15}, number = {10}, pages = {e0240531}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Clinical inertia can lead to poor glycemic control among type 2 diabetes patients. However, there is paucity of information on clinical inertia in low- and middle-income countries including Malaysia. This study aimed to determine the time to treatment intensification among T2D patients with HbA1c of ≥7% (≥53 mmol/mol) in Malaysian public health clinics. The proportion of patients with treatment intensification and its associated factors were also determined. MATERIAL AND METHODS: This was a five-year retrospective open cohort study using secondary data from the National Diabetes Registry. The study setting was all public health clinics (n = 47) in the state of Negeri Sembilan, Malaysia. Time to treatment intensification was defined as the number of years from the index year until the addition of another oral antidiabetic drug or initiation of insulin. Life table survival analysis based on best-worst case scenarios was used to determine the time to treatment intensification. Discrete-time proportional hazards model was fitted for the factors associated with treatment intensification. RESULTS: The mean follow-up duration was 2.6 (SD 1.1) years. Of 7,646 patients, the median time to treatment intensification was 1.29 years (15.5 months), 1.58 years (19.0 months) and 2.32 years (27.8 months) under the best-, average- and worst-case scenarios respectively. The proportion of patients with treatment intensification was 45.4% (95% CI: 44.2-46.5), of which 34.6% occurred only after one year. Younger adults, overweight, obesity, use of antiplatelet medications and poorer HbA1c were positively associated with treatment intensification. Patients treated with more oral antidiabetics were less likely to have treatment intensification. CONCLUSION: Clinical inertia is present in the management of T2D patients in Malaysian public health clinics. We recommend further studies in lower- and middle-income countries to explore its causes so that targeted strategies can be developed to address this issue.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN29, title = {Improvement of nutritional intake for the low-income urban dwellers with hypertension in Malaysia}, author = {N. A. Azizan and H. A. Majid and A. Nahar Mohamed and T. T. Su}, doi = {10.1177/2050312120960563}, issn = {2050-3121 (Print) 2050-3121}, year = {2020}, date = {2020-01-01}, journal = {SAGE Open Med}, volume = {8}, pages = {2050312120960563}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVE: To ascertain the effect of dietary practice modification and a peer-support home blood pressure monitoring program on the nutritional intake (macronutrients and micronutrients), blood pressure and biochemical profiles of hypertension patients in a low-income community setting. METHODS: This is a pre- and post-measurement intervention study conducted in low-income community housing projects in Kuala Lumpur, Malaysia. A total of 90 participants aged 18 years and above with hypertension received intervention. The participants were divided into small groups and received instructions on the use of home blood pressure measurement. They also attended a series of talks on dietary intake modification and exercise demonstration for the first six months (active phase). In another 6 months (maintenance phase), they received only pamphlet and SMS reminders. Their anthropometry, blood pressure, dietary, and biochemical parameter changes were measured at baseline, 6 months, and 12 months of intervention. RESULTS: Macronutrients and micronutrients showed a significant improvement at the end of 12-month dietary intervention. The energy, carbohydrate, protein, total fat, sodium, and potassium are showing significant reduction from baseline to end of the 12-month intervention. There is no significant reduction in blood pressure. Fasting blood glucose, renal sodium, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol showed a significant improvement, after controlling for age and reported physical activity. CONCLUSION: The intervention improved the nutritional intake and biochemical profiles of the low-income urban population with hypertension. This promising result should be replicated in a larger scale study.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN62, title = {Risk of eczema, wheezing and respiratory tract infections in the first year of life: A systematic review of vitamin D concentrations during pregnancy and at birth}, author = {M. A. Mustapa Kamal Basha and H. A. Majid and N. Razali and A. Yahya}, doi = {10.1371/journal.pone.0233890}, issn = {1932-6203}, year = {2020}, date = {2020-01-01}, journal = {PLoS One}, volume = {15}, number = {6}, pages = {e0233890}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Allergic conditions and respiratory tract infections (RTIs) are common causes of morbidity and mortality in childhood. The relationship between vitamin D status in pregnancy (mothers), early life (infants) and health outcomes such as allergies and RTIs in infancy is unclear. To date, studies have shown conflicting results. OBJECTIVE: This systematic review aims to gather and appraise existing evidence on the associations between serum vitamin D concentrations during pregnancy and at birth and the development of eczema, wheezing, and RTIs in infants. DATA SOURCES: PubMed, MEDLINE, ProQuest, Scopus, CINAHL, Cochrane Library and Academic Search Premier databases were searched systematically using specified search terms and keywords. STUDY SELECTION: Articles on the associations between serum vitamin D concentrations during pregnancy and at birth and eczema, wheezing, and RTIs among infants (1-year-old and younger) published up to 31 March 2019 were identified, screened and retrieved. RESULTS: From the initial 2678 articles screened, ten met the inclusion criteria and were included in the final analysis. There were mixed and conflicting results with regards to the relationship between maternal and cord blood vitamin D concentrations and the three health outcomes-eczema, wheezing and RTIs-in infants. CONCLUSION: Current findings revealed no robust and consistent associations between vitamin D status in early life and the risk of developing eczema, wheezing and RTIs in infants. PROSPERO registration no. CRD42018093039.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN120, title = {Dietary Practices and Meal Patterns among Overweight and Obese School Children in Malaysia: Baseline Data from a School-Based Intervention Study}, author = {R. Selamat and J. Raib and N. A. Abdul Aziz and N. Zulkafly and A. N. Ismail and W. Mohamad WNA and N. I. N. Nasruddin and M. Y. Jalaludin and F. Md Zain and Z. Ishak and A. Yahya and A. H. Mokhtar}, doi = {10.1080/03670244.2019.1694922}, issn = {0367-0244}, year = {2020}, date = {2020-01-01}, journal = {Ecol Food Nutr}, volume = {59}, number = {3}, pages = {263-278}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {This study aimed to determine dietary practices and meal patterns among Malaysian overweight and obese school children at baseline. This study was part of a school-based obesity intervention study, My Body is Fit and Fabulous at School (MyBFF@school). It involved 1045 primary and 1041 secondary overweight and obese school children from a randomly selected 23 out of 1196 primary and 15 out of 416 secondary government schools in central Peninsular Malaysia. The results showed a significantly higher of adequate intake (4-8 servings/day) of cereals and grains among primary (54.7%) than secondary school children (48.2%). About 28.2% of primary and 32.6% of secondary school children had consumed adequate fruit (2 servings/day), while a very low percentage of both primary (5.0%) and secondary (3.6%) school children consumed adequate vegetables (3 servings/day). As for the meal patterns, school children in both primary and secondary were not taking breakfast regularly (mean±SD for primary: 3.16 ± 2.61 days/week vs secondary: 2.97 ± 2.52 days/week). There was also a significantly higher mean frequency of primary school children brought plain water to school than the secondary school children. In conclusion, urgent actions to address improper dietary practices and meal patterns of overweight and obese school children in Malaysia are warranted.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN69, title = {The Association Between E-Cigarette Use Behaviors and Saliva Cotinine Concentration Among Healthy E-Cigarette Users in Malaysia}, author = {L. P. Wong and S. N. Mohd Salim and H. Alias and N. Aghamohammadi and V. C. W. Hoe and M. Isahak and M. Ali Mohd}, doi = {10.1097/jan.0000000000000335}, issn = {1088-4602}, year = {2020}, date = {2020-01-01}, journal = {J Addict Nurs}, volume = {31}, number = {2}, pages = {102-109}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Electronic cigarettes (e-cigarettes) have rapidly increased in popularity within the last 2 years in Malaysia. The study aims to understand the association between e-cigarette use behaviors and salivary cotinine (a CYP2AA metabolite of nicotine) concentration to inform the development of future e-cigarette control policies. A convenience sample of saliva from 144 e-cigarette users was obtained between November and December 2015. The study participants used refill liquid containing between 0 and 12 mg/ml of nicotine. The overall median cotinine concentration of the study participants was 81.1 ng/ml (interquartile range = 8.5-195.8). Among the zero-nicotine and single e-cigarette users, the median cotinine level was 51.1 (interquartile range = 8.20-125.35) ng/ml. Factors significantly associated with a higher salivary cotinine concentration were dual use of e-cigarettes and tobacco cigarettes, regular and daily e-cigarette use, a longer duration of e-cigarette use, using a higher amount of e-liquid, and a shorter duration to finish a refill. Multivariate analysis revealed that e-cigarette use of 1-6 and 6-12 months (but not 1 month and below) was significantly associated with a higher cotinine concentration. Cotinine found in zero-nicotine e-liquids implies the importance of stringent regulatory governance for the consistency of labeled nicotine content of e-cigarette liquid in the market. Zero-nicotine e-cigarette users should also be informed of the likelihood of environmental exposure to tobacco smoke. Future studies conducted on larger samples are warranted to validate the association between duration of e-cigarette use and salivary cotinine concentration as well as to investigate underlying mechanisms.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN52, title = {Anxiety symptoms and preventive measures during the COVID-19 outbreak in Taiwan}, author = {L. P. Wong and C. C. Hung and H. Alias and T. S. Lee}, doi = {10.1186/s12888-020-02786-8}, issn = {1471-244x}, year = {2020}, date = {2020-01-01}, journal = {BMC Psychiatry}, volume = {20}, number = {1}, pages = {376}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: It is hypothesized that anxiety and behavioral responses are intense at the beginning of an epidemic. The objective of this study was to investigate anxiety symptoms and use of preventive measures against COVID-19. The study also compared the association between preventive measures and anxiety symptoms during the week immediately preceding the study and those symptoms and measures at the beginning of the outbreak. METHODS: A cross-sectional population survey using an online questionnaire commenced on 14 February 2020. The study participants were residents of Taiwan ages 20 to 70 years. The 6-item state version of the State-Trait Anxiety Inventory (STAI-6) was used to assess anxiety symptoms. The questions about preventive measures asked participants about their personal protection, cough etiquette, contact precautions, voluntary quarantine, and prompt reporting. Multivariable logistic regression was used to determine the factors influencing an increase in the preventive measures scores. RESULTS: Of a total of 3555 completed responses, a total of 52.1% (95% confidence interval [CI] 50.4-53.7) of the respondents reported moderate to severe levels of anxiety symptoms in the past week, whereas 48.8% (95%CI 47.2-50.5) reported moderate to severe anxiety symptoms at the beginning of the outbreak. With a higher score indicating greater anxiety, the median scores for anxiety symptoms in the past week and at the beginning of the outbreak were 46.7 (IQR [interquartile range] 36.7-53.3) and 43.3 (IQR 36.7-53.3), respectively. The median scores for the preventive measures taken in the past week and at the beginning of the outbreak were 26.0 (IQR 21.0-30.0) and 24.0 (IQR 19.0-28.0), respectively, out of a maximum score of 36. In the multivariable analysis, an increased anxiety symptom score from the beginning of the outbreak to the past week (adjusted OR = 7.38, 95%CI 6.28-8.66) was a strongly significant determinant of an increased preventive measures score in the past week compared with the score at the beginning of the outbreak. CONCLUSIONS: Anxiety and preventive measures scores were high and increased with the epidemic rate. Higher anxiety was associated with an increased use of preventive measures against COVID-19.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN99, title = {Cochrane Rehabilitation: 2019 annual report}, author = {C. Arienti and C. Kiekens and R. Bettinsoli and J. P. Engkasan and F. Gimigliano and F. Grubisic and T. Howe and E. Ilieva and S. G. Lazzarini and W. M. Levack and A. Malmivaara and T. Meyer and A. Oral and M. Patrini and J. Pollet and F. A. Rathore and S. Negrini}, doi = {10.23736/s1973-9087.20.06188-2}, issn = {1973-9087}, year = {2020}, date = {2020-01-01}, journal = {Eur J Phys Rehabil Med}, volume = {56}, number = {1}, pages = {120-125}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {During its third year of existence, Cochrane Rehabilitation goals included to point out the main methodological issues in rehabilitation research, and to increase the Knowledge Translation activities. This has been performed through its committees and specific projects. In 2019, Cochrane Rehabilitation worked on five different special projects at different stages of development: 1) a collaboration with the World Health Organization to extract the best evidence for Rehabilitation (Be4rehab); 2) the development of a reporting checklist for Randomised Controlled Trials in rehabilitation (RCTRACK); 3) the definition of what is the rehabilitation for research purposes; 4) the ebook project; and 5) a prioritization exercise for Cochrane Reviews production. The Review Committee finalized the screening and "tagging" of all rehabilitation reviews in the Cochrane library; the Publication Committee increased the number of international journals with which publish Cochrane Corners; the Education Committee continued performing educational activities such as workshops in different meetings; the Methodology Committee performed the second Cochrane Rehabilitation Methodological Meeting and published many papers; the Communication Committee spread the rehabilitation evidence through different channels and translated the contents in different languages. The collaboration with several National and International Rehabilitation Scientific Societies, Universities, Hospitals, Research Centers and other organizations keeps on growing.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN107, title = {The association between methods of biopsy and survival following breast cancer: A hospital registry based cohort study}, author = {Y. C. Kong and N. Bhoo-Pathy and M. O'Rorke and S. Subramaniam and N. T. Bhoo-Pathy and M. H. See and S. Jamaris and K. H. Teoh and A. Z. Bustam and L. M. Looi and N. A. Taib and C. H. Yip}, doi = {10.1097/md.0000000000019093}, issn = {0025-7974 (Print) 0025-7974}, year = {2020}, date = {2020-01-01}, journal = {Medicine (Baltimore)}, volume = {99}, number = {6}, pages = {e19093}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Percutaneous biopsy in breast cancer has been associated with an increased risk of malignant cell seeding. However, the importance of these observations remains obscure due to lack of corroborating evidence from clinical studies. We determined whether method of biopsy is associated with breast cancer survival. This hospital registry-based cohort study included 3416 non-metastatic breast cancer patients diagnosed from 1993 to 2011 in a tertiary setting. Factors associated with biopsy methods were assessed. Multivariable Cox regression analysis was used to determine the independent prognostic impact of method of biopsy. Overall, 990 patients were diagnosed by core needle biopsy (CNB), 1364 by fine needle aspiration cytology (FNAC), and 1062 by excision biopsy. Excision biopsy was significantly associated with more favorable tumor characteristics. Radiotherapy modified the prognostic impact of biopsy method (Pinteraction \< .001). Following multivariable analysis, excision biopsy was consistently associated with lower risk of mortality compared to FNAC in women receiving adjuvant radiotherapy (adjusted hazard ratio: 0.81, 95%CI: 0.66-0.99), but not in those who did not receive adjuvant radiotherapy (adjusted hazard ratio: 0.87, 95%CI: 0.65-1.17). While the risk of mortality was not different between patients undergoing FNAC and CNB when radiotherapy is administered, in the absence of radiotherapy, CNB was associated with higher risk of mortality than FNAC (adjusted hazard ratio: 1.57, 95%CI: 1.16-2.12). Given that our results contradict with findings of previous clinical studies assessing the prognostic impact of method of biopsy in women with breast cancer, further studies are warranted.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN89, title = {Moving towards culturally competent health systems for migrants? Applying systems thinking in a qualitative study in Malaysia and Thailand}, author = {N. S. Pocock and Z. Chan and T. Loganathan and R. Suphanchaimat and H. Kosiyaporn and P. Allotey and W. K. Chan and D. Tan}, doi = {10.1371/journal.pone.0231154}, issn = {1932-6203}, year = {2020}, date = {2020-01-01}, journal = {PLoS One}, volume = {15}, number = {4}, pages = {e0231154}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Cultural competency describes interventions that aim to improve accessibility and effectiveness of health services for people from ethnic minority backgrounds. Interventions include interpreter services, migrant peer educators and health worker training to provide culturally competent care. Very few studies have focussed on cultural competency for migrant service use in Low- and Middle-Income Countries (LMIC). Migrants and refugees in Thailand and Malaysia report difficulties in accessing health systems and discrimination by service providers. In this paper we describe stakeholder perceptions of migrants' and health workers' language and cultural competency, and how this affects migrant workers' health, especially in Malaysia where an interpreter system has not yet been formalised. METHOD: We conducted in-depth interviews with stakeholders in Malaysia (N = 44) and Thailand (N = 50), alongside policy document review in both countries. Data were analysed thematically. Results informed development of Systems Thinking diagrams hypothesizing potential intervention points to improve cultural competency, namely via addressing language barriers. RESULTS: Language ability was a core tenet of cultural competency as described by participants in both countries. Malay was perceived to be an easy language that migrants could learn quickly, with perceived proficiency differing by source country and length of stay in Malaysia. Language barriers were a source of frustration for both migrants and health workers, which compounded communication of complex conditions including mental health as well as obtaining informed consent from migrant patients. Health workers in Malaysia used strategies including google translate and hand gestures to communicate, while migrant patients were encouraged to bring friends to act as informal interpreters during consultations. Current health services are not migrant friendly, which deters use. Concerns around overuse of services by non-citizens among the domestic population may partly explain the lack of policy support for cultural competency in Malaysia. Service provision for migrants in Thailand was more culturally sensitive as formal interpreters, known as Migrant Health Workers (MHW), could be hired in public facilities, as well as Migrant Health Volunteers (MHV) who provide basic health education in communities. CONCLUSION: Perceptions of overuse by migrants in a health system acts as a barrier against system or institutional level improvements for cultural competency, in an already stretched health system. At the micro-level, language interventions with migrant workers appear to be the most feasible leverage point but raises the question of who should bear responsibility for cost and provision-employers, the government, or migrants themselves.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN53, title = {Genome-Wide Association Study Data Reveal Genetic Susceptibility to Chronic Inflammatory Intestinal Diseases and Pancreatic Ductal Adenocarcinoma Risk}, author = {F. Yuan and R. J. Hung and N. Walsh and H. Zhang and E. A. Platz and W. Wheeler and L. Song and A. A. Arslan and L. E. Beane Freeman and P. Bracci and F. Canzian and M. Du and S. Gallinger and G. G. Giles and P. J. Goodman and C. Kooperberg and L. Le Marchand and R. E. Neale and J. Rosendahl and G. Scelo and X. O. Shu and K. Visvanathan and E. White and W. Zheng and D. Albanes and P. Amiano and G. Andreotti and A. Babic and W. R. Bamlet and S. I. Berndt and P. Brennan and B. Bueno-de-Mesquita and J. E. Buring and P. T. Campbell and S. J. Chanock and C. S. Fuchs and J. M. Gaziano and M. G. Goggins and T. Hackert and P. Hartge and M. M. Hassan and E. A. Holly and R. N. Hoover and V. Katzke and H. Kirsten and R. C. Kurtz and I. M. Lee and N. Malats and R. L. Milne and N. Murphy and K. Ng and A. L. Oberg and M. Porta and K. G. Rabe and F. X. Real and N. Rothman and H. D. Sesso and D. T. Silverman and I. M. Thompson and J. Wactawski-Wende and X. Wang and N. Wentzensen and L. R. Wilkens and H. Yu and A. Zeleniuch-Jacquotte and J. Shi and E. J. Duell and L. T. Amundadottir and D. Li and G. M. Petersen and B. M. Wolpin and H. A. Risch and K. Yu and A. P. Klein and R. Stolzenberg-Solomon}, doi = {10.1158/0008-5472.Can-20-0447}, issn = {0008-5472 (Print) 0008-5472}, year = {2020}, date = {2020-01-01}, journal = {Cancer Res}, volume = {80}, number = {18}, pages = {4004-4013}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Registry-based epidemiologic studies suggest associations between chronic inflammatory intestinal diseases and pancreatic ductal adenocarcinoma (PDAC). As genetic susceptibility contributes to a large proportion of chronic inflammatory intestinal diseases, we hypothesize that the genomic regions surrounding established genome-wide associated variants for these chronic inflammatory diseases are associated with PDAC. We examined the association between PDAC and genomic regions (±500 kb) surrounding established common susceptibility variants for ulcerative colitis, Crohn's disease, inflammatory bowel disease, celiac disease, chronic pancreatitis, and primary sclerosing cholangitis. We analyzed summary statistics from genome-wide association studies data for 8,384 cases and 11,955 controls of European descent from two large consortium studies using the summary data-based adaptive rank truncated product method to examine the overall association of combined genomic regions for each inflammatory disease group. Combined genomic susceptibility regions for ulcerative colitis, Crohn disease, inflammatory bowel disease, and chronic pancreatitis were associated with PDAC at P values \< 0.05 (0.0040, 0.0057, 0.011, and 3.4 × 10(-6), respectively). After excluding the 20 PDAC susceptibility regions (±500 kb) previously identified by GWAS, the genomic regions for ulcerative colitis, Crohn disease, and inflammatory bowel disease remained associated with PDAC (P = 0.0029, 0.0057, and 0.0098, respectively). Genomic regions for celiac disease (P = 0.22) and primary sclerosing cholangitis (P = 0.078) were not associated with PDAC. Our results support the hypothesis that genomic regions surrounding variants associated with inflammatory intestinal diseases, particularly, ulcerative colitis, Crohn disease, inflammatory bowel disease, and chronic pancreatitis are associated with PDAC. SIGNIFICANCE: The joint effects of common variants in genomic regions containing susceptibility loci for inflammatory bowel disease and chronic pancreatitis are associated with PDAC and may provide insights to understanding pancreatic cancer etiology.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN136, title = {Financial toxicity and its associations with health-related quality of life among urologic cancer patients in an upper middle-income country}, author = {C. Y. Ting and G. C. Teh and K. L. Yu and H. Alias and H. M. Tan and L. P. Wong}, doi = {10.1007/s00520-019-04975-y}, issn = {0941-4355}, year = {2020}, date = {2020-01-01}, journal = {Support Care Cancer}, volume = {28}, number = {4}, pages = {1703-1715}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: This study examined the prevalence of financial toxicity (FT) and associated factors among urologic cancer patients. The association between FT and health-related quality of life (HRQoL) was also investigated. METHODS: A total of 429 respondents diagnosed with urologic cancers (prostate cancer, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed using a structured questionnaire. Objective and subjective FT were measured by catastrophic health expenditure (healthcare-cost-to-income ratio greater than 40%) and the Personal Financial Well-being Scale, respectively. HRQoL was measured with the Functional Assessment of Cancer Therapy - General 7 Items scale. RESULTS: Objective and subjective FT were experienced by 16.1 and 47.3% of the respondents, respectively. Respondents who sought treatment at a private hospital and had out-of-pocket health expenditures were more likely to experience objective FT, after adjustment for covariates. Respondents who were female and had a monthly household income less than MYR 5000 were more likely to experience average to high subjective FT. Greater objective FT (OR = 2.75, 95% CI 1.09-6.95) and subjective FT (OR = 4.68, 95% CI 2.63-8.30) were associated with poor HRQoL. CONCLUSIONS: The significant association between both objective and subjective FT and HRQoL highlights the importance of reducing FT among urologic cancer patients. Subjective FT was found to have a greater negative impact on HRQoL.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN149, title = {Latest Updates in Dengue Fever Therapeutics: Natural, Marine and Synthetic Drugs}, author = {S. Hosseini and R. B. Mu\~{n}oz-Soto and J. Oliva-Ram\'{i}rez and P. V\'{a}zquez-Villegas and N. Aghamohammadi and A. Rodriguez-Garcia and S. O. Martinez-Chapa}, doi = {10.2174/0929867325666180629124709}, issn = {0929-8673}, year = {2020}, date = {2020-01-01}, journal = {Curr Med Chem}, volume = {27}, number = {5}, pages = {719-744}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {In this paper, we review the history of Dengue, the mechanism of infection, the molecular characteristics and components of Dengue, the mechanism of entry to the target cells, cyclization of the genome and replication process, as well as translation of the proteins for virus assembly. The major emphasis of this work is on natural products and plant extracts, which were used for as palliative or adjuvant treatment of Dengue. This review article also summarizes the latest findings in regards to the marine products as effective drugs to target different symptoms of Dengue. Furthermore, an update on synthetic drugs for treating Dengue is provided in this review. As a novel alternative, we describe monoclonal antibody therapy for Dengue management and treatment.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN26, title = {School-Based Intervention to Improve Healthy Eating Practices Among Malaysian Adolescents: A Feasibility Study Protocol}, author = {S. Mohammadi and T. T. Su and M. Y. Jalaludin and M. Dahlui and M. N. Azmi Mohamed and A. Papadaki and R. Jago and Z. Toumpakari and H. A. Majid}, doi = {10.3389/fpubh.2020.549637}, issn = {2296-2565 (Print) 2296-2565}, year = {2020}, date = {2020-01-01}, journal = {Front Public Health}, volume = {8}, pages = {549637}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Introduction: School environments can influence students' dietary habits. Hence, implementing a healthy canteen intervention programme in schools is a recommended strategy to improve students' dietary intake. This study will evaluate the feasibility of providing healthier food and beverage options in selected secondary schools in Malaysia by working with canteen vendors. It also will assess the changes in food choices before and after the intervention. Methods: A feasibility cluster randomised controlled study will be conducted in six secondary schools (intervention}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN61, title = {Genome-Wide Gene-Diabetes and Gene-Obesity Interaction Scan in 8,255 Cases and 11,900 Controls from PanScan and PanC4 Consortia}, author = {H. Tang and L. Jiang and R. Z. Stolzenberg-Solomon and A. A. Arslan and L. E. Beane Freeman and P. M. Bracci and P. Brennan and F. Canzian and M. Du and S. Gallinger and G. G. Giles and P. J. Goodman and C. Kooperberg and L. Le Marchand and R. E. Neale and X. O. Shu and K. Visvanathan and E. White and W. Zheng and D. Albanes and G. Andreotti and A. Babic and W. R. Bamlet and S. I. Berndt and A. Blackford and B. Bueno-de-Mesquita and J. E. Buring and D. Campa and S. J. Chanock and E. Childs and E. J. Duell and C. Fuchs and J. M. Gaziano and M. Goggins and P. Hartge and M. H. Hassam and E. A. Holly and R. N. Hoover and R. J. Hung and R. C. Kurtz and I. M. Lee and N. Malats and R. L. Milne and K. Ng and A. L. Oberg and I. Orlow and U. Peters and M. Porta and K. G. Rabe and N. Rothman and G. Scelo and H. D. Sesso and D. T. Silverman and Jr. I. M. Thompson and A. Tj\onneland and A. Trichopoulou and J. Wactawski-Wende and N. Wentzensen and L. R. Wilkens and H. Yu and A. Zeleniuch-Jacquotte and L. T. Amundadottir and E. J. Jacobs and G. M. Petersen and B. M. Wolpin and H. A. Risch and N. Chatterjee and A. P. Klein and D. Li and P. Kraft and P. Wei}, doi = {10.1158/1055-9965.Epi-20-0275}, issn = {1055-9965 (Print) 1055-9965}, year = {2020}, date = {2020-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {29}, number = {9}, pages = {1784-1791}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Obesity and diabetes are major modifiable risk factors for pancreatic cancer. Interactions between genetic variants and diabetes/obesity have not previously been comprehensively investigated in pancreatic cancer at the genome-wide level. METHODS: We conducted a gene-environment interaction (GxE) analysis including 8,255 cases and 11,900 controls from four pancreatic cancer genome-wide association study (GWAS) datasets (Pancreatic Cancer Cohort Consortium I-III and Pancreatic Cancer Case Control Consortium). Obesity (body mass index ≥30 kg/m(2)) and diabetes (duration ≥3 years) were the environmental variables of interest. Approximately 870,000 SNPs (minor allele frequency ≥0.005, genotyped in at least one dataset) were analyzed. Case-control (CC), case-only (CO), and joint-effect test methods were used for SNP-level GxE analysis. As a complementary approach, gene-based GxE analysis was also performed. Age, sex, study site, and principal components accounting for population substructure were included as covariates. Meta-analysis was applied to combine individual GWAS summary statistics. RESULTS: No genome-wide significant interactions (departures from a log-additive odds model) with diabetes or obesity were detected at the SNP level by the CC or CO approaches. The joint-effect test detected numerous genome-wide significant GxE signals in the GWAS main effects top hit regions, but the significance diminished after adjusting for the GWAS top hits. In the gene-based analysis, a significant interaction of diabetes with variants in the FAM63A (family with sequence similarity 63 member A) gene (significance threshold P \< 1.25 × 10(-6)) was observed in the meta-analysis (P (GxE) = 1.2 ×10(-6), P (Joint) = 4.2 ×10(-7)). CONCLUSIONS: This analysis did not find significant GxE interactions at the SNP level but found one significant interaction with diabetes at the gene level. A larger sample size might unveil additional genetic factors via GxE scans. IMPACT: This study may contribute to discovering the mechanism of diabetes-associated pancreatic cancer.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN70, title = {Comparing a Social and Communication App, Telephone Intervention, and Usual Care for Diabetes Self-Management: 3-Arm Quasiexperimental Evaluation Study}, author = {C. J. Chiu and Y. C. Yu and Y. F. Du and Y. C. Yang and J. Y. Chen and L. P. Wong and C. Tanasugarn}, doi = {10.2196/14024}, issn = {2291-5222}, year = {2020}, date = {2020-01-01}, journal = {JMIR Mhealth Uhealth}, volume = {8}, number = {6}, pages = {e14024}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Many technology-assisted innovations have been used to manage disease. However, most of these innovations are not broadly used by older adults due to their cost. Additionally, disease management through technology-assisted innovations has not been compared with other interventions. OBJECTIVE: In this study, we tested the employment of a free and widely used social and communication app to help older adults with diabetes manage their distress and glycemic control. We also compared the effectiveness of the app with 2 other methods, namely telephone and conventional health education, and determined which subgroup experiences the most effects within each intervention. METHODS: Adults aged ≥50 years with type 2 diabetes were recruited from Southern Taiwan (N=231) and were allocated to different 3-month interventions. Informed consent was obtained at the Ministry of Science and Technology and approved by the National Cheng Kung University Hospital Institutional Review Board (No. A-ER-102-425). RESULTS: Participants in the mobile-based group had significant reductions in hemoglobin A1c compared with the telephone-based and usual care groups (mean changes of -0.4%, 0.1%, and 0.03%, respectively; P=.02). Diabetes-specific distress decreased to a greater extent in the mobile-based group compared to the other 2 groups (mean changes of -5.16, -3.49, and -2.44, respectively}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN73, title = {The effect of mindfulness-based training on stress, anxiety, depression and job satisfaction among ward nurses: A randomized control trial}, author = {S. F. Ghawadra and K. Lim Abdullah and W. Y. Choo and M. Danaee and C. K. Phang}, doi = {10.1111/jonm.13049}, issn = {0966-0429}, year = {2020}, date = {2020-01-01}, journal = {J Nurs Manag}, volume = {28}, number = {5}, pages = {1088-1097}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {AIM: To assess the effect of a 4-week mindfulness-based training intervention on improving stress, anxiety, depression and job satisfaction among ward nurses. BACKGROUND: Previous literature showed that mindfulness-based training is useful for helping nurses cope with stress. METHOD: Nurses who have mild to moderate levels of stress, anxiety and depression identified from a teaching hospital were invited to a randomized control trial. The intervention group had a 2-hr Mindfulness-Based Training workshop, followed by 4 weeks of guided self-practice Mindfulness-Based Training website. Both the intervention group (n = 118) and the control group (n = 106) were evaluated pre- and post-intervention, and 8 weeks later (follow-up) using the Depression, Anxiety, and Stress Scale-21, Job Satisfaction Scale and Mindful Attention Awareness Scale. RESULTS: There was a significant effect over time on stress, anxiety, depression and mindfulness level (p \< .05). Regarding the difference between the groups and interaction between time and group, there was a significant effect for anxiety (p = .037 p = .008) and job satisfaction (p \< .001}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN30, title = {Oncological safety and postoperative complications in oncoplastic breast surgery among Asian women: A single institutional review}, author = {L. Y. Teoh and L. L. Lai and A. Hanim Aa and M. S. Teh and S. Jamaris and A. Yahya and K. H. Ng and M. H. See}, doi = {10.1111/tbj.14060}, issn = {1075-122x}, year = {2020}, date = {2020-01-01}, journal = {Breast J}, volume = {26}, number = {11}, pages = {2208-2212}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Oncoplastic breast surgery (OBS) improves margin clearance and produces good esthetic outcome in breast cancer treatment. This study evaluates the complications and outcome of OBS in a multiracial patient cohort. Data of 421 patients between 2011 and 2018 were analyzed. The majority were Malays (41.8%), followed by Chinese (39.7%) and Indians (16.8%). Low local complications were noted, with no significant differences in disease-free survival (P = .927) and overall survival (P = .719) between low and high OBS levels. Shared decision-making in offering OBS for Asian women has potential to become a practical option in breast cancer treatment.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN66, title = {Prediction of the Influential Factors on Eating Behaviors: A Hybrid Model of Structural Equation Modelling-Artificial Neural Networks}, author = {M. M. Kheirollahpour and M. M. Danaee and Afaf Merican and Aaaa Shariff}, doi = {10.1155/2020/4194293}, issn = {2356-6140 (Print) 1537-744x}, year = {2020}, date = {2020-01-01}, journal = {ScientificWorldJournal}, volume = {2020}, pages = {4194293}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {The importance of eating behavior risk factors in the primary prevention of obesity has been established. Researchers mostly use the linear model to determine associations among these risk factors. However, in reality, the presence of nonlinearity among these factors causes a bias in the prediction models. The aim of this study was to explore the potential of a hybrid model to predict the eating behaviors. The hybrid model of structural equation modelling (SEM) and artificial neural networks (ANN) was applied to evaluate the prediction model. The SEM analysis was used to check the relationship of the emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) and their effect on different categories of eating behavior patterns (EBP). In the second step, the input and output required for ANN analysis were obtained from SEM analysis and were applied in the neural network model. 340 university students participated in this study. The hybrid model (SEM-ANN) was conducted using multilayer perceptron (MLP) with feed-forward network topology. Moreover, Levenberg-Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The tangent/sigmoid function was used for the input layer, while the linear function was applied for the output layer. The coefficient of determination (R (2)) and mean square error (MSE) were calculated. Using the hybrid model, the optimal network happened at MLP 3-17-8. It was proved that the hybrid model was superior to SEM methods because the R (2) of the model was increased by 27%, while the MSE was decreased by 9.6%. Moreover, it was found that BSC, BAS, and EES significantly affected healthy and unhealthy eating behavior patterns. Thus, a hybrid approach could be suggested as a significant methodological contribution from a machine learning standpoint, and it can be implemented as software to predict models with the highest accuracy.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN32, title = {Mendelian Randomization Analysis of n-6 Polyunsaturated Fatty Acid Levels and Pancreatic Cancer Risk}, author = {D. H. Ghoneim and J. Zhu and W. Zheng and J. Long and H. J. Murff and F. Ye and V. W. Setiawan and L. R. Wilkens and N. K. Khankari and P. Haycock and S. O. Antwi and Y. Yang and A. A. Arslan and L. E. Beane Freeman and P. M. Bracci and F. Canzian and M. Du and S. Gallinger and G. G. Giles and P. J. Goodman and C. Kooperberg and L. Le Marchand and R. E. Neale and G. Scelo and K. Visvanathan and E. White and D. Albanes and P. Amiano and G. Andreotti and A. Babic and W. R. Bamlet and S. I. Berndt and L. K. Brais and P. Brennan and B. Bueno-de-Mesquita and J. E. Buring and P. T. Campbell and K. G. Rabe and S. J. Chanock and P. Duggal and C. S. Fuchs and J. M. Gaziano and M. G. Goggins and T. Hackert and M. M. Hassan and K. J. Helzlsouer and E. A. Holly and R. N. Hoover and V. Katske and R. C. Kurtz and I. M. Lee and N. Malats and R. L. Milne and N. Murphy and A. L. Oberg and M. Porta and N. Rothman and H. D. Sesso and D. T. Silverman and Jr. I. M. Thompson and J. Wactawski-Wende and X. Wang and N. Wentzensen and H. Yu and A. Zeleniuch-Jacquotte and K. Yu and B. M. Wolpin and E. J. Jacobs and E. J. Duell and H. A. Risch and G. M. Petersen and L. T. Amundadottir and P. Kraft and A. P. Klein and R. Z. Stolzenberg-Solomon and X. O. Shu and L. Wu}, doi = {10.1158/1055-9965.Epi-20-0651}, issn = {1055-9965 (Print) 1055-9965}, year = {2020}, date = {2020-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {29}, number = {12}, pages = {2735-2739}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Whether circulating polyunsaturated fatty acid (PUFA) levels are associated with pancreatic cancer risk is uncertain. Mendelian randomization (MR) represents a study design using genetic instruments to better characterize the relationship between exposure and outcome. METHODS: We utilized data from genome-wide association studies within the Pancreatic Cancer Cohort Consortium and Pancreatic Cancer Case-Control Consortium, involving approximately 9,269 cases and 12,530 controls of European descent, to evaluate associations between pancreatic cancer risk and genetically predicted plasma n-6 PUFA levels. Conventional MR analyses were performed using individual-level and summary-level data. RESULTS: Using genetic instruments, we did not find evidence of associations between genetically predicted plasma n-6 PUFA levels and pancreatic cancer risk [estimates per one SD increase in each PUFA-specific weighted genetic score using summary statistics: linoleic acid odds ratio (OR) = 1.00, 95% confidence interval (CI) = 0.98-1.02; arachidonic acid OR = 1.00, 95% CI = 0.99-1.01; and dihomo-gamma-linolenic acid OR = 0.95, 95% CI = 0.87-1.02]. The OR estimates remained virtually unchanged after adjustment for covariates, using individual-level data or summary statistics, or stratification by age and sex. CONCLUSIONS: Our results suggest that variations of genetically determined plasma n-6 PUFA levels are not associated with pancreatic cancer risk. IMPACT: These results suggest that modifying n-6 PUFA levels through food sources or supplementation may not influence risk of pancreatic cancer.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN110, title = {Translation and Validation of the Breast Cancer Awareness Measurement Tool in Malaysia (B-CAM-M)}, author = {M. N. N. Htay and M. Donnelly and D. Schliemann and S. Y. Loh and M. Dahlui and N. S. B. Ibrahim Tamin and S. Somasundaram and T. T. Su}, doi = {10.31557/apjcp.2020.21.1.217}, issn = {1513-7368 (Print) 1513-7368}, year = {2020}, date = {2020-01-01}, journal = {Asian Pac J Cancer Prev}, volume = {21}, number = {1}, pages = {217-223}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Breast cancer is the most common cancer among women in Malaysia, and the incidence of 31.1 per 100,000 population is comparatively higher than other Southeast Asian countries. Diagnosis tends to occur at later stages which may be due, partly, to inadequate knowledge about warning signs and symptoms. Therefore, this study investigated the validity and reliability of a UK-developed measure in the context of assessing women's awareness of breast cancer in Malaysia. AIMS: This study aimed to translate, adapt and validate the internationally recognised Breast Cancer Awareness Measure (B-CAM) into the Malay language. METHODS: The original B-CAM (Cancer Research UK) was forward and backward translated and content validation was ascertained. Face validity (n=30), test-retest reliability (n=50) and the internal consistency of the B-CAM-M (M for Malay language) were assessed in a community sample of adults (n=251) in 2018. RESULTS: The translated B-CAM-M was validated by an expert panel. The Item-Content Validity Index ranged from .83 to 1.00. The results from the survey (n=251) indicated that the B-CAM-M was well received by Malay-speaking women across the main ethnic groups (85 Malay, 84 Chinese and 82 Indian adults). Cronbach alpha scores for the knowledge about breast cancer symptoms (0.83) and the barriers to healthcare seeking items (0.75) were high. Test-retest reliability (separated by 2-week-interval) with 50 randomly selected participants from the community survey produced intra-class correlations ranging from 0.39 to 0.69. CONCLUSION: The Malay-version, the B-CAM-M, is a culturally acceptable, valid and reliable assessment tool with which to measure breast cancer awareness among Malay-speaking women.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN111, title = {Vaccine hesitancy and the resurgence of vaccine preventable diseases: the way forward for Malaysia, a Southeast Asian country}, author = {L. P. Wong and P. F. Wong and S. AbuBakar}, doi = {10.1080/21645515.2019.1706935}, issn = {2164-5515 (Print) 2164-5515}, year = {2020}, date = {2020-01-01}, journal = {Hum Vaccin Immunother}, volume = {16}, number = {7}, pages = {1511-1520}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {This study engaged health professionals in in-depth, semi-structured interviews to explore their opinions concerning the issues surrounding vaccine hesitancy in Malaysia and strategies to improve vaccination to stamp the rise of vaccine preventable diseases (VPDs). Opinions on how to address the resurgence of VPDs in the era of increasing vaccine hesitancy were obtained. Eight health professionals, including geriatricians, pediatricians, microbiologists, public health specialists, and family medicine specialists were interviewed. The influence of anti-vaccination propaganda, past-experience of adverse event following immunization (AEFI), perceived religious prohibition, a belief that traditional complementary and alternative medicine (TCAM) use is safer, pseudoscience beliefs, and anti-vaccine conspiracy theories were identified as reasons for refusing to vaccinate. The interplay of social, cultural and religious perspectives in influencing perceived religious prohibition, pseudoscience beliefs, and the use of TCAM contributing to vaccine refusal was found. Five broad themes emerged from the health professionals regarding strategies to address vaccine hesitancy, including establishing an electronic vaccination registry, increasing public awareness initiatives, providing feedback to the public on the findings of AEFI, training of front-line healthcare providers, and banning the dissemination of anti-vaccine information via social media. With regards to identifying strategies to address the resurgence of VPDs, mandatory vaccination received mixed opinions; many viewed supplementary immunization activity and the prevention of travel and migration of unvaccinated individuals as being necessary. In conclusion, the present study identified unique local cultural, traditional and religious beliefs that could contribute to vaccine hesitancy in addition to issues surrounding vaccination refusal similarly faced by other countries around the world. This information are important for the formulation of targeted intervention strategies to stamp vaccine hesitancy in Malaysia which are also a useful guide for other countries especially in the Southeast Asia region facing similar vaccine hesitancy issues.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN121, title = {A nutrient-wide association study for risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition and the Netherlands Cohort Study}, author = {N. Papadimitriou and D. Muller and P. A. Brandt and M. Geybels and C. J. Patel and M. J. Gunter and D. S. Lopez and T. J. Key and A. Perez-Cornago and P. Ferrari and P. Vineis and E. Weiderpass and H. Boeing and A. Agudo and M. J. S\'{a}nchez and K. Overvad and T. K\"{u}hn and R. T. Fortner and D. Palli and I. Drake and A. Bjartell and C. Santiuste and B. H. Bueno-de-Mesquita and V. Krogh and A. Tj\onneland and D. F. Lauritzen and A. B. Gurrea and J. R. Quir\'{o}s and P. Stattin and A. Trichopoulou and G. Martimianaki and A. Karakatsani and E. Thysell and I. Johansson and F. Ricceri and R. Tumino and N. Larra\~{n}aga and K. T. Khaw and E. Riboli and I. Tzoulaki and K. K. Tsilidis}, doi = {10.1007/s00394-019-02132-z}, issn = {1436-6207 (Print) 1436-6207}, year = {2020}, date = {2020-01-01}, journal = {Eur J Nutr}, volume = {59}, number = {7}, pages = {2929-2937}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: The evidence from the literature regarding the association of dietary factors and risk of prostate cancer is inconclusive. METHODS: A nutrient-wide association study was conducted to systematically and comprehensively evaluate the associations between 92 foods or nutrients and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox proportional hazard regression models adjusted for total energy intake, smoking status, body mass index, physical activity, diabetes and education were used to estimate hazard ratios and 95% confidence intervals for standardized dietary intakes. As in genome-wide association studies, correction for multiple comparisons was applied using the false discovery rate (FDR \< 5%) method and suggested results were replicated in an independent cohort, the Netherlands Cohort Study (NLCS). RESULTS: A total of 5916 and 3842 incident cases of prostate cancer were diagnosed during a mean follow-up of 14 and 20 years in EPIC and NLCS, respectively. None of the dietary factors was associated with the risk of total prostate cancer in EPIC (minimum FDR-corrected P, 0.37). Null associations were also observed by disease stage, grade and fatality, except for positive associations observed for intake of dry cakes/biscuits with low-grade and butter with aggressive prostate cancer, respectively, out of which the intake of dry cakes/biscuits was replicated in the NLCS. CONCLUSIONS: Our findings provide little support for an association for the majority of the 92 examined dietary factors and risk of prostate cancer. The association of dry cakes/biscuits with low-grade prostate cancer warrants further replication given the scarcity in the literature.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN123, title = {Circulating miR-3197 and miR-2116-5p as novel biomarkers for diabetic retinopathy}, author = {H. Ji and Q. Yi and L. Chen and L. Wong and Y. Liu and G. Xu and J. Zhao and T. Huang and B. Li and Y. Yang and W. Li and L. Han and S. Duan}, doi = {10.1016/j.cca.2019.10.036}, issn = {0009-8981}, year = {2020}, date = {2020-01-01}, journal = {Clin Chim Acta}, volume = {501}, pages = {147-153}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Diabetic retinopathy (DR) is the leading cause of vision loss among older adults. The goal of this case-control study was to identify circulating miRNAs for the diagnosis of DR. The miRNeasy Serum/Plasma Kit was used to extract serum miRNAs. The μParaflo™ MicroRNA microarray was used to detect the expression levels of the miRNAs. The miRWalk algorithm was applied to predict the target genes of the miRNAs, which were further confirmed by the dual luciferase reporter gene system in HEK293T cells. A microarray was performed between 5 DR cases and 5 age-, sex-, body mass index-, and duration of diabetes-matched type 2 diabetic (T2DM) controls. The quantitative reverse transcription polymerase chain reaction technique was used to validate the differentially expressed circulating miRNAs in 45 DR cases and 45 well-matched controls. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the circulating miRNAs as diagnostic biomarkers for DR. Our microarray analysis screened out miR-2116-5p and miR-3197 as significantly up-regulated in DR cases compared with the controls. Furthermore, two miRNAs were validated in the 45 DR cases and 45 controls. The ROC analysis suggested that both miR-3197 and miR-2116-5p distinguished DR cases from controls. An additional dual-luciferase reporter gene assay confirmed that notch homolog 2 (NOTCH2) was the target gene of miR-2116-5p. Both miR-3197 and miR-2116-5p were identified as promising diagnostic biomarkers for DR. Future research is still needed to explore the molecular mechanisms of miR-3197 and miR-2116-5p in the pathogenesis of DR.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN33, title = {Nursing practice environment, resilience, and intention to leave among critical care nurses}, author = {L. Y. Ying and V. Ramoo and L. W. Ling and S. T. Nahasaram and C. P. Lei and L. K. Leong and M. Danaee}, doi = {10.1111/nicc.12551}, issn = {1362-1017}, year = {2020}, date = {2020-01-01}, journal = {Nurs Crit Care}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Retaining experienced critical care nurses (CCNs) remains a challenge for health care organizations. Nursing practice environment and resilience are both seen as modifiable factors in ameliorating the impact on CCNs' intention to leave and have not yet been explored in Malaysia. AIMS AND OBJECTIVES: To assess the association between perceived nursing practice environment, resilience, and intention to leave among CCNs and to determine the effect of resilience on intention to leave after controlling for other independent variables. DESIGN: This was a cross-sectional survey. METHODS: The universal sampling method was used to recruit nurses from adult and paediatric (including neonatal) critical care units of a large public university hospital in Malaysia. Descriptive analysis and χ(2) and hierarchical logistic regression tests were used to analyse the data. RESULTS: A total of 229 CCNs completed the self-administrated questionnaire. Of the nurses, 76.4% perceived their practice environment as being favourable, 54.1% were moderately resilient, and only 20% were intending to leave. The logistic regression model explained 13.1% of variance in intention to leave and suggested that being single, an unfavourable practice environment, and increasing resilience were significant predictors of nurses' intention to leave. CONCLUSION: This study found that an unfavourable practice environment is a strong predictor of intention to leave; however, further exploration is needed to explain the higher likelihood of expressing intention to leave among CCNs when their resilience level increases. RELEVANCE TO CLINICAL PRACTICE: Looking into staff allocation and equality of workload assignments may improve the perception of the work environment and help minimize intention to leave among nurses.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN124, title = {Predictors of low back pain among secondary school teachers in Malaysia: a longitudinal study}, author = {E. N. Zamri and V. C. W. Hoe and F. M. Moy}, doi = {10.2486/indhealth.2019-0106}, issn = {0019-8366 (Print) 0019-8366}, year = {2020}, date = {2020-01-01}, journal = {Ind Health}, volume = {58}, number = {3}, pages = {254-264}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Low back pain (LBP) is prevalent among workers both in developed and developing countries. School teachers represent a high proportion of the working population in Malaysia. However, there is a lack of longitudinal study on predictors and course of LBP among teachers. Therefore, this study aimed to determine the predictors and course of LBP among secondary school teachers. Longitudinal data of 701 teachers in Selangor, Malaysia were collected from May 2015 to October 2016. Associations between predictors and LBP were analysed using logistic regression and reported as odds ratio (OR) and 95% confidence interval (CI). At 12-month of follow-up, 44% (95%CI: 40.6%, 48.0%) of the participants reported having LBP. In the regression model that included all risk factors, only LBP at baseline (OR 10.43, 95%CI: 6.19, 17.58) was associated with LBP at 12-month follow-up. When LBP at baseline was removed from the model, anxiety symptom (OR 2.51, 95%CI: 1.19, 5.30) and lifting heavy weights (OR 4.16, 95%CI: 1.40, 12.30) were found to be significantly associated with LBP at 12-month follow-up. In conclusion, issues on anxiety and lifting heavy weights should be addressed to reduce the occurrence of LBP despite the presence of health condition itself (LBP at baseline).}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN91, title = {Change in public awareness of colorectal cancer symptoms following the Be Cancer Alert Campaign in the multi-ethnic population of Malaysia}, author = {D. Schliemann and D. Paramasivam and M. Dahlui and C. R. Cardwell and S. Somasundaram and N. S. B. Ibrahim Tamin and C. Donnelly and T. T. Su and M. Donnelly}, doi = {10.1186/s12885-020-06742-3}, issn = {1471-2407}, year = {2020}, date = {2020-01-01}, journal = {BMC Cancer}, volume = {20}, number = {1}, pages = {252}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Colorectal cancer (CRC) cases are detected late in Malaysia similar to most Asian countries. The Be Cancer Alert Campaign (BCAC) was a culturally adapted mass media campaign designed to improve CRC awareness and reduce late detection in Malaysia. The evaluation of the BCAC-CRC aimed to assess campaign reach, campaign impact and health service use. METHODS: Participants aged ≥40 years (n = 730) from randomly selected households in Selangor State Malaysia, completed interview-based assessments. Campaign reach was assessed in terms of responses to an adapted questionnaire that was used in evaluations in other countries. The impact of the campaign was assessed in terms of awareness, confidence to detect symptoms and self-efficacy to discuss symptoms with a doctor as captured by the Cancer Awareness Measure (CAM). CAM was administered before-and-after campaign implementation and responses by BCAC recognisers (i.e. participants who recognised one or more of the BCAC television, radio or print advertisements when prompted) and non-recognisers (i.e. participants who did not recognise any of the BCAC advertisements) were compared analytically. Logistic regression analysed comparative differences in cancer awareness by socio-demographic characteristics and recognition of the BCAC materials. RESULTS: Over 65% of participants (n = 484) recognised the BCAC-CRC. Campaign-recognisers were significantly more likely to be aware of each CRC symptom at follow-up and were more confident about noticing symptoms (46.9% vs 34.9%}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN64, title = {Impact of migraine on workplace productivity and monetary loss: a study of employees in banking sector in Malaysia}, author = {L. P. Wong and H. Alias and N. Bhoo-Pathy and I. Chung and Y. C. Chong and S. Kalra and Zubs Shah}, doi = {10.1186/s10194-020-01144-z}, issn = {1129-2369 (Print) 1129-2369}, year = {2020}, date = {2020-01-01}, journal = {J Headache Pain}, volume = {21}, number = {1}, pages = {68}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND/OBJECTIVE: Productivity and monetary loss due to migraine in the workplace may be substantial. This study aimed to determine the impact of migraine on productivity and monetary lost among employees in the banking sectors, in a multiethnic middle income country. METHODS: A cross-sectional online survey was conducted among employees in two multinational banks in Malaysia between April and July 2019. Screening for migraine was conducted using the self-administered ID-Migraine™ questionnaire. Migraine-related disability (MIDAS) and headache frequency were recorded. Impact of migraine on work productivity and activities were evaluated using the Work Productivity and Activity Impairment (WPAI) questionnaire. RESULTS: Of the 1268 employees who submitted complete responses, 47.2% (n = 598) were screened positive for migraine. Strikingly, the mean percent productivity loss at work (presenteeism) was almost 20-fold higher than the mean percent work time missed due to migraine (absenteeism) (39.1% versus 1.9%). The mean percent productivity loss in regular activity (activity impairment) and overall work productivity loss (work impairment) was 38.4% and 39.9%, respectively. It was also found that the costs related to presenteeism (MYR 5392.6) (US$1296) was 3.5-fold higher than absenteeism (MYR1,548.3) (US$370). Highest monetary loss related to presenteeism was reported in migraineurs with frequency of headache of above 3 days (MYR 25,691.2) (US$6176), whereas highest monetary loss related to absenteeism was reported in migraineurs with MIDAS grade IV (MYR 12,369.1) (US$2973). Only 30% of migraineurs of MIDAS grade IV reported taking prescribed medication. Notably, a vast majority (96%) of migraineurs who had three or lower episodes of migraine per month did not seek treatment. CONCLUSION: The significant impact of migraine on work productivity and regular activity, appears to lead to substantial monetary loss attributed to not only absenteeism, but more importantly to presenteeism. This study also highlights the unmet needs in migraine management among employees in the banking sector.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN48, title = {From the MJM Editors' Desk: Common errors authors make in submission to the Medical Journal of Malaysia}, author = {L. Rampal and B. S. Liew and P. Oothuman and R. Philip and S. Mohd Sidik and V. C. Hoe and A. Baharudin}, issn = {0300-5283 (Print) 0300-5283}, year = {2020}, date = {2020-01-01}, journal = {Med J Malaysia}, volume = {75}, number = {4}, pages = {323-324}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Proper understanding the 'Instructions to authors' for a particular journal is the key towards successful submission of a manuscript which will lead to it being published. Common errors that are frequently made by authors in their submission to the Malaysia Journal of Malaysia (MJM) that lead to rejection of their submission or requiring major revisions or minor revisions are listed and discussed in this article. Outright rejection prior to even a peer review process may be made for an article due to: it is poorly written or when there is suspicion on the authenticity of the submission, which contains elements that are suspected to be plagiarised, it is a duplicate submission or not in the format required by the MJM. The editor in charge of the issue makes a recommendation to the Editor in Chief for the final decision.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN126, title = {Organisational antecedents of workplace victimisation: The role of organisational climate, culture, leadership, support, and justice in predicting junior doctors' exposure to bullying at work}, author = {E. Z. Samsudin and M. Isahak and S. Rampal and I. Rosnah and M. I. Zakaria}, doi = {10.1002/hpm.2926}, issn = {0749-6753}, year = {2020}, date = {2020-01-01}, journal = {Int J Health Plann Manage}, volume = {35}, number = {1}, pages = {346-367}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Workplace bullying is a pervasive phenomenon among junior doctors that may negatively impact their training and abilities to deliver quality healthcare, yet evidence on the factors of bullying among them remains lacking. This study examined the role of organisational climate, culture, leadership, support, and justice in junior doctors' exposure to workplace bullying on the basis of the work environment hypothesis, which suggests that workplace psychosocial factors are the main antecedents of bullying at work. Multilevel analysis of a universal sample (n = 1074) of junior doctors working in the central zone of Malaysia, using mixed effects logistic regression, was conducted. Analysis indicates that junior doctors working in departments with neutral and positive organisational climate, moderate and high degree of clan culture, moderate and high degree of adhocracy culture, moderate degree of hierarchy culture, moderate degree of production and achievement-oriented leadership style, moderate and high degree of organisational support, moderate degree of procedural justice, moderate and high degree of interactional justice, and high degree of distributive justice have lower odds of bullying compared with their counterparts. The results present evidence that all aspects of the organisation influence junior doctors' exposure to bullying and should be considered when developing antibullying initiatives targeted at them.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN97, title = {HPV vaccination intent and willingness to pay for 2-,4-, and 9-valent HPV vaccines: A study of adult women aged 27-45 years in China}, author = {Y. Lin and Z. Lin and F. He and H. Chen and X. Lin and G. D. Zimet and H. Alias and S. He and Z. Hu and L. P. Wong}, doi = {10.1016/j.vaccine.2020.02.042}, issn = {0264-410x}, year = {2020}, date = {2020-01-01}, journal = {Vaccine}, volume = {38}, number = {14}, pages = {3021-3030}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVE: This study aims to investigate acceptance and willingness to pay for HPV vaccination among adult women in China. METHODS: An online survey was sent to mothers aged 27-45 years of primary school pupils in the Fujian province, China. Participants completed questions about HPV related knowledge and health beliefs, intention to take the HPV vaccine and the willingness to pay for bivalent vaccine (2vHPV), quadrivalent vaccine (4vHPV), and 9-valent HPV vaccine (9vHPV). RESULTS: Of a total of 2339 complete responses, 58.3% reported intent to obtain HPV vaccine. Mothers who were younger in age, residing in urban, working in managerial or professional occupations, who knew someone with cervical cancer and who were able to make independent decisions about the HPV vaccine (vs. joint decision with spouse) were more likely to express intent to have HPV vaccination. Perceived barriers, cues to action and self-efficacy were three of the constructs in the health belief model that significantly influenced HPV vaccination intent. A higher proportion of participants expressed willingness to pay for 2vHPV (81.2%) and 4vHPV (75.9%), as compared to 9vHPV (67.7%). CONCLUSION: Adults women expressed moderate intention to receive the HPV vaccine. Intervention to address barriers to uptake of the HPV vaccine among adult women in China is warranted.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN34, title = {Health status, healthcare utilisation, and quality of life among the coastal communities in Sabah: Protocol of a population-based survey}, author = {M. Dahlui and A. Azzeri and M. A. Zain and M. I. Mohd Noor and H. Jaafar and A. Y. H. Then and J. Suhaimi and F. Kari and L. A. Creencia and J. R. Madarcos and E. Jose and L. E. Fleming and M. P. White and K. Morrissey and K. S. Fadzil and H. C. Goh}, doi = {10.1097/md.0000000000022067}, issn = {0025-7974 (Print) 0025-7974}, year = {2020}, date = {2020-01-01}, journal = {Medicine (Baltimore)}, volume = {99}, number = {37}, pages = {e22067}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {INTRODUCTION: Coastal areas in Malaysia can have important impacts on the livelihoods and health of local communities. Efforts by Malaysian government to develop and improve the landscape and ecosystem have been planned; however, the progress has been relatively slow because some of the coastal areas are remote and relatively inaccessible. Thus, these coastal communities face various challenges in health, healthcare and quality of life. This paper presents a study protocol to examine the health status, healthcare utilisation, and quality of life among the coastal communities. In addition, the relationship between the community and their coastal environment is examined. METHODOLOGY AND ANALYSIS: The population of interest is the coastal communities residing within the Tun Mustapha Park in Sabah, Malaysia. The data collection is planned for a duration of 6 months and the findings are expected by December 2020. A random cluster sampling will be conducted at three districts of Sabah. This study will collect 600 adult respondents (300 households are estimated to be collected) at age of 18 and above. The project is a cross sectional study via face-to-face interview with administered questionnaires, anthropometrics measurements and observation of the living condition performed by trained interviewers.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN90, title = {A holistic approach is needed to control the perpetual burden of soil-transmitted helminth infections among indigenous schoolchildren in Malaysia}, author = {N. A. Nasr and H. M. Al-Mekhlafi and Y. A. L. Lim and F. N. Elyana and H. Sady and W. M. Atroosh and S. Dawaki and A. K. Al-Delaimy and M. A. Al-Areeqi and A. A. Wehaish and T. S. Anuar and R. Mahmud}, doi = {10.1080/20477724.2020.1747855}, issn = {2047-7724 (Print) 2047-7724}, year = {2020}, date = {2020-01-01}, journal = {Pathog Glob Health}, volume = {114}, number = {3}, pages = {145-159}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {A cross-sectional survey was conducted among 1,142 Orang Ali schoolchildren in six states of Peninsular Malaysia to investigate the current prevalence and risk factors of STH infections. Faecal samples were examined using direct smear, formalin-ether sedimentation, Kato-Katz, and Harada-Mori methods. A pre-tested questionnaire was used to collect information on the demographic, socioeconomic, personal hygiene, and health status of the participants. Overall, 70.1% (95% CI = 67.4, 72.7) of the participants were infected with at least one of the STH species. The prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm infections was 63.1%, 61.8% and 11.5%, respectively. Moderate-to-heavy STH infections accounted for 61.3% of the total infections. Univariate and logistic regression analyses revealed different sets of risk factors, with age (\> 10 years) being the significant risk factor of all three STH species. Moreover, other species-specific risk factors were identified including being a member of the Senoi tribe, family size (≥ 7 members), school size (150-250 pupils), maternal unemployment, unimproved source of drinking water, lacking improved toilet in the house, inadequate WASH facilities at school, not washing hands before eating, and not washing fruits before eating; presence of domestic animals, and not wearing shoes when outside. The high prevalence of STH infections found in the study population exceeds the WHO policy intervention threshold (20% prevalence). Thus, an innovative holistic approach should be adopted to control STH infections among these children as part of the efforts to improve the quality of life of the entire Orang Asli population. .}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN27, title = {Dose-Response Relationship between Western Diet and Being Overweight among Teachers in Malaysia}, author = {J. Y. Eng and F. M. Moy and A. Bulgiba and S. Rampal}, doi = {10.3390/nu12103092}, issn = {2072-6643}, year = {2020}, date = {2020-01-01}, journal = {Nutrients}, volume = {12}, number = {10}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {The rising prevalence of overweight and obesity is partly due to nutrition transition. The reported association between dietary patterns and overweight/obesity has been controversial because of inconsistent results and weak observed associations. Although it has been hypothesized that an unhealthy diet can increase obesity risk, none of the previous studies have examined the dose-response association using nonlinear dose-response analyses. This study aimed to examine the dose-response association between major dietary patterns and overweight/obesity. This was a cross-sectional study involving teachers selected through stratified multistage sampling from public schools in three Malaysian states. Dietary intake was assessed using a food frequency questionnaire, and two major dietary patterns (Western and Prudent diet) were extracted using factor analysis. Logistic regression followed by trend analysis was used to test the difference in odds of overweight and obesity in each quintile of diet score. A further analysis using restricted cubic spline models was performed to examine the dose-response associations of dietary patterns with odds of overweight/obesity. The logistic regression analysis showed that participants with the highest quintile of Western diet score were 1.4 times more likely to be overweight/obese compared to those in the lowest quintile (95% CI: 1.11, 1.83, p-trend \< 0.001). The odds of overweight/obesity showed a significant increasing trend across quintiles of Western diet among both men and women (p-trend \< 0.001). In the dose-response analysis, a positive linear association (P(nonlinearity) = 0.6139) was observed where overweight/obesity was more likely to occur among participants with a Western diet score greater than a mean score of zero. There was an inverse trend of odds of overweight/obesity across quintiles of Prudent diet score, significant only for men (p for trend \< 0.001). Linear association was found between Prudent diet score and odds of overweight/obesity among both men (P(nonlinearity) = 0.6685) and women (P(nonlinearity) = 0.3684) in the dose-response analysis. No threshold at the level of adherence to Prudent diet was linked to odds of overweight/obesity. Dose-response analysis indicated that women with a Western diet score greater than zero were more likely to be overweight or obese among women. In men, higher adherence to Western diet was associated with increased odds of overweight/obesity, while greater adherence to Prudent diet decreased the odds of overweight/obesity. Promoting and enhancing the consumption of Prudent diet and limit in Western diet may be used to guide the development of evidence-based diet interventions to curb overweight and obesity.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN63, title = {Knowledge, attitude and practice on dengue prevention and dengue seroprevalence in a dengue hotspot in Malaysia: A cross-sectional study}, author = {S. Selvarajoo and J. W. K. Liew and W. Tan and X. Y. Lim and W. F. Refai and R. A. Zaki and N. Sethi and W. Y. Wan Sulaiman and Y. A. L. Lim and J. Vadivelu and I. Vythilingam}, doi = {10.1038/s41598-020-66212-5}, issn = {2045-2322}, year = {2020}, date = {2020-01-01}, journal = {Sci Rep}, volume = {10}, number = {1}, pages = {9534}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Dengue has become a global public health problem. Despite reactive efforts by the government in Malaysia, the dengue cases are on the increase. Adequate knowledge, positive attitude and correct practice for dengue control are essential to stamp out the disease. Hence, this study aims to assess the factors associated with dengue knowledge, attitude and practice (KAP), as well as the association with dengue IgM and IgG seropositivity. A community-based cross-sectional study was conducted in a closed, dengue endemic area with multi-storey dwellings . Five hundred individuals (aged 18 years and above) were approached for pre-tested KAP and seroprevalences assessment. The study showed only half of the total participants have good knowledge (50.7%) but they had insufficient knowledge about dengue during pregnancy. 53.2% of people had poor attitude and 50.2% reported poor practice for dengue control. Out of 85 respondents who agreed to participate in the dengue seroprevalence study, 74.1% (n = 63) were positive for dengue IgG and 7.1% (n = 6) were positive for dengue IgM. Among all sociodemographic variable, race is the only independent predicator for all KAP levels (P \< 0.05). In conclusion, proactive and sustainable efforts are needed to bring a behavioural change among communities in order to fight dengue outbreaks in endemic areas.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN68, title = {Self-perceived burden and its associations with health-related quality of life among urologic cancer patients}, author = {C. Y. Ting and G. C. Teh and K. L. Yu and H. Alias and H. M. Tan and L. P. Wong}, doi = {10.1111/ecc.13248}, issn = {0961-5423}, year = {2020}, date = {2020-01-01}, journal = {Eur J Cancer Care (Engl)}, volume = {29}, number = {4}, pages = {e13248}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVE: This study examined the prevalence of self-perceived burden (SPB) and its association with health-related quality of life (HRQoL) among urologic cancer patients. METHODS: This was a prospective, cross-sectional study. A total of 429 respondents diagnosed with urologic cancers (prostate, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed by using a structured questionnaire. SPB and HRQoL were measured by the Self-perceived Burden Scale and the Functional Assessment of Cancer Therapy-General 7 Item Scale respectively. RESULTS AND CONCLUSION: Self-perceived burden was experienced by 73.2% of the respondents. Respondents who had a lower education level, a monthly household income \<MYR 5,000, monthly household expenditures \<MYR 3,000 or whose Eastern Cooperative Oncology Group performance status (ECOG-PS) rating was higher and who faced medium to high subjective financial toxicity (FT) were more likely to experience low HRQoL, but not SPB, after adjustment for covariates. As medium to high subjective FT is significantly associated with high SPB and low HRQoL, future interventions should be prioritised to address subjective FT, which, in turn, would reduce SPB and improve HRQoL.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN36, title = {Association between night-shift work, sleep quality and health-related quality of life: a cross-sectional study among manufacturing workers in a middle-income setting}, author = {Y. C. Lim and V. C. W. Hoe and A. Darus and N. Bhoo-Pathy}, doi = {10.1136/bmjopen-2019-034455}, issn = {2044-6055}, year = {2020}, date = {2020-01-01}, journal = {BMJ Open}, volume = {10}, number = {9}, pages = {e034455}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVES: Night-shift work may adversely affect health. This study aimed to determine the impact of night-shift work on health-related quality of life (HRQoL), and to assess whether sleep quality was a mediating factor. DESIGN: A cross-sectional study. SETTING: 11 manufacturing factories in Malaysia. PARTICIPANTS: 177 night-shift workers aged 40-65 years old were compared with 317 non-night-shift workers. PRIMARY AND SECONDARY OUTCOMES: Participants completed a self-administered questionnaire on socio-demographics and lifestyle factors, 12-item Short Form Health Survey V.2 (SF-12v2) and the Pittsburgh Sleep Quality Index (PSQI). The Baron and Kenny's method, Sobel test and multiple mediation model with bootstrapping were applied to determine whether PSQI score or its components mediated the association between night-shift work and HRQoL. RESULTS: Night-shift work was associated with sleep impairment and HRQoL. Night-shift workers had significantly lower mean scores in all the eight SF-12 domains (p\<0.001). Compared with non-night-shift workers, night-shift workers were significantly more likely to report poorer sleep quality, longer sleep latency, shorter sleep duration, sleep disturbances and daytime dysfunction (p\<0.001). Mediation analyses showed that PSQI global score mediated the association between night-shift work and HRQoL. 'Subjective sleep quality' (indirect effect=-0.24}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN35, title = {Willingness to Use HIV Self-Testing and Associated Factors Among Transgender Women in Malaysia}, author = {R. Shrestha and J. M. Galka and I. Azwa and S. H. Lim and T. E. Guadamuz and F. L. Altice and J. A. Wickersham}, doi = {10.1089/trgh.2019.0085}, issn = {2688-4887 (Print) 2380-193x}, year = {2020}, date = {2020-01-01}, journal = {Transgend Health}, volume = {5}, number = {3}, pages = {182-190}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Background: While global research on the implementation of HIV self-testing (HIVST) has increased exponentially, few studies have assessed information on HIVST uptake factors (i.e., willingness, preferences) in transgender women (TW) and none in the Malaysian context. We therefore sought to assess willingness to use HIVST among this understudied key population. Methods: A cross-sectional survey was conducted among 361 HIV-negative Malaysian TW in 2017. Participants were recruited using flyers, announcements through social media, and direct referral from staff members of the community-based organizations serving the TW communities. Multivariable logistic regression was used to identify correlates of willingness to use HIVST. Results: Nearly half of the participants (47.6%) reported that they would be willing to use HIVST. Multivariable analysis showed that willingness to use HIVST was positively associated with having experienced sexual assault in childhood (adjusted odds ratio [aOR]=3.239, p\<0.001), having ever used mobile phone or apps to find sex work clients (aOR=1.677}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN101, title = {Clinical recognition of elder maltreatment and intention to report among primary care doctors}, author = {F. H. Mohd Mydin and S. Othman and W. Y. Choo and N. N. M. Hairi and F. M. Hairi and S. N. Syed Karim and M. P. Tan and Z. Ali and S. Abdul Aziz and R. Mohd and R. Ramli and R. Mohamad and L. R. Awaludin and Z. Adnan}, doi = {10.1080/08946566.2020.1731640}, issn = {0894-6566}, year = {2020}, date = {2020-01-01}, journal = {J Elder Abuse Negl}, volume = {32}, number = {1}, pages = {72-83}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {This study aimed to determine the primary care doctors' ability to recognize elder maltreatment and their intentions to report on such conditions. About 358 primary care doctors participated in this study. Outcomes were assessed using a validated five context-relevant clinical vignettes. Primary care doctor's recognition of sexual abuse was highest (91.0%); while the lowest (70.2%) in case signifying physical abuse. Despite being able to ascertain elder maltreatment, the intention to report the event is generally low even for cases exemplifying physical abuse, emotional abuse and neglect. However, intentions to report cases of sexual and financial abuse are 86.9% and 73.5% respectively. Findings highlighted the uncertainties of primary care doctors in distinguishing the clinical findings of non-accidental injuries and injuries due to acts of maltreatment. This provides support for educational intervention and guidelines or policies to improve the knowledge and skills of primary care doctors to intervene in elder maltreatment.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN55, title = {Progressive and accelerated weight and body fat loss in Parkinson's disease: A three-year prospective longitudinal study}, author = {V. W. Yong and Y. J. Tan and Y. D. Ng and X. Y. Choo and K. Sugumaran and K. Chinna and M. N. Md Shah and R. R. A. Raja Aman and F. M. Moy and N. Mohd Ramli and M. Grossmann and S. Y. Lim and A. H. Tan}, doi = {10.1016/j.parkreldis.2020.06.015}, issn = {1353-8020}, year = {2020}, date = {2020-01-01}, journal = {Parkinsonism Relat Disord}, volume = {77}, pages = {28-35}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {INTRODUCTION: Although weight loss is common in Parkinson's disease (PD), longitudinal studies assessing weight and body composition changes are limited. METHODS: In this three-year longitudinal study, 125 subjects (77 PD patients and 48 spousal/sibling controls) underwent clinical, biochemical and body composition assessments using dual-energy X-ray absorptiometry. RESULTS: Patients were older than controls (65.6 ± 8.9 vs. 62.6 ± 7.1}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN115, title = {The study of seroprevalence of hepatitis E virus and an investigation into the lifestyle behaviours of the aborigines in Malaysia}, author = {L. P. Wong and H. Alias and S. H. Choy and X. T. Goh and S. C. Lee and Y. A. L. Lim and B. P. Kee and K. H. Chua and A. Kamaruzaman and Z. Zheng and Q. Zhao and T. Wu}, doi = {10.1111/zph.12681}, issn = {1863-1959}, year = {2020}, date = {2020-01-01}, journal = {Zoonoses Public Health}, volume = {67}, number = {3}, pages = {263-270}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Malaysia is a non-endemic country for hepatitis E virus (HEV) infection. However, seroprevalence as high as 50% among samples of aboriginal people were reported over two decades ago. A total of 207 samples collected from seven aboriginal villages in rural settlements across two states in Malaysia were analysed for anti-HEV IgG and IgM by an enzyme-linked immunoassay. Following the detection of anti-HEV seroprevalence, we organized health outreach to inform and educate the community. Qualitative interviews were conducted with individuals tested positive for anti-HEV antibodies. Data derived from interviews and observations were used to investigate possible lifestyle behaviours associated with HEV infection. Anti-HEV IgG was detected in six samples (5.9%) from the village of Dusun Kubur. Qualitative inquiry and observation study revealed poor dietary and household hygiene, contaminated food and water, contact with animal faeces, unsanitary and domestic waste disposal, and wildlife reservoirs could be the contributing factors for transmission and acquisition of HEV infection. Investigation during health outreach is important to provide insights for future empirical research and implementation for improvement of lifestyle behaviours among the aborigines. Managing the risk of HEV infection in the aborigines may reduce the risk of HEV transmission to the local communities.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN117, title = {A Transcriptome-Wide Association Study Identifies Novel Candidate Susceptibility Genes for Pancreatic Cancer}, author = {J. Zhong and A. Jermusyk and L. Wu and J. W. Hoskins and I. Collins and E. Mocci and M. Zhang and L. Song and C. C. Chung and T. Zhang and W. Xiao and D. Albanes and G. Andreotti and A. A. Arslan and A. Babic and W. R. Bamlet and L. Beane-Freeman and S. Berndt and A. Borgida and P. M. Bracci and L. Brais and P. Brennan and B. Bueno-de-Mesquita and J. Buring and F. Canzian and E. J. Childs and M. Cotterchio and M. Du and E. J. Duell and C. Fuchs and S. Gallinger and J. M. Gaziano and G. G. Giles and E. Giovannucci and M. Goggins and G. E. Goodman and P. J. Goodman and C. Haiman and P. Hartge and M. Hasan and K. J. Helzlsouer and E. A. Holly and E. A. Klein and M. Kogevinas and R. J. Kurtz and L. LeMarchand and N. Malats and S. M\"{a}nnist\"{o} and R. Milne and R. E. Neale and K. Ng and O. Obazee and A. L. Oberg and I. Orlow and A. V. Patel and U. Peters and M. Porta and N. Rothman and G. Scelo and H. D. Sesso and G. Severi and S. Sieri and D. Silverman and M. Sund and A. Tj\onneland and M. D. Thornquist and G. S. Tobias and A. Trichopoulou and S. K. Van Den Eeden and K. Visvanathan and J. Wactawski-Wende and N. Wentzensen and E. White and H. Yu and C. Yuan and A. Zeleniuch-Jacquotte and R. Hoover and K. Brown and C. Kooperberg and H. A. Risch and E. J. Jacobs and D. Li and K. Yu and X. O. Shu and S. J. Chanock and B. M. Wolpin and R. Z. Stolzenberg-Solomon and N. Chatterjee and A. P. Klein and J. P. Smith and P. Kraft and J. Shi and G. M. Petersen and W. Zheng and L. T. Amundadottir}, doi = {10.1093/jnci/djz246}, issn = {0027-8874 (Print) 0027-8874}, year = {2020}, date = {2020-01-01}, journal = {J Natl Cancer Inst}, volume = {112}, number = {10}, pages = {1003-1012}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Although 20 pancreatic cancer susceptibility loci have been identified through genome-wide association studies in individuals of European ancestry, much of its heritability remains unexplained and the genes responsible largely unknown. METHODS: To discover novel pancreatic cancer risk loci and possible causal genes, we performed a pancreatic cancer transcriptome-wide association study in Europeans using three approaches: FUSION, MetaXcan, and Summary-MulTiXcan. We integrated genome-wide association studies summary statistics from 9040 pancreatic cancer cases and 12 496 controls, with gene expression prediction models built using transcriptome data from histologically normal pancreatic tissue samples (NCI Laboratory of Translational Genomics [n = 95] and Genotype-Tissue Expression v7 [n = 174] datasets) and data from 48 different tissues (Genotype-Tissue Expression v7}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN147, title = {An inverse association between the Mediterranean diet and bladder cancer risk: a pooled analysis of 13 cohort studies}, author = {W. J. A. Witlox and F. H. M. Osch and M. Brinkman and S. Jochems and M. E. Goossens and E. Weiderpass and E. White and P. A. Brandt and G. G. Giles and R. L. Milne and I. Huybrechts and H. O. Adami and B. Bueno-de-Mesquita and A. Wesselius and M. P. Zeegers}, doi = {10.1007/s00394-019-01907-8}, issn = {1436-6207 (Print) 1436-6207}, year = {2020}, date = {2020-01-01}, journal = {Eur J Nutr}, volume = {59}, number = {1}, pages = {287-296}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {PURPOSE: The role of diet in bladder carcinogenesis has yet to be established. To date most studies have investigated dietary components individually, rather than as dietary patterns, which may provide stronger evidence for any influence of diet on bladder carcinogenesis. The Mediterranean diet has been associated with many health benefits, but few studies have investigated its association with bladder cancer risk. METHODS: We investigated the potential association between the Mediterranean diet score (MDS) and risk of developing bladder cancer by pooling 13 prospective cohort studies included in the BLadder cancer Epidemiology and Nutritional Determinants (BLEND) study and applying a Cox regression analysis. RESULTS: Dietary data from 646,222 study participants, including 3639 incident bladder cancer cases, were analysed. We observed an inverse association between Mediterranean diet and bladder cancer risk (HR(high) 0.85 [95% CI 0.77, 0.93]). When stratifying the results on non-muscle-invasive or muscle-invasive disease or sex the association remained similar and the HR estimate was consistently below 1.00 both for medium and high adherence to the Mediterranean diet. A consistent association was observed when disregarding fat or alcohol intake. CONCLUSION: We found evidence that adherence to the Mediterranean diet was associated with reduced risk of developing bladder cancer, suggesting a positive effect of the diet as a whole and not just one component.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN45, title = {Salivary and serum cathelicidin LL-37 levels in subjects with rheumatoid arthritis and chronic periodontitis}, author = {C. W. Cheah and A. R. Al-Maleki and J. Vadivelu and M. Danaee and S. Sockalingam and N. A. Baharuddin and R. D. Vaithilingam}, doi = {10.1111/1756-185x.13919}, issn = {1756-1841}, year = {2020}, date = {2020-01-01}, journal = {Int J Rheum Dis}, volume = {23}, number = {10}, pages = {1344-1352}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {INTRODUCTION: Rheumatoid arthritis (RA) is associated with chronic periodontitis (CP) due to shared risk factors, immuno-genetics and tissue destruction pathways. Human cathelicidin LL-37 has been suggested as a possible mechanistic link for these diseases. This study investigated the levels of salivary and serum LL-37 in subjects with RA and CP and their correlation with disease parameters. METHOD: Subjects were allocated into RA (n = 49) or non-RA (NRA) (n = 55) groups, where 3 subgroups were further established; chronic periodontitis (CP), gingivitis (G) and periodontal health (H). Demographic and periodontal parameters were collected. Rheumatology data were obtained from hospital records. Serum and salivary LL-37 levels were measured using enzyme-linked immunosorbent assay and compared for all groups. RESULTS: For salivary LL-37, RA-CP was significantly higher than NRA-G and NRA-H (P = .047). For serum LL-37, all RA and NRA-CP were significantly higher than NRA-G and NRA-H (P = .024). Salivary LL-37 correlated negatively with clinical attachment loss (CAL) (P = .048), but positively with erythrocyte sedimentation rate (ESR) in RA-H (P = .045). Serum LL-37 showed positive correlation with ESR (P = .037) in RA-G, with C-reactive protein (P = .017) in RA-H, but negative correlation with number of teeth (P = .002) in NRA-CP. Rheumatology data correlated positively with periodontal parameters in RA-CP group. CONCLUSION: NRA-CP subjects with high serum LL-37 should receive comprehensive periodontal therapy. Positive correlation between rheumatology data and periodontal parameters showed that RA disease stability may be obtained by assessing the periodontal condition. Periodontal therapy is necessary to compliment RA treatment to achieve optimum outcome for RA patients with concurrent CP.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN18, title = {Battling COVID-19 pandemic waves in six South-East Asian countries: A real-time consensus review}, author = {L. Rampal and B. S. Liew and M. Choolani and K. Ganasegeran and A. Pramanick and S. A. Vallibhakara and P. Tejativaddhana and V. C. Hoe}, issn = {0300-5283 (Print) 0300-5283}, year = {2020}, date = {2020-01-01}, journal = {Med J Malaysia}, volume = {75}, number = {6}, pages = {613-625}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {INTRODUCTION: COVID-19 has caused unprecedented public health concerns, triggering an escalated burden to health systems worldwide. The pandemic has altered people's living norms, yet coherently escalating countries' socioeconomic instability. This real-time consensus review aims to describe the epidemiological trends of COVID-19 pandemic across six South-East Asian nations, and countryspecific experiences on pandemic preparedness, responses and interventions. METHODS: Consensus-driven approach between authors from the six selected countries was applied. Country specific policy documents, official government media statements, mainstream news portals, global statistics databases and latest published literature available between January-October 2020 were utilised for information retrieval. Situational and epidemiological trend analyses were conducted. Country-specific interventions and challenges were described. Based on evidence appraised, a descriptive framework was considered through a consensus. The authors subsequently outlined the lessons learned, challenges ahead and interventions that needs to be in place to control the pandemic. RESULTS: The total number of people infected with COVID-19 between 1 January and 16 November 2020 had reached 48,520 in Malaysia, 58,124 in Singapore, 3,875 in Thailand, 470,648 in Indonesia, 409,574 in Philippines and 70,161 in Myanmar. The total number of people infected with COVID- 19 in the six countries from January to 31 October 2020 were 936,866 cases and the mortality rate was 2.42%. Indonesia had 410,088 cases with a mortality rate of 3.38%, Philippines had 380,729 cases with a mortality rate of 1.90%, Myanmar had 52,706 cases with a mortality rate of 2.34%, Thailand had 3,780 cases with a mortality rate of 1.56%, Malaysia had 31,548 cases with a mortality rate of 0.79%, and Singapore had 58,015 cases with a mortality rate of 0.05% over the 10- month period. Each country response varied depending on its real-time situations based on the number of active cases and economic situation of the country. CONCLUSION: The number of COVID-19 cases in these countries waxed and waned over the 10-month period, the number of cases may be coming down in one country, and vice versa in another. Each country, if acting alone, will not be able to control this pandemic. Sharing of information and resources across nations is the key to successful control of the pandemic. There is a need to reflect on how the pandemic affects individuals, families and the community as a whole. There are many people who cannot afford to be isolated from their families and daily wage workers who cannot afford to miss work. Are we as a medical community, only empathising with our patients or are we doing our utmost to uphold them during this time of crisis? Are there any other avenues which can curb the epidemic while reducing its impact on the health and socio-economic condition of the individual, community and the nation?}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN49, title = {Migrant Women's Access to Sexual and Reproductive Health Services in Malaysia: A Qualitative Study}, author = {T. Loganathan and Z. X. Chan and A. W. Smalen and N. S. Pocock}, doi = {10.3390/ijerph17155376}, issn = {1661-7827 (Print) 1660-4601}, year = {2020}, date = {2020-01-01}, journal = {Int J Environ Res Public Health}, volume = {17}, number = {15}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Providing sexual and reproductive health (SRH) services to migrant workers is key to fulfilling sustainable developmental goals. This study aims to explore key informants' views on the provision of SRH services for migrant women in Malaysia, exploring the provision of SRH education, contraception, abortion, antenatal and delivery, as well as the management of gender-based violence. In-depth interviews of 44 stakeholders were conducted from July 2018 to July 2019. Data were thematically analysed. Migrant workers that fall pregnant are unable to work legally and are subject to deportation. Despite this, we found that insufficient SRH information and contraceptive access are provided, as these are seen to encourage promiscuity. Pregnancy, rather than sexually transmitted infection prevention, is a core concern among migrant women, the latter of which is not adequately addressed by private providers. Abortions are often seen as the only option for pregnant migrants. Unsafe abortions occur which are linked to financial constraints and cultural disapproval, despite surgical abortions being legal in Malaysia. Pregnant migrants often delay care-seeking, and this may explain poor obstetric outcomes. Although health facilities for gender-based violence are available, non-citizen women face additional barriers in terms of discrimination and scrutiny by authorities. Migrant women face extremely limited options for SRH services in Malaysia and these should be expanded.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN109, title = {Physical activity and risks of breast and colorectal cancer: a Mendelian randomisation analysis}, author = {N. Papadimitriou and N. Dimou and K. K. Tsilidis and B. Banbury and R. M. Martin and S. J. Lewis and N. Kazmi and T. M. Robinson and D. Albanes and K. Aleksandrova and S. I. Berndt and D. Timothy Bishop and H. Brenner and D. D. Buchanan and B. Bueno-de-Mesquita and P. T. Campbell and S. Castellv\'{i}-Bel and A. T. Chan and J. Chang-Claude and M. Ellingjord-Dale and J. C. Figueiredo and S. J. Gallinger and G. G. Giles and E. Giovannucci and S. B. Gruber and A. Gsur and J. Hampe and H. Hampel and S. Harlid and T. A. Harrison and M. Hoffmeister and J. L. Hopper and L. Hsu and J. Mar\'{i}a Huerta and J. R. Huyghe and M. A. Jenkins and T. O. Keku and T. K\"{u}hn and C. La Vecchia and L. Le Marchand and C. I. Li and L. Li and A. Lindblom and N. M. Lindor and B. Lynch and S. D. Markowitz and G. Masala and A. M. May and R. Milne and E. Monninkhof and L. Moreno and V. Moreno and P. A. Newcomb and K. Offit and V. Perduca and P. D. P. Pharoah and E. A. Platz and J. D. Potter and G. Rennert and E. Riboli and M. J. S\'{a}nchez and S. L. Schmit and R. E. Schoen and G. Severi and S. Sieri and M. L. Slattery and M. Song and C. M. Tangen and S. N. Thibodeau and R. C. Travis and A. Trichopoulou and C. M. Ulrich and F. J. B. Duijnhoven and B. Van Guelpen and P. Vodicka and E. White and A. Wolk and M. O. Woods and A. H. Wu and U. Peters and M. J. Gunter and N. Murphy}, doi = {10.1038/s41467-020-14389-8}, issn = {2041-1723}, year = {2020}, date = {2020-01-01}, journal = {Nat Commun}, volume = {11}, number = {1}, pages = {597}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Physical activity has been associated with lower risks of breast and colorectal cancer in epidemiological studies; however, it is unknown if these associations are causal or confounded. In two-sample Mendelian randomisation analyses, using summary genetic data from the UK Biobank and GWA consortia, we found that a one standard deviation increment in average acceleration was associated with lower risks of breast cancer (odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.27 to 0.98}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN116, title = {Understanding the Financial Needs Following Diagnosis of Breast Cancer in a Setting with Universal Health Coverage}, author = {Y. C. Kong and L. P. Wong and C. W. Ng and N. A. Taib and N. T. Bhoo-Pathy and M. M. Yusof and A. F. Aziz and P. Yehgambaram and W. Z. W. Ishak and C. H. Yip and N. Bhoo-Pathy}, doi = {10.1634/theoncologist.2019-0426}, issn = {1083-7159 (Print) 1083-7159}, year = {2020}, date = {2020-01-01}, journal = {Oncologist}, volume = {25}, number = {6}, pages = {497-504}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: A diagnosis of cancer negatively impacts the financial wellbeing of affected individuals as well as their households. We aimed to gain an in-depth understanding of the financial needs following diagnosis of breast cancer in a middle-income setting with universal health coverage. MATERIALS AND METHODS: Twelve focus group discussions (n = 64) were conducted with women with breast cancer from two public and three private hospitals. This study specifically focused on (a) health costs, (b) nonhealth costs, (c) employment and earnings, and (d) financial assistance. Thematic analysis was used. RESULTS: Financial needs related to cancer treatment and health care varied according to the participant's socioeconomic background and type of medical insurance. Although having medical insurance alleviated cancer treatment-related financial difficulties, limited policy coverage for cancer care and suboptimal reimbursement policies were common complaints. Nonhealth expenditures were also cited as an important source of financial distress; patients from low-income households reported transport and parking costs as troublesome, with some struggling to afford basic necessities, whereas participants from higher-income households mentioned hired help, special food and/or supplements and appliances as expensive needs following cancer. Needy patients had a hard time navigating through the complex system to obtain financial support. Irrespective of socioeconomic status, reductions in household income due to loss of employment and/or earnings were a major source of economic hardship. CONCLUSION: There are many unmet financial needs following a diagnosis of (breast) cancer even in settings with universal health coverage. Health care professionals may only be able to fulfill these unmet needs through multisectoral collaborations, catalyzed by strong political will. IMPLICATIONS FOR PRACTICE: As unmet financial needs exist among patients with cancer across all socioeconomic groups, including for patients with medical insurance, financial navigation should be prioritized as an important component of cancer survivorship services, including in the low- and middle-income settings. Apart from assisting survivors to understand the costs of cancer care, navigate the complex system to obtain financial assistance, or file health insurance claims, any planned patient navigation program should also provide support to deal with employment-related challenges and navigate return to work. It is also echoed that costs for essential personal items (e.g., breast prostheses) should be covered by health insurance or subsidized by the government.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN127, title = {Predicted basal metabolic rate and cancer risk in the European Prospective Investigation into Cancer and Nutrition}, author = {N. Kliemann and N. Murphy and V. Viallon and H. Freisling and K. K. Tsilidis and S. Rinaldi and F. R. Mancini and G. Fagherazzi and M. C. Boutron-Ruault and H. Boeing and M. B. Schulze and G. Masala and V. Krogh and C. Sacerdote and M. S. Magistris and B. Bueno-de-Mesquita and E. Weiderpass and T. K\"{u}hn and R. Kaaks and P. Jakszyn and D. Redondo-S\'{a}nchez and P. Amiano and M. D. Chirlaque and A. B. Gurrea and U. Ericson and I. Drake and T. H. N\ost and D. Aune and A. M. May and A. Tj\onneland and C. C. Dahm and K. Overvad and R. Tumino and J. R. Quir\'{o}s and A. Trichopoulou and A. Karakatsani and C. La Vecchia and L. M. Nilsson and E. Riboli and I. Huybrechts and M. J. Gunter}, doi = {10.1002/ijc.32753}, issn = {0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {147}, number = {3}, pages = {648-661}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Emerging evidence suggests that a metabolic profile associated with obesity may be a more relevant risk factor for some cancers than adiposity per se. Basal metabolic rate (BMR) is an indicator of overall body metabolism and may be a proxy for the impact of a specific metabolic profile on cancer risk. Therefore, we investigated the association of predicted BMR with incidence of 13 obesity-related cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). BMR at baseline was calculated using the WHO/FAO/UNU equations and the relationships between BMR and cancer risk were investigated using multivariable Cox proportional hazards regression models. A total of 141,295 men and 317,613 women, with a mean follow-up of 14 years were included in the analysis. Overall, higher BMR was associated with a greater risk for most cancers that have been linked with obesity. However, among normal weight participants, higher BMR was associated with elevated risks of esophageal adenocarcinoma (hazard ratio per 1-standard deviation change in BMR [HR(1-SD) ]: 2.46; 95% CI 1.20; 5.03) and distal colon cancer (HR(1-SD) : 1.33; 95% CI 1.001; 1.77) among men and with proximal colon (HR(1-SD) : 1.16; 95% CI 1.01; 1.35), pancreatic (HR(1-SD) : 1.37; 95% CI 1.13; 1.66), thyroid (HR(1-SD) : 1.65; 95% CI 1.33; 2.05), postmenopausal breast (HR(1-SD) : 1.17; 95% CI 1.11; 1.22) and endometrial (HR(1-SD) : 1.20; 95% CI 1.03; 1.40) cancers in women. These results indicate that higher BMR may be an indicator of a metabolic phenotype associated with risk of certain cancer types, and may be a useful predictor of cancer risk independent of body fatness.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN59, title = {Knowledge, Attitudes, Impact, and Anxiety Regarding COVID-19 Infection Among the Public in China}, author = {Y. Lin and Z. Hu and H. Alias and L. P. Wong}, doi = {10.3389/fpubh.2020.00236}, issn = {2296-2565 (Print) 2296-2565}, year = {2020}, date = {2020-01-01}, journal = {Front Public Health}, volume = {8}, pages = {236}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Objectives: Sufficient knowledge and positive attitudes are crucial to the prevention of COVID-19. However, little is known about public awareness and attitudes regarding COVID-19 in China. The impact of COVID-19 on the societal well-being and anxiety levels of the public has never been documented. The aim of this study was to survey the knowledge, attitudes, impact, and anxiety levels of the people of China in relation to the COVID-19 outbreak. Method: A cross-sectional population survey using an online questionnaire was undertaken between Jan 24 and Feb 24, 2020. The study participants were residents of mainland China over the age of 18 years. The attitude items in this study measured the perceived threat of COVID-19 based on the Health Belief Model. Anxiety was measured with the State-Trait Anxiety Inventory (STAI), a self-reported questionnaire that measure both state (STAI-S), and trait anxiety (STAI-T) Results: A total of 2,446 completed responses were received. The mean and standard deviation (SD) for the total knowledge score was 20.3 (SD ± 2.9) out of a possible score of 23. The social disruption and household economic impact were notable, particularly in provinces with higher cumulative confirmed cases. The majority of responses indicated a low perceived susceptibility of being infected (86.7% [95%CI 85.4-88.1]), with a fair proportion of respondents perceiving a higher severity (62.9% [95% CI 61.0-64.8]). The mean total impact score was 9.9 (SD ± 3.8) out of a possible score of 15. The mean score for STAI-S was 48.7 (SD ± 10.8), whereas the mean STAI-T score was 45.7 (SD ± 8.5). By demographics, women reported significantly higher odds for higher levels of both STAI-S (OR = 1.67) and STAI-T (OR = 1.30) compared to men. People of a younger age were also more likely to experience higher STAI-S and STAI-T. Higher perceived susceptibility and severity and impact were strong predictors of higher levels of STAI-S and STAI-T. Conclusion: Our findings can assist in tailoring public communication to change people's knowledge and attitudes. The present study also underlined the importance of the promotion of mental health during infectious disease outbreaks to help in moderating the perceived threat, social and household economic impact, targeting the vulnerable segment of the population.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN67, title = {A systematic review of randomized controlled trials of psychoeducation interventions for patients diagnosed with schizophrenia}, author = {M. M. Alhadidi and K. Lim Abdullah and T. L. Yoong and L. Al Hadid and M. Danaee}, doi = {10.1177/0020764020919475}, issn = {0020-7640}, year = {2020}, date = {2020-01-01}, journal = {Int J Soc Psychiatry}, volume = {66}, number = {6}, pages = {542-552}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Schizophrenia is one of the most complicated psychiatric disorders, and, although medication therapy continues to be the core treatment for schizophrenia, there is a need for psychotherapy that helps in providing patients comprehensive mental health care. Psychoeducation is one of the most recognized psychosocial interventions specific to schizophrenia. Further knowledge about the impact of this type of intervention on patients diagnosed with schizophrenia needs to be acquired. AIM: This review aimed to explore the effects of psychoeducational interventions on improving outcome measures for patients diagnosed with schizophrenia. METHODS: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline was used in this systematic review. Two reviewers were involved in screening articles for inclusion and in the data extraction process. The selected studies were assessed for quality using the 'Consolidated Standards of Reporting Trial (CONSORT)' checklist. Out of the 441 records identified, 11 papers were considered for full review (from 2000 to 2018). RESULTS: The psychoeducational interventions showed a consistent improvement in many outcome measures. Most of the reviewed studies focused on outpatients and the method of delivering the psychoeducational interventions was mostly in lecture format. CONCLUSION: This systematic review of randomized controlled trial studies emphasizes the positive impact of psychoeducational interventions for patients diagnosed with schizophrenia concerning various outcome measures. The findings of this review have important implications for both nursing practice and research, as the information presented can be used by the administrators and stakeholders of mental health facilities to increase their understanding and awareness of the importance of integrating psychoeducational interventions in the routine care of patients diagnosed with schizophrenia.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN38, title = {Circulating bilirubin levels and risk of colorectal cancer: serological and Mendelian randomization analyses}, author = {N. Seyed Khoei and M. Jenab and N. Murphy and B. L. Banbury and R. Carreras-Torres and V. Viallon and T. K\"{u}hn and B. Bueno-de-Mesquita and K. Aleksandrova and A. J. Cross and E. Weiderpass and M. Stepien and A. Bulmer and A. Tj\onneland and M. C. Boutron-Ruault and G. Severi and F. Carbonnel and V. Katzke and H. Boeing and M. M. Bergmann and A. Trichopoulou and A. Karakatsani and G. Martimianaki and D. Palli and G. Tagliabue and S. Panico and R. Tumino and C. Sacerdote and G. Skeie and S. Merino and C. Bonet and M. Rodr\'{i}guez-Barranco and L. Gil and M. D. Chirlaque and E. Ardanaz and R. Myte and J. Hultdin and A. Perez-Cornago and D. Aune and K. K. Tsilidis and D. Albanes and J. A. Baron and S. I. Berndt and S. B\'{e}zieau and H. Brenner and P. T. Campbell and G. Casey and A. T. Chan and J. Chang-Claude and S. J. Chanock and M. Cotterchio and S. Gallinger and S. B. Gruber and R. W. Haile and J. Hampe and M. Hoffmeister and J. L. Hopper and L. Hsu and J. R. Huyghe and M. A. Jenkins and A. D. Joshi and E. Kampman and S. C. Larsson and L. Le Marchand and C. I. Li and L. Li and A. Lindblom and N. M. Lindor and V. Mart\'{i}n and V. Moreno and P. A. Newcomb and K. Offit and S. Ogino and P. S. Parfrey and P. D. P. Pharoah and G. Rennert and L. C. Sakoda and C. Schafmayer and S. L. Schmit and R. E. Schoen and M. L. Slattery and S. N. Thibodeau and C. M. Ulrich and F. J. B. Duijnhoven and K. Weigl and S. J. Weinstein and E. White and A. Wolk and M. O. Woods and A. H. Wu and X. Zhang and P. Ferrari and G. Anton and A. Peters and U. Peters and M. J. Gunter and K. H. Wagner and H. Freisling}, doi = {10.1186/s12916-020-01703-w}, issn = {1741-7015}, year = {2020}, date = {2020-01-01}, journal = {BMC Med}, volume = {18}, number = {1}, pages = {229}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Bilirubin, a byproduct of hemoglobin breakdown and purported anti-oxidant, is thought to be cancer preventive. We conducted complementary serological and Mendelian randomization (MR) analyses to investigate whether alterations in circulating levels of bilirubin are associated with risk of colorectal cancer (CRC). We decided a priori to perform analyses separately in men and women based on suggestive evidence that associations may differ by sex. METHODS: In a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC), pre-diagnostic unconjugated bilirubin (UCB, the main component of total bilirubin) concentrations were measured by high-performance liquid chromatography in plasma samples of 1386 CRC cases and their individually matched controls. Additionally, 115 single-nucleotide polymorphisms (SNPs) robustly associated (P \< 5 × 10(-8)) with circulating total bilirubin were instrumented in a 2-sample MR to test for a potential causal effect of bilirubin on CRC risk in 52,775 CRC cases and 45,940 matched controls in the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), the Colon Cancer Family Registry (CCFR), and the Colorectal Transdisciplinary (CORECT) study. RESULTS: The associations between circulating UCB levels and CRC risk differed by sex (P(heterogeneity) = 0.008). Among men, higher levels of UCB were positively associated with CRC risk (odds ratio [OR] = 1.19, 95% confidence interval [CI] = 1.04-1.36; per 1-SD increment of log-UCB). In women, an inverse association was observed (OR = 0.86 (0.76-0.97)). In the MR analysis of the main UGT1A1 SNP (rs6431625), genetically predicted higher levels of total bilirubin were associated with a 7% increase in CRC risk in men (OR = 1.07 (1.02-1.12); P = 0.006; per 1-SD increment of total bilirubin), while there was no association in women (OR = 1.01 (0.96-1.06); P = 0.73). Raised bilirubin levels, predicted by instrumental variables excluding rs6431625, were suggestive of an inverse association with CRC in men, but not in women. These differences by sex did not reach formal statistical significance (P(heterogeneity) ≥ 0.2). CONCLUSIONS: Additional insight into the relationship between circulating bilirubin and CRC is needed in order to conclude on a potential causal role of bilirubin in CRC development.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN112, title = {Human Papillomavirus (HPV) Vaccine Uptake and the Willingness to Receive the HPV Vaccination among Female College Students in China: A Multicenter Study}, author = {D. You and L. Han and L. Li and J. Hu and G. D. Zimet and H. Alias and M. Danaee and L. Cai and F. Zeng and L. P. Wong}, doi = {10.3390/vaccines8010031}, issn = {2076-393X (Print) 2076-393x}, year = {2020}, date = {2020-01-01}, journal = {Vaccines (Basel)}, volume = {8}, number = {1}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: This study aimed to determine human papillomavirus (HPV) vaccine uptake and willingness to receive HPV vaccination among female college students, in China, and its associated factors. METHODS: An online cross-sectional survey of female college students across the eastern, central, and western regions of China was undertaken between April and September 2019. Partial least squares structural equation modeling (PLS-SEM) was used to examine factors associated with the HPV vaccine uptake and willingness to receive the HPV vaccine. RESULTS: Among the total 4220 students who participated in this study, 11.0% reported having been vaccinated against HPV. There are direct effects of indicators of higher socioeconomic status, older age (β = 0.084 and p = 0.006), and geographical region (residing in Eastern China, β = 0.033, and p = 0.024) on HPV vaccine uptake. Higher knowledge (β = 0.062 and p \< 0.000) and perceived susceptibility (β = 0.043 and p = 0.002) were also predictors of HPV vaccine uptake. Of those who had not received the HPV vaccine, 53.5% expressed a willingness to do so. Likewise, social economic status indicators were associated with the willingness to receive the HPV vaccine. Total knowledge score (β = 0.138 and p \< 0.001), both perceived susceptibility (β = 0.092 and p \< 0.001) and perceived benefit (β = 0.088 and p \< 0.001), and sexual experience (β = 0.041 and p = 0.007) had a positive and significant direct effect on the willingness to receive the HPV vaccine, while perceived barriers (β = -0.071 and p \< 0.001) had a negative effect on the willingness to receive the HPV vaccine. CONCLUSIONS: Geographical region and socioeconomic disparities in the HPV vaccination uptake rate and willingness to receive the HPV vaccine provide valuable information for public health planning that aims to improve vaccination rates in underserved areas in China. The influence of knowledge and perceptions of HPV vaccination suggests the importance of communication for HPV immunization.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN135, title = {Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition}, author = {S. Christakoudi and A. Kakourou and G. Markozannes and I. Tzoulaki and E. Weiderpass and P. Brennan and M. Gunter and C. C. Dahm and K. Overvad and A. Olsen and A. Tj\onneland and M. C. Boutron-Ruault and A. L. Madika and G. Severi and V. Katzke and T. K\"{u}hn and M. M. Bergmann and H. Boeing and A. Karakatsani and G. Martimianaki and P. Thriskos and G. Masala and S. Sieri and S. Panico and R. Tumino and F. Ricceri and A. Agudo and D. Redondo-S\'{a}nchez and S. M. Colorado-Yohar and O. Mokoroa and O. Melander and T. Stocks and C. H\"{a}ggstr\"{o}m and S. Harlid and B. Bueno-de-Mesquita and C. H. Gils and R. C. H. Vermeulen and K. T. Khaw and N. J. Wareham and T. Y. N. Tong and H. Freisling and M. Johansson and H. Lennon and D. Aune and E. Riboli and D. Trichopoulos and A. Trichopoulou and K. K. Tsilidis}, doi = {10.1002/ijc.32576}, issn = {0020-7136 (Print) 0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {146}, number = {10}, pages = {2680-2693}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08-1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14-1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07-1.26) (SBP)}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN96, title = {Why girls get married early in Sarawak, Malaysia - an exploratory qualitative study}, author = {A. Kohno and M. Dahlui and N. D. Nik Farid and R. Safii and T. Nakayama}, doi = {10.1186/s12905-020-00911-z}, issn = {1472-6874}, year = {2020}, date = {2020-01-01}, journal = {BMC Womens Health}, volume = {20}, number = {1}, pages = {46}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Child marriage, a marriage that involves someone under the age of 18 years, is a long-standing social issue in Sarawak state, Malaysia. The state has taken several measures to improve situations of inequity for women who get married early; however, the practice is still a common part of the tradition and culture. The aim of this study was to explore the factors leading to child marriage in Sarawak state, Malaysia. METHODS: This was an exploratory qualitative study conducted via semi-structured interviews with twenty-two women who were married when they were younger than 18 years old in Kuching, Sarawak, Malaysia. Participants were recruited through purposive and convenient sampling with the use of data from a reproductive health clinic and recruitment in villages. Thematic analysis was used for data analysis. RESULTS: Four overarching themes were identified: health risk behaviour, family poverty, early marriage as fate, and family disharmony. CONCLUSIONS: In-depth understanding of the unique factors leading to child marriage locally will facilitate the introduction of new approaches to interventions to eradicate child marriage in Sarawak state, Malaysia.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN100, title = {The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned?}, author = {N. C. Peeri and N. Shrestha and M. S. Rahman and R. Zaki and Z. Tan and S. Bibi and M. Baghbanzadeh and N. Aghamohammadi and W. Zhang and U. Haque}, doi = {10.1093/ije/dyaa033}, issn = {0300-5771 (Print) 0300-5771}, year = {2020}, date = {2020-01-01}, journal = {Int J Epidemiol}, volume = {49}, number = {3}, pages = {717-726}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVES: To provide an overview of the three major deadly coronaviruses and identify areas for improvement of future preparedness plans, as well as provide a critical assessment of the risk factors and actionable items for stopping their spread, utilizing lessons learned from the first two deadly coronavirus outbreaks, as well as initial reports from the current novel coronavirus (COVID-19) epidemic in Wuhan, China. METHODS: Utilizing the Centers for Disease Control and Prevention (CDC, USA) website, and a comprehensive review of PubMed literature, we obtained information regarding clinical signs and symptoms, treatment and diagnosis, transmission methods, protection methods and risk factors for Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS) and COVID-19. Comparisons between the viruses were made. RESULTS: Inadequate risk assessment regarding the urgency of the situation, and limited reporting on the virus within China has, in part, led to the rapid spread of COVID-19 throughout mainland China and into proximal and distant countries. Compared with SARS and MERS, COVID-19 has spread more rapidly, due in part to increased globalization and the focus of the epidemic. Wuhan, China is a large hub connecting the North, South, East and West of China via railways and a major international airport. The availability of connecting flights, the timing of the outbreak during the Chinese (Lunar) New Year, and the massive rail transit hub located in Wuhan has enabled the virus to perforate throughout China, and eventually, globally. CONCLUSIONS: We conclude that we did not learn from the two prior epidemics of coronavirus and were ill-prepared to deal with the challenges the COVID-19 epidemic has posed. Future research should attempt to address the uses and implications of internet of things (IoT) technologies for mapping the spread of infection.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN37, title = {A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort}, author = {S. Christakoudi and K. K. Tsilidis and D. C. Muller and H. Freisling and E. Weiderpass and K. Overvad and S. S\"{o}derberg and C. H\"{a}ggstr\"{o}m and T. Pischon and C. C. Dahm and J. Zhang and A. Tj\onneland and J. Halkj\aer and C. MacDonald and M. C. Boutron-Ruault and F. R. Mancini and T. K\"{u}hn and R. Kaaks and M. B. Schulze and A. Trichopoulou and A. Karakatsani and E. Peppa and G. Masala and V. Pala and S. Panico and R. Tumino and C. Sacerdote and J. R. Quir\'{o}s and A. Agudo and M. J. S\'{a}nchez and L. Cirera and A. Barricarte-Gurrea and P. Amiano and E. Memarian and E. Sonestedt and B. Bueno-de-Mesquita and A. M. May and K. T. Khaw and N. J. Wareham and T. Y. N. Tong and I. Huybrechts and H. Noh and E. K. Aglago and M. Ellingjord-Dale and H. A. Ward and D. Aune and E. Riboli}, doi = {10.1038/s41598-020-71302-5}, issn = {2045-2322}, year = {2020}, date = {2020-01-01}, journal = {Sci Rep}, volume = {10}, number = {1}, pages = {14541}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) and Cox proportional hazards models adjusted for other risk factors. During a mean follow-up of 16.1 years, 38,178 participants died. Combining in one model BMI and a strongly correlated waist index altered the association patterns with mortality, to a predominantly negative association for BMI and a stronger positive association for the waist index, while combining BMI with the uncorrelated A Body Shape Index (ABSI) preserved the association patterns. Sex-specific cohort-wide quartiles of waist indices correlated with BMI could not separate high-risk from low-risk individuals within underweight (BMI \< 18.5 kg/m(2)) or obese (BMI ≥ 30 kg/m(2)) categories, while the highest quartile of ABSI separated 18-39% of the individuals within each BMI category, which had 22-55% higher risk of death. In conclusion, only a waist index independent of BMI by design, such as ABSI, complements BMI and enables efficient risk stratification, which could facilitate personalisation of screening, treatment and monitoring.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN56, title = {Health Literacy Research in Malaysia: Health Literacy and Other Aging Challenges Among Malaysian Public Employees}, author = {T. T. Su and N. H. A. Bahuri and M. A. Said}, doi = {10.3233/shti200034}, issn = {0926-9630}, year = {2020}, date = {2020-01-01}, journal = {Stud Health Technol Inform}, volume = {269}, pages = {212-219}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {This report focuses on a study that addresses the role of health literacy in the challenges surrounding aging. The study was conducted among n=533 public employees ages 40 to 60 years old in Johor state, Malaysia. The validated Malay version of World Health Organization Quality of Life Instrument (WHOQOL-BREF) and the Short-Form Health Literacy Instrument (HLS-SF12) were used to assess perceived quality of life and general health literacy respectively. The WHOQOL-BREF comprises 26 items with six outcomes and the HLS-SF12 consists 12 items. This study provides an overview of participant quality of life, which was operationalized as a precondition of active aging. The participants' preconditions related to active aging were worrisome as 28% perceived their quality of life as poor and 34% were dissatisfied with their health. More positively, health literacy was found to be a significant determinant that may enable active aging.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN128, title = {Validity and Reliability of a Nutrition Screening Tool in Identifying Malnutrition Among Hospitalized Adult Patients}, author = {P. C. Tah and C. C. Kee and H. A. Majid}, doi = {10.1002/ncp.10416}, issn = {0884-5336}, year = {2020}, date = {2020-01-01}, journal = {Nutr Clin Pract}, volume = {35}, number = {5}, pages = {942-950}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Malnutrition among hospitalized patients is closely associated with various medical complications. This study aimed to determine the validity and reliability of a 3-Minute Nutrition Screening (3-MinNS) tool in identifying the risk of malnutrition among hospitalized patients that can be administered by healthcare professionals. METHODS: A cross-sectional study was conducted between January and December 2012. A total of 350 adult patients in a teaching hospital were screened for risk of malnutrition using 3-MinNS and Subjective Global Assessment (SGA). To assess interrater reliability, each patient was screened for risk of malnutrition using 3-MinNS by 2 different nurses on 2 different occasions within 24 hours after admission. To assess the validity of 3-MinNS, the level of risk of malnutrition identified by the nurses using 3-MinNS was compared with the risk of malnutrition as assessed by a dietitian using SGA within 48 hours after the patients' enrolment into the study. The sensitivity, specificity, and predictive values were calculated in detecting patients at risk of malnutrition. Interrater reliability was determined using κ statistics. RESULTS: Using SGA, the estimated prevalence of moderate to severe malnutrition was 36.3% (127/350). There was 94% proportional agreement between 2 nurses using 3-MinNS, and interrater reliability was substantial (κ = 0.79, P \< .001). The analysis showed that 3-MinNS had moderate sensitivity (61.4%-68.5%) but high specificity (95.1%). CONCLUSIONS: The 3-MinNS is a reliable and valid screening tool for use by healthcare professionals for identifying newly admitted medical and surgical patients who are at risk of malnutrition.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN40, title = {Impact of a mass media campaign on breast cancer symptoms awareness and screening uptake in Malaysia: findings from a quasi-experimental study}, author = {D. Schliemann and M. N. N. Htay and M. Dahlui and D. Paramasivam and C. R. Cardwell and N. S. B. Ibrahim Tamin and S. Somasundaram and C. Donnelly and T. T. Su and M. Donnelly}, doi = {10.1136/bmjopen-2019-036503}, issn = {2044-6055}, year = {2020}, date = {2020-01-01}, journal = {BMJ Open}, volume = {10}, number = {8}, pages = {e036503}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVE: To evaluate the impact of a mass media campaign in terms of improving breast cancer (BC) symptoms awareness and screening uptake. DESIGN: Before-and after-study with comparator groups. SETTING: Selangor State, Malaysia. PARTICIPANTS: Malaysian women aged \>40 years (n=676) from randomly selected households. INTERVENTION: A culturally adapted mass media campaign (TV, radio, print media and social media). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary endpoint was BC symptoms awareness, which was assessed with the Breast Cancer Awareness Measure precampaign and postcampaign. Secondary outcomes included campaign reach, self-efficacy to notice BC symptoms and clinical outcomes. Clinical breast examination and mammogram screening data were collected from hospitals and clinics. RESULTS: Most participants recognised at least one of the campaign materials (65.2%). The odds of seeing the campaign were lowest for Chinese women (adjusted OR 0.25, 95% CI 0.15 to 0.40) compared with Malays and for women aged \>70 years (adjusted OR 0.47, 95% CI 0.23 to 0.94) compared with younger women. Participants who recognised the campaign were significantly more likely to have improved awareness postcampaign compared with non-recognisers particularly for key symptoms such as 'a lump or thickening in your breast' (88.9% vs 62.1%) and 'discharge or bleeding from nipple' (79.7% vs 55.3%). Improvement in symptoms awareness scores was not associated with sociodemographic variables. CONCLUSIONS: Implementation in Malaysia of an evidence-based mass media campaign from the UK that was culturally adapted appeared to lead to improved awareness about some BC symptoms, though various modes of media communication and perhaps other health education approaches may be required to extend the reach to diverse, multiethnic populations and all age groups.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN21, title = {Meta-synthesis of Qualitative Research of Pre-exposure Prophylaxis (PrEP) Adherence Among Men Who Have Sex With Men (MSM)}, author = {S. Z. Ching and L. P. Wong and M. A. B. Said and S. H. Lim}, doi = {10.1521/aeap.2020.32.5.416}, issn = {0899-9546}, year = {2020}, date = {2020-01-01}, journal = {AIDS Educ Prev}, volume = {32}, number = {5}, pages = {416-431}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {The aim of the study was to consolidate evidence on barriers and facilitators to PrEP adherence among men who have sex with men. PubMed, Science Direct, and EBSCO host were utilized to search for relevant articles. Six articles from PubMed, published between 2010 and 2018, were reviewed. Thematic analysis was employed to synthesize findings. At the individual level, HIV susceptibility, knowledge of PrEP, and individual lifestyle affected PrEP adherence. At the organizational level, cost of PrEP and quality of PrEP services influenced adherence to PrEP. At the societal level, social stigma, financial assistance or medical insurance, and family and peer support were determinants of PrEP adherence. Facilitators included perceived high risk of HIV infection and payment assistance, while barriers included social stigma and high cost of PrEP. Social stigma and structural level factors such as payment assistance and cost of PrEP need to be examined to ensure optimal adherence to PrEP.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN54, title = {The impact of adult trauma triage training on decision-making skills and accuracy of triage decision at emergency departments in Malaysia: A randomized control trial}, author = {S. A. Ghazali and K. L. Abdullah and F. M. Moy and R. Ahmad and E. O. D. Hussin}, doi = {10.1016/j.ienj.2020.100889}, issn = {1878-013x}, year = {2020}, date = {2020-01-01}, journal = {Int Emerg Nurs}, volume = {51}, pages = {100889}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {INTRODUCTION: Patients who visit emergency departments need to undergo a precise assessment to determine their priority and accurate triage category to ensure they receive the right treatment. AIM: To identify the effect of triage training on the skills and accuracy of triage decisions for adult trauma patients. METHOD: A randomized controlled trial design was conducted in ten emergency department of public hospitals. A total of 143 registered nurses and medical officer assistants who performed triage roles were recruited for the control group (n = 74) and the intervention group (n = 69). The skill and accuracy of triage decisions were measured two weeks and four weeks after the intervention group were exposed to the intervention. RESULTS: There was a significant effect on the skill of triage decision-making between the control and the intervention group p \< 0.001, η(2)(partial) = 0.31. Concerning the accuracy of triage decisions, the effect was significantly different between the control group and the intervention group p \< 0.001, η(2)(partial) = 0.66 across time. CONCLUSION: The triage training improved the skills of the participants and the accuracy of triage decision-making across time.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN129, title = {Heavy metals (Cr, Pb, Cd, Ni) in aerosols emitted from electronic cigarettes sold in Malaysia}, author = {C. Y. Ting and N. A. Ahmad Sabri and L. L. Tiong and H. Zailani and L. P. Wong and N. Agha Mohammadi and L. Anchah}, doi = {10.1080/10934529.2019.1665950}, issn = {1093-4529}, year = {2020}, date = {2020-01-01}, journal = {J Environ Sci Health A Tox Hazard Subst Environ Eng}, volume = {55}, number = {1}, pages = {55-62}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {While past studies have detected heavy metals in aerosols emitted from electronic cigarettes (ECIG), they have provided little information detailing the practical implications of the findings to the Malaysian population due to variations between products. The aims of this study were to analyse heavy metals of interest (HMOI) in the aerosols emitted from selected ECIG and to evaluate potential health risks by referring to the permissible daily exposure (PDE) from inhalational medications defined by the United States Pharmacopeia Chapter 232. All four HMOI were detected in aerosols emitted from the selected ECIG in Sarawak. Among the four, Cr was present at the highest median levels (6.86 ng/m(3)), followed by Ni (0.30 ng/m(3)), Pb (0.19 ng/m(3)) and Cd (0.01 ng/m(3)). Five out of 100 combinations (5%) of ECIG and ECIG liquids were found to emit Cr that exceed the recommended PDE. Future studies examining more heavy metal variants, using a larger sample size and different analytical techniques to compare various ECIGs are recommended.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN41, title = {Correction to: Impact of migraine on workplace productivity and monetary loss: a study of employees in banking sector in Malaysia}, author = {L. P. Wong and H. Alias and N. Bhoo-Pathy and I. Chung and Y. C. Chong and S. Kalra and Z. U. Bahkt Sultan Shah}, doi = {10.1186/s10194-020-01172-9}, issn = {1129-2369 (Print) 1129-2369}, year = {2020}, date = {2020-01-01}, journal = {J Headache Pain}, volume = {21}, number = {1}, pages = {104}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {An amendment to this paper has been published and can be accessed via the original article.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN130, title = {Exogenous hormone use and cutaneous melanoma risk in women: The European Prospective Investigation into Cancer and Nutrition}, author = {I. Cervenka and M. Al Rahmoun and Y. Mahamat-Saleh and A. Fournier and M. C. Boutron-Ruault and G. Severi and S. Caini and D. Palli and R. Ghiasvand and M. B. Veierod and E. Botteri and A. Tj\onneland and A. Olsen and R. T. Fortner and R. Kaaks and M. B. Schulze and S. Panico and A. Trichopoulou and C. Dessinioti and K. Niforou and S. Sieri and R. Tumino and C. Sacerdote and B. Bueno-de-Mesquita and T. M. Sandanger and S. Colorado-Yohar and M. J. S\'{a}nchez and L. Gil Majuelo and L. Lujan-Barroso and E. Ardanaz and S. Merino and K. Isaksson and S. Butt and I. Ljuslinder and M. Jansson and R. C. Travis and K. T. Khaw and E. Weiderpass and L. Dossus and S. Rinaldi and M. Kvaskoff}, doi = {10.1002/ijc.32674}, issn = {0020-7136}, year = {2020}, date = {2020-01-01}, journal = {Int J Cancer}, volume = {146}, number = {12}, pages = {3267-3280}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in 1992 in 10 European countries. Information on exogenous hormone use at baseline was derived from country-specific self-administered questionnaires. We used Cox proportional hazards regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Over 1992-2015, 1,696 melanoma cases were identified among 334,483 women, whereof 770 cases among 134,758 postmenopausal women. There was a positive, borderline-significant association between OC use and melanoma risk (HR = 1.12, 95% CI = 1.00-1.26), with no detected heterogeneity across countries (p(homogeneity) = 0.42). This risk increased linearly with duration of use (p(trend) = 0.01). Among postmenopausal women, ever use of MHT was associated with a nonsignificant increase in melanoma risk overall (HR = 1.14, 95% CI = 0.97-1.43), which was heterogeneous across countries (p(homogeneity) = 0.05). Our findings do not support a strong and direct association between exogenous hormone use and melanoma risk. In order to better understand these relations, further research should be performed using prospectively collected data including detailed information on types of hormone, and on sun exposure, which may act as an important confounder or effect modifier on these relations.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN71, title = {Individual antecedents of workplace victimisation: The role of negative affect, personality and self-esteem in junior doctors' exposure to bullying at work}, author = {E. Z. Samsudin and M. Isahak and S. Rampal and I. Rosnah and M. I. Zakaria}, doi = {10.1002/hpm.2985}, issn = {0749-6753}, year = {2020}, date = {2020-01-01}, journal = {Int J Health Plann Manage}, volume = {35}, number = {5}, pages = {1065-1082}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Previous studies have indicated that junior doctors commonly experience workplace bullying and that it may adversely impact medical training and delivery of quality healthcare. Yet, evidence on the precursors of bullying among them remains elusive. Drawing on the individual-disposition hypothesis, the present paper examined the relationships of negative affect, personality and self-esteem with workplace bullying among junior doctors. Multilevel analysis of a universal sample (n = 1074) of junior doctors working in the central zone of Malaysia using mixed effects logistic regression was performed. The results indicate that participants with moderate (AOR 4.40, 95% CI 2.20-8.77) and high degree (AOR 13.69, 95% CI 6.46-29.02) of negative affect as well as high degree of neuroticism (AOR 2.99, 95% CI 1.71-5.21) have higher odds of being bullied compared to their counterparts. The findings present evidence that individual traits are associated with junior doctors' exposure to bullying. While victim blaming should be avoided, this suggest that antibullying measures with an interpersonal focus should be considered when developing antibullying initiatives targeted at junior doctors. This includes primary intervention such as cognitive training, secondary interventions such as resource enhancement building and conflict management skills training, and tertiary interventions such as counselling.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN131, title = {Prediagnostic Plasma Bile Acid Levels and Colon Cancer Risk: A Prospective Study}, author = {T. K\"{u}hn and M. Stepien and M. L\'{o}pez-Nogueroles and A. Damms-Machado and D. Sookthai and T. Johnson and M. Roca and A. H\"{u}sing and S. G. Maldonado and A. J. Cross and N. Murphy and H. Freisling and S. Rinaldi and A. Scalbert and V. Fedirko and G. Severi and M. C. Boutron-Ruault and F. R. Mancini and S. A. Sowah and H. Boeing and P. Jakszyn and M. J. S\'{a}nchez and S. Merino and S. Colorado-Yohar and A. Barricarte and K. T. Khaw and J. A. Schmidt and A. Perez-Cornago and A. Trichopoulou and A. Karakatsani and P. Thriskos and D. Palli and C. Agnoli and R. Tumino and C. Sacerdote and S. Panico and B. Bueno-de-Mesquita and C. H. Gils and A. K. Heath and M. J. Gunter and E. Riboli and A. Lahoz and M. Jenab and R. Kaaks}, doi = {10.1093/jnci/djz166}, issn = {0027-8874 (Print) 0027-8874}, year = {2020}, date = {2020-01-01}, journal = {J Natl Cancer Inst}, volume = {112}, number = {5}, pages = {516-524}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Bile acids have been proposed to promote colon carcinogenesis. However, there are limited prospective data on circulating bile acid levels and colon cancer risk in humans. METHODS: Associations between prediagnostic plasma levels of 17 primary, secondary, and tertiary bile acid metabolites (conjugated and unconjugated) and colon cancer risk were evaluated in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Bile acid levels were quantified by tandem mass spectrometry in samples from 569 incident colon cancer cases and 569 matched controls. Multivariable logistic regression analyses were used to estimate odds ratios (ORs) for colon cancer risk across quartiles of bile acid concentrations. RESULTS: Positive associations were observed between colon cancer risk and plasma levels of seven conjugated bile acid metabolites: the primary bile acids glycocholic acid (ORquartile 4 vs quartile 1= 2.22, 95% confidence interval [CI] = 1.52 to 3.26), taurocholic acid (OR = 1.78, 95% CI = 1.23 to 2.58), glycochenodeoxycholic acid (OR = 1.68, 95% CI = 1.13 to 2.48), taurochenodeoxycholic acid (OR = 1.62, 95% CI = 1.11 to 2.36), and glycohyocholic acid (OR = 1.65, 95% CI = 1.13 to 2.40), and the secondary bile acids glycodeoxycholic acid (OR = 1.68, 95% CI = 1.12 to 2.54) and taurodeoxycholic acid (OR = 1.54, 95% CI = 1.02 to 2.31). By contrast, unconjugated bile acids and tertiary bile acids were not associated with risk. CONCLUSIONS: This prospective study showed that prediagnostic levels of certain conjugated primary and secondary bile acids were positively associated with risk of colon cancer. Our findings support experimental data to suggest that a high bile acid load is colon cancer promotive.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN58, title = {Influence of Mass and Social Media on Psychobehavioral Responses Among Medical Students During the Downward Trend of COVID-19 in Fujian, China: Cross-Sectional Study}, author = {Y. Lin and Z. Hu and H. Alias and L. P. Wong}, doi = {10.2196/19982}, issn = {1439-4456 (Print) 1438-8871}, year = {2020}, date = {2020-01-01}, journal = {J Med Internet Res}, volume = {22}, number = {7}, pages = {e19982}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: An extensive amount of information related to the novel coronavirus (COVID-19) pandemic was disseminated by mass and social media in China. To date, there is limited evidence on how this infodemic may influence psychobehavioral responses to the crisis. OBJECTIVE: The aim of this study is to assess the psychobehavioral responses to the COVID-19 outbreak and examine their associations with mass and social media exposure. METHODS: A cross-sectional study among medical and health sciences students from the Fujian Medical University in Fuzhou, China, was conducted between April 6-22, 2020. RESULTS: A total of 2086 completed responses were received. Multivariable analyses demonstrated that four constructs of the Health Belief Model (HBM)-higher perception of susceptibility (odds ratio [OR] 1.44; 95% CI 1.07-1.94), severity (OR 1.32; 95% CI 1.10-1.59), self-efficacy (OR 1.61; 95% CI 1.21-2.15), and perceived control or intention to carry out prevention measures (OR 1.32; 95% CI 1.09-1.59)-were significantly associated with a higher mass media exposure score, whereas only three constructs-higher perception of severity (OR 1.43; 95% CI 1.19-1.72), self-efficacy (OR 1.85; 95% CI 1.38-2.48), and perceived control or intention to carry out prevention measures (OR 1.32; 95% CI 1.08-1.58)-were significantly associated with a higher social media exposure score. Lower emotional consequences and barriers to carry out prevention measures were also significantly associated with greater mass and social media exposure. Our findings on anxiety levels revealed that 38.1% (n=795; 95% CI 36.0-40.2) of respondents reported moderate-to-severe anxiety. A lower anxiety level was significantly associated with higher mass and social media exposure in the univariable analyses; however, the associations were not significant in the multivariable analyses. CONCLUSIONS: In essence, both mass and social media are useful means of disseminating health messages and contribute to the betterment of psychobehavioral responses to COVID-19. Our findings stress the importance of the credibility of information shared through mass and social media outlets and viable strategies to counter misinformation during a pandemic.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN103, title = {Material security and adherence to antiretroviral therapy among HIV-positive people who use illicit drugs}, author = {N. A. Mohd Salleh and J. Van Draanen and E. Nosova and R. Barrios and M. J. Milloy and L. Richardson}, doi = {10.1097/qad.0000000000002501}, issn = {0269-9370 (Print) 0269-9370}, year = {2020}, date = {2020-01-01}, journal = {Aids}, volume = {34}, number = {7}, pages = {1037-1045}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {OBJECTIVE: To examine the relationship between poverty, operationalized using a novel material security measure, and adherence to antiretroviral therapy (ART) among people who use illicit drugs (PWUD) in a context of universal access to HIV care. DESIGN: We analyzed data from a community-recruited prospective cohort in Vancouver, Canada (n = 623), from 2014 to 2017. METHODS: We used multivariable generalized mixed-effects analyses to estimate longitudinal factors associated with mean material security score. We then estimated the association between achieving at least 95% adherence to ART and overall mean material score, as well as mean score for three factors derived from a factor analysis. The three-factor structure, employed in the current analyses, were factor 1 (basic needs); factor 2 (housing-related variables) and factor 3 (economic resources). RESULTS: Recent incarceration [β-coefficient (β) = -0.176, 95% confidence interval (95% CI): -0.288 to -0.063], unmet health needs [β = -0.110, 95% CI: -0.178 to -0.042), unmet social service needs (β = -0.264, 95% CI: -0.336 to -0.193) and having access to social services (β= -0.102, 95% CI: -0.1586 to -0.0465) were among the factors associated with lower material security scores. Contrary to expectations that low levels of material security in this population would lead to poor ART adherence, we did not observe a significant relationship between adherence and overall material security score, or for each factor individually. CONCLUSION: Our findings highlight the potentially important role of no-cost, universal access to HIV prevention and treatment, in mitigating the impact of socioeconomic disadvantage on ART adherence.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN148, title = {"You Have to Keep Yourself Hidden": Perspectives From Malaysian Malay-Muslim Men Who Have Sex With Men on Policy, Network, Community, and Individual Influences on HIV Risk}, author = {S. H. Lim and S. E. Brown and S. A. Shaw and A. Kamarulzaman and F. L. Altice and C. Beyrer}, doi = {10.1080/00918369.2018.1525946}, issn = {0091-8369}, year = {2020}, date = {2020-01-01}, journal = {J Homosex}, volume = {67}, number = {1}, pages = {104-126}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {Malay-Muslim men who have sex with men (MSM) are marginalized and hidden in Malaysia, a predominantly Muslim country in southeast Asia. We explored the policy, network, community, and individual factors related to HIV infection among Malay-Muslim MSM through 26 in-depth interviews and one focus group discussion (n = 5) conducted in Kuala Lumpur and Kota Bharu between October 2013 and January 2014. As religion plays an important role in their lives, participants viewed homosexuality as a sin. Low risk perception and misconceptions about HIV/AIDS were common, and most participants expressed reluctance to consult a doctor unless they had symptoms. Additionally, buying condoms was embarrassing and anxiety-producing. Fear of discrimination by health care providers and community hindered participants from disclosing sexual behaviors and accessing health services. Homophobic comments and policies by the government and religious leaders were concerns of participants. A safe and enabling environment is needed to reduce HIV risks among Malay-Muslim MSM.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN132, title = {Diagnosis of severe dengue: Challenges, needs and opportunities}, author = {P. F. Wong and L. P. Wong and S. AbuBakar}, doi = {10.1016/j.jiph.2019.07.012}, issn = {1876-0341}, year = {2020}, date = {2020-01-01}, journal = {J Infect Public Health}, volume = {13}, number = {2}, pages = {193-198}, school = {Department of SPM, Faculty of Medicine, University of Malaya}, abstract = {BACKGROUND: Delayed diagnosis of dengue cases with increased risk for severe disease could lead to poor disease outcome. To date there is no specific laboratory diagnostic test for severe dengue. This qualitative study explored expert views regarding current issues in diagnosing severe dengue, rationale for severe dengue-specific diagnostics, future prospects and features of potential diagnostics for severe dengue. METHODS: In-depth individual interviews with thematic saturation were conducted between May and July 2018. The data was analyzed using thematic analysis. RESULTS: Based on expert opinion, diagnosis of severe dengue is challenging as it depends on astute clinical interpretation of non-dengue-specific clinical and laboratory findings. A specific test that detects impending manifestation of severe dengue could 1) overcome failure in identifying severe disease for referral or admission, 2) facilitate timely and appropriate management of plasma leakage and bleeding, 3) overcome the lack of clinical expertise and laboratory diagnosis in rural health settings. The most important feature of any diagnostics for severe dengue is the point-of-care (POC) format where it can be performed at or near the bedside. CONCLUSION: The development of diagnostics to detect impending severe dengue is warranted to reduce the morbidity and mortality rates of dengue infection and it should be prioritized.}, note = {Master of Public Health}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{WongLP2019, title = {Smoking: Prevention, Cessation and Health Effects}, author = {I Madanhire and C Mbohwa and N Maddu and L Tang and A Chowdhury and L Xiu}, editor = {L P Wong and V C W Hoe}, url = {https://spm.um.edu.my/knowledge-centre/books/smoking-prevention-cessation-and-health-effects/}, isbn = {978-1-78923-879-2}, year = {2019}, date = {2019-11-30}, publisher = {IntechOpen}, address = {United Kingdom}, abstract = {Smoking can lead to a variety of ongoing complications in the body as well as long-term effects on body systems. While smoking can increase the risk of a variety of problems over several years, some of the bodily effects are immediate. This book provides a comprehensive overview of opinions and research findings on smoking and its harmful effects and serves as a valuable reference for researchers and the general public. The issue of electronic cigarettes is one of the most controversial topics in public health. This book also provides an overview of electronic cigarettes and opinions about their use patterns and health concerns, up-to-date evidence of the health risks and safety of electronic cigarettes are discussed. This book also highlights the policies and regulations on electronic cigarettes that vary across countries. Lastly, readers are also enlightened on the future perspectives of electronic cigarettes and whether they are a threat or an opportunity for public health.}, keywords = {}, pubstate = {published}, tppubtype = {book} } @inproceedings{RN16778, title = {Performance evaluation of energy autonomous sensors for air quality monitoring in internet of vehicles}, author = {S S Anjum and R M Noor and I Ahmedy and M H Anisi and N Aghamohammadi and N B Khamis and M A Qureshi}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85068965443\&doi=10.1109%2fVTCSpring.2019.8746496\&partnerID=40\&md5=e55f0a091854989436af0d5ddad43f96}, doi = {10.1109/VTCSpring.2019.8746496}, year = {2019}, date = {2019-05-01}, volume = {2019-April}, abstract = {The technological advancements in the field of internet of things (IoT) have paved way for the evolution of internet of vehicles (IoV), where the things are replaced with vehicles through enabling technologies such as vehicular adhoc networks (VANETs) and intelligent transportation systems (ITS).The technology of simultaneous wireless information and power transfer (SWIPT) provides potential opportunity for increasing the lifetime of the energy-autonomous nodes in vehicular networks. Moreover, the integration of SWIPT with cognitive radio sensor networks (CRSN) has been proved as a vital technique for increasing throughput and effective utilization of the spectrum.In this paper, we consider a cooperative CRSN with near field SWIPT technique for autonomous vehicles (AUV) to monitor the air quality, where the secondary user (SU) forwards and sends the information to the destination through the energy harvested from the radio frequency (RF) signal, thereby focusing towards achieving maximum throughput and also address the trade-off between performance and energy consumption. The problem is formulated using Energy Harvesting and Information Transfer(EHIT) technique and the proof-of-concept is presented based upon a small-scale hardware model to test the performance of the sensors. The results indicate that the proposed SWIPT method for energy autonomous sensors provides optimal solution and has higher performance in comparison to the state-of-art solutions. © 2019 IEEE.}, keywords = {}, pubstate = {published}, tppubtype = {inproceedings} } @article{RN16670, title = {The Prevalence of Smoking, Determinants and Chance of Psychological Problems among Smokers in an Urban Community Housing Project in Malaysia}, author = {R Abd Rashid and S Kanagasundram and M Danaee and H Abdul Majid and A H Sulaiman and M M Ahmad Zahari and C G Ng and B Francis and W A I Wan Husin and T T Su}, doi = {10.3390/ijerph16101762}, issn = {1660-4601}, year = {2019}, date = {2019-01-01}, journal = {Int J Environ Res Public Health}, volume = {16}, number = {10}, abstract = {Objective: This study was conducted to assess the prevalence, pattern of smoking and sociodemographic factors among Kerinchi residents in Kuala Lumpur, as well as to identify the association between smoking, stress, anxiety and depression. Methods: This study was carried out at four community housing projects in the Lembah Pantai area in Kuala Lumpur. Data was collected between 3 February 2012, and 29 November 2012. Data collectors made house visits and used interviewer administered questionnaires containing questions on demographic data and smoking patterns. Depression anxiety stress scale (DASS) was used to assess psychological symptoms. Alcohol smoking and substance involvement screening tool (ASSIST) scale was used to assess nicotine use. Results: Data from 1989 individuals (833 households) showed the age of respondents ranged from 18 to 89 years and the mean age was 39.12 years. There were 316 smokers indicating the prevalence of smoking was 15.85%, with 35.5% among males and 1.8% among females. Further, 86.6% of smokers were Malay and 87% were Muslims. Divorce was associated with smoking. Unemployment and housewives were less associated with smoking. Depression and anxiety were significantly associated with smoking (OR = 1.347. 95% CI: 1.042-1.741) and (OR = 1.401. 95% CI: 1.095-1.793) respectively. Conclusion: Screening for depression and anxiety should be routinely performed in the primary care setting and in population-based health screening to intervene early in patients who smoke.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16669, title = {Job Stress and Nurses Well-Being: Prayer and Age as Moderators}, author = {M Achour and I Binti Abdul Ghani Azmi and M Bin Isahak and M R Mohd Nor and M Y Z Mohd Yusoff}, doi = {10.1007/s10597-019-00410-y}, issn = {0010-3853}, year = {2019}, date = {2019-01-01}, journal = {Community Ment Health J}, volume = {55}, number = {7}, pages = {1226-1235}, abstract = {There is increasing popularity among researchers, scholars, and policymakers concerning the efficacy of prayer as a coping strategy for job stress. This study examines the moderating effects of prayer and age on the relationship between job stress and nurses' well-being in UMMC. Three hundred (300) Muslim nursing staff working at the University of Malaya Medical Centre were sampled. Data were collected via questionnaires. The findings of this study show that the effect of job stress on well-being is significant for nurses and that prayer of nurses contributed to alleviating job stress and enhancing well-being. This study is limited to nurses in one public hospital in a developing country. Thus, it would be more interesting if the study could be extended to other public and private institutions in a Muslim country, and a comparison could be done between other religions as well.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16659, title = {Consumption of Fish and Long-chain n-3 Polyunsaturated Fatty Acids Is Associated With Reduced Risk of Colorectal Cancer in a Large European Cohort}, author = {E K Aglago and I Huybrechts and N Murphy and C Casagrande and G Nicolas and T Pischon and V Fedirko and G Severi and M C Boutron-Ruault and A Fournier and V Katzke and T Kuhn and A Olsen and A Tjonneland and C C Dahm and K Overvad and C Lasheras and A Agudo and M J Sanchez and P Amiano and J M Huerta and E Ardanaz and A Perez-Cornago and A Trichopoulou and A Karakatsani and G Martimianaki and D Palli and V Pala and R Tumino and A Naccarati and S Panico and B Bueno-de-Mesquita and A May and J W G Derksen and S Hellstrand and B Ohlsson and M Wennberg and B Van Guelpen and G Skeie and M Brustad and E Weiderpass and A J Cross and H Ward and E Riboli and T Norat and V Chajes and M J Gunter}, doi = {10.1016/j.cgh.2019.06.031}, issn = {1542-3565}, year = {2019}, date = {2019-01-01}, journal = {Clin Gastroenterol Hepatol}, abstract = {BACKGROUND \& AIMS: There is an unclear association between intake of fish and long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFAs) and colorectal cancer (CRC). We examined the association between fish consumption, dietary and circulating levels of n-3 LC-PUFAs, and ratio of n-6:n-3 LC-PUFA with CRC using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: Dietary intake of fish (total, fatty/oily, lean/white) and n-3 LC-PUFA were estimated by food frequency questionnaires given to 521,324 participants in the EPIC study; among these, 6291 individuals developed CRC (median follow up, 14.9 years). Levels of phospholipid LC-PUFA were measured by gas chromatography in plasma samples from a sub-group of 461 CRC cases and 461 matched individuals without CRC (controls). Multivariable Cox proportional hazards and conditional logistic regression models were used to calculate hazard ratios (HRs) and odds ratios (ORs), respectively, with 95% CIs. RESULTS: Total intake of fish (HR for quintile 5 vs 1, 0.88; 95% CI, 0.80-0.96; Ptrend = .005), fatty fish (HR for quintile 5 vs 1, 0.90; 95% CI, 0.82-0.98; Ptrend = .009), and lean fish (HR for quintile 5 vs 1, 0.91; 95% CI, 0.83-1.00; Ptrend = .016) were inversely associated with CRC incidence. Intake of total n-3 LC-PUFA (HR for quintile 5 vs 1, 0.86; 95% CI, 0.78-0.95; Ptrend = .010) was also associated with reduced risk of CRC, whereas dietary ratio of n-6:n-3 LC-PUFA was associated with increased risk of CRC (HR for quintile 5 vs 1, 1.31; 95% CI, 1.18-1.45; Ptrend \< .001). Plasma levels of phospholipid n-3 LC-PUFA was not associated with overall CRC risk, but an inverse trend was observed for proximal compared with distal colon cancer (Pheterogeneity = .026). CONCLUSIONS: In an analysis of dietary patterns of participants in the EPIC study, we found regular consumption of fish, at recommended levels, to be associated with a lower risk of CRC, possibly through exposure to n-3 LC-PUFA. Levels of n-3 LC-PUFA in plasma were not associated with CRC risk, but there may be differences in risk at different regions of the colon.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16632, title = {Factors associated with healthcare workers willingness to participate in disasters: a cross-sectional study in Sana'a, Yemen}, author = {W Al-Hunaishi and V C Hoe and K Chinna}, doi = {10.1136/bmjopen-2019-030547}, issn = {2044-6055}, year = {2019}, date = {2019-01-01}, journal = {BMJ Open}, volume = {9}, number = {10}, pages = {e030547}, abstract = {OBJECTIVES: Willingness to participate in disasters is usually overlooked and not addressed in disaster preparedness training courses to ensure health service coverage. This will lead to issues during the disaster's response. This study, therefore, aims to assess healthcare workers willingness to participate in biological and natural disasters, and to identify its associated factors. DESIGN: This is a cross-sectional study using a self-administered questionnaire. The questionnaire was distributed to 1093 healthcare workers. The data were analysed using multiple logistic regression with significance level p\<0.05. Ethical clearance and consent of the participants were duly obtained. SETTING: In three public hospitals that provide tertiary-level healthcare in Sana'a City, Yemen. PARTICIPANTS: There were 692 nurses and doctors (response rate 63.3%) completed the questionnaires. RESULTS: Almost half of the participants 55.1% were nurses and 44.9% were doctors. The study found that self-efficacy was associated with willingness to participate in disaster response for any type of disasters (OR 1.319, 95% CI 1.197 to 1.453), natural disasters (OR 1.143, 95% CI 1.069 to 1.221) and influenza pandemic (OR 1.114, 95% CI 1.050 to 1.182). The results further show that willingness is associated with healthcare workers being young, male and having higher educational qualifications. CONCLUSION: Self-efficacy has been found to be an important factor associated with willingness. Improving self-efficacy through training in disaster preparedness may increase willingness of healthcare workers to participate in a disaster.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16720, title = {Maternal, prenatal and traditional practice factors associated with perinatal mortality in Yemen}, author = {A H Al-Shahethi and R A Zaki and A W A Al-Serouri and A Bulgiba}, doi = {10.1016/j.wombi.2018.06.016}, issn = {1871-5192}, year = {2019}, date = {2019-01-01}, journal = {Women Birth}, volume = {32}, number = {2}, pages = {e204-e215}, abstract = {BACKGROUND: Perinatal mortality remains a major international problem responsible for nearly six million stillbirths and neonatal deaths. OBJECTIVES: To estimate the perinatal mortality rate in Sana'a, Yemen and to identify risk factors for perinatal deaths. METHODS: A community-based prospective cohort study was carried out between 2015 and 2016. Nine-hundred and eighty pregnant women were identified and followed up to 7 days following birth. A multi-stage cluster sampling was used to select participants from community households', residing in the five districts of the Sana'a City, Yemen. RESULTS: Total of 952 pregnant women were tracked up to 7 days after giving birth. The perinatal mortality rate, the stillbirth rate and the early neonatal mortality rate, were 89.3 per 1000, 46.2 per 1000 and 45.2 per 1000, respectively. In multivariable analysis older age (35+ years) of mothers at birth (Relative Risk=2.83), teenage mothers' age at first pregnancy (\<18 years) (Relative Risk=1.57), primipara mothers (Relative Risk=1.90), multi-nuclear family (Relative Risk=1.74), mud house (Relative Risk=2.02), mothers who underwent female genital mutilation (Relative Risk=2.92) and mothers who chewed khat (Relative Risk=1.60) were factors associated with increased risk of perinatal death, whereas a positive mother's tetanus vaccination status (Relative Risk=0.49) were significant protective factors against perinatal deaths. CONCLUSION: Rates of perinatal mortality were higher in Sana'a City compared to perinatal mortality at the national level estimated by World Health Organization. It is imperative there be sustainable interventions in order to improve the country's maternal and newborn health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16694, title = {Dentition status among an ethnically diverse older urban Malaysian population}, author = {M A Amanat and J John and T M Pin and M Danaee and V Malhotra and S A Abbas and S B Kamaruzzaman}, doi = {10.1093/pubmed/fdz014}, issn = {1741-3842}, year = {2019}, date = {2019-01-01}, journal = {J Public Health (Oxf)}, abstract = {BACKGROUND: Poor oral health affects not only dietary choices but overall well-being. This study explores the influence of lifestyle, socio-demographics and utilization of dental services on the dentition status of an older urban Malaysian population. METHODS: A total of 1210 participants 60 years and above, representing the three main ethnic groups were recruited from a larger cohort study. Weighted factors valued for comparison included socio demographics and health status. Knowledge of and attitude and behaviour towards personal oral health were also assessed. Dentition status, adapted from WHO oral health guidelines, was the dependent variable investigated. Data were analysed using descriptive chi square test and multivariate binary logistic regression. RESULTS: Overall, 1187 respondents completed the study. The dentition status and oral health related knowledge, attitude and behaviour varied between the three ethnic groups. The Chinese were significantly less likely to have \>/=13 missing teeth (OR = 0.698, 95% CI: 0.521-0.937) and \>/=1 decayed teeth (0.653; 0.519-0.932) compared to the Malays, while the Indians were significantly less likely than the Malays to have \>/=1 decayed teeth (0.695; 0.519-0.932) and \>/=2 filled teeth (0.781; 0.540-1.128). CONCLUSION: Ethnic differences in dentition outcome are related to oral health utilization highlighting the influence of cultural differences and the need for culturally sensitivity interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16744, title = {Care Recipient Multimorbidity and Health Impacts on Informal Caregivers: A Systematic Review}, author = {A Amer Nordin and F Mohd Hairi and W Y Choo and N N Hairi}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85074799228\&doi=10.1093%2fgeront%2fgny072\&partnerID=40\&md5=be3ec5ca894a508227576ad6c624addc}, doi = {10.1093/geront/gny072}, year = {2019}, date = {2019-01-01}, journal = {Gerontologist}, volume = {59}, number = {5}, pages = {e611-e628}, abstract = {Background and Objectives Caregiving outcomes have often been reported in terms of care recipients of single disease, rather than multiple health conditions. A systematic review was conducted to outline caregiving health outcomes and its association with care recipient multimorbidity for informal caregivers of older adults. Research Design and Methods A search strategy was applied in six databases and grey literature. Inclusion criteria were primary observational studies on informal caregiving for care recipients aged 60 years and above, in the English language. Informal caregivers were those not formally hired and multimorbidity referred to presence of at least two health conditions. From a total of 2,101 titles, 230 abstracts were screened, and 19 articles were included. Quality assessment was conducted with application of the Newcastle-Ottawa-Scale. Results Health-related and caregiving-related outcomes have been assessed for informal caregivers of older adults with multimorbidity. Caregiver subjective burden was most commonly evaluated and often reported to be low to moderate. In association with care recipient multimorbidity, caregiver burden, quality of life, and perceived difficulty in assisting the older adults were examined in 14 of the studies with mixed results. Studies were heterogeneous, with nonuniform definitions of informal caregivers and multimorbidity as well as measurement tools. Discussion and Implications This narrative review found that caring for older adults with multimorbidity impacts caregivers, although overall evidence is not conclusive. Despite caregiving-related outcomes being most commonly assessed among the caregivers, particularly subjective burden, findings suggest that it is worthwhile to examine other outcomes to enrich the evidence base. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16727, title = {The Prevalence and Associated Factors of Depression, Anxiety and Stress of First Year Undergraduate Students in a Public Higher Learning Institution in Malaysia}, author = {N S Amir Hamzah and N D Nik Farid and A Yahya and C Chin and T T Su and S R L Rampal and M Dahlui}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85073992634\&doi=10.1007%2fs10826-019-01537-y\&partnerID=40\&md5=0849c3fb627ef2e4807a7da1b35556fb}, doi = {10.1007/s10826-019-01537-y}, year = {2019}, date = {2019-01-01}, journal = {Journal of Child and Family Studies}, volume = {28}, number = {12}, pages = {3545-3557}, abstract = {Objectives: While university life is characterized by the pursuit of greater educational opportunities and employment prospects, it can also be a trigger of mental health problems. This study aims to: (a) measure the prevalence of depression, anxiety, and stress among first-year undergraduate students in the University of Malaya, and; (b) determine the associated factors of depression, anxiety, and stress. Methods: This cross-sectional study consisted of two phases: survey administration and physical assessment. In the first phase, data were collected electronically using a mobile application during the orientation week. The Depression, Anxiety and Stress Scale-21 (DASS-21) questionnaire was employed to assess respondents’ mental health status. In the second phase, anthropometric measurements which included height, weight, waist circumference, and blood pressure were taken. Results: Of 1602 students, the prevalence of moderate to extremely severe depression was 21% (n = 341), anxiety 50% (n = 793), and stress 12% (n = 197). Findings showed that students who lived with non-family members were more likely to develop depression (OR: 1.846, 95% CI: 1.266\textendash2.693), anxiety (OR: 1.529, 95% CI: 1.024\textendash2.284), and stress (OR: 1.655, 95% CI: 1.110\textendash2.468). Those with previous medical history were more likely to have anxiety (OR: 1.697, 95% CI: 1.097\textendash2.626). Interestingly, students from the Southern region (OR: 0.667, 95% CI: 0.468\textendash0.950) and from Sabah and Sarawak (OR: 0.503, 95% CI: 0.281\textendash0.900) were less likely to report depression. Conclusions: Future intervention programs should follow the socio-ecological model while addressing university students’ mental health needs. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16684, title = {Provider Costs of Treating Colorectal Cancer in Government Hospital of Malaysia}, author = {M Azzani and M Dahlui and W Z W Ishak and A C Roslani and T T Su}, doi = {10.21315/mjms2019.26.1.7}, issn = {1394-195X (Print) 1394-195x}, year = {2019}, date = {2019-01-01}, journal = {Malays J Med Sci}, volume = {26}, number = {1}, pages = {73-86}, abstract = {Background: The incidence of colorectal cancer (CRC) is rapidly rising in several Asian countries, including Malaysia, but there is little data on health care provider costs in this region. The aim of this study was to estimate the cost of CRC management from the perspective of the health care provider, based on standard operating procedures. Methods: A combination of top-down approach and activity-based costing was applied. The standard operating procedure (SOP) for CRC was developed for each stage according to national data and guidelines at the University of Malaya Medical Centre (UMMC). The unit cost was calculated and incorporated into the treatment pathway in order to obtain the total cost of managing a single CRC patient according to the stage of illness. The cost data were represented by means and standard deviation and the results were demonstrated by tabulation. All cost data are presented in Malaysian Ringgit (RM). The cost difference between early stage (Stage I) and late stage (Stage II-IV) was analysed using independent t-test. Results: The cost per patient increased with stage of CRC, from RM13,672 (USD4,410.30) for stage I, to RM27,972 (USD9,023.20) for Stage IV. The early stage had statistically significant lower cost compared to late stage t(2) = -4.729}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16685, title = {Determinants of Household Catastrophic Health Expenditure: A Systematic Review}, author = {M Azzani and A C Roslani and T T Su}, doi = {10.21315/mjms2019.26.1.3}, issn = {1394-195X (Print) 1394-195x}, year = {2019}, date = {2019-01-01}, journal = {Malays J Med Sci}, volume = {26}, number = {1}, pages = {15-43}, abstract = {The World Health Organization estimates that annually 150 million people experience severe (catastrophic) financial difficulties as a result of healthcare payments. Therefore, a systematic review was carried out to identify the determinants of household catastrophic health expenditure (CHE) in low-to high-income countries around the world. Both electronic and manual searches were conducted. The main outcome of interest was the determinants of CHE due to healthcare payments. Thirty eight studies met the inclusion criteria for review. The analysis revealed that household economic status, incidence of hospitalisation, presence of an elderly or disabled household member in the family, and presence of a family member with a chronic illness were the common significant factors associated with household CHE. The crucial finding of the current study is that socioeconomic inequality plays an important role in the incidence of CHE all over the world, where low-income households are at high risk of financial hardship from healthcare payments. This suggests that healthcare financing policies should be revised in order to narrow the gap in socioeconomic inequality and social safety nets should be implemented and strengthened for people who have a high need for health care.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16718, title = {Circulating insulin-like growth factor I in relation to melanoma risk in the European prospective investigation into cancer and nutrition}, author = {K E Bradbury and P N Appleby and S J Tipper and R C Travis and N E Allen and M Kvaskoff and K Overvad and A Tjonneland and J Halkjaer and I Cervenka and Y Mahamat-Saleh and F Bonnet and R Kaaks and R T Fortner and H Boeing and A Trichopoulou and C La Vecchia and A J Stratigos and D Palli and S Grioni and G Matullo and S Panico and R Tumino and P H Peeters and H B Bueno-de-Mesquita and R Ghiasvand and M B Veierod and E Weiderpass and C Bonet and E Molina and J M Huerta and N Larranaga and A Barricarte and S Merino and K Isaksson and T Stocks and I Ljuslinder and O Hemmingsson and N Wareham and K T Khaw and M J Gunter and S Rinaldi and K K Tsilidis and D Aune and E Riboli and T J Key}, doi = {10.1002/ijc.31854}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, volume = {144}, number = {5}, pages = {957-966}, abstract = {Insulin-like growth factor-I (IGF-I) regulates cell proliferation and apoptosis, and is thought to play a role in tumour development. Previous prospective studies have shown that higher circulating concentrations of IGF-I are associated with a higher risk of cancers at specific sites, including breast and prostate. No prospective study has examined the association between circulating IGF-I concentrations and melanoma risk. A nested case-control study of 1,221 melanoma cases and 1,221 controls was performed in the European Prospective Investigation into Cancer and Nutrition cohort, a prospective cohort of 520,000 participants recruited from 10 European countries. Conditional logistic regression was used to estimate odds ratios (ORs) for incident melanoma in relation to circulating IGF-I concentrations, measured by immunoassay. Analyses were conditioned on the matching factors and further adjusted for age at blood collection, education, height, BMI, smoking status, alcohol intake, marital status, physical activity and in women only, use of menopausal hormone therapy. There was no significant association between circulating IGF-I concentration and melanoma risk (OR for highest vs lowest fifth = 0.93 [95% confidence interval [CI]: 0.71 to 1.22]). There was no significant heterogeneity in the association between IGF-I concentrations and melanoma risk when subdivided by gender, age at blood collection, BMI, height, age at diagnosis, time between blood collection and diagnosis, or by anatomical site or histological subtype of the tumour (Pheterogeneity\>/=0.078). We found no evidence for an association between circulating concentrations of IGF-I measured in adulthood and the risk of melanoma.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16633, title = {Mapping 123 million neonatal, infant and child deaths between 2000 and 2017}, author = {R Burstein and N J Henry and M L Collison and L B Marczak and A Sligar and S Watson and N Marquez and M Abbasalizad-Farhangi and M Abbasi and F Abd-Allah and A Abdoli and M Abdollahi and I Abdollahpour and R S Abdulkader and M R M Abrigo and D Acharya and O M Adebayo and V Adekanmbi and D Adham and M Afshari and M Aghaali and K Ahmadi and M Ahmadi and E Ahmadpour and R Ahmed and C G Akal and J O Akinyemi and F Alahdab and N Alam and G M Alamene and K A Alene and M Alijanzadeh and C Alinia and V Alipour and S M Aljunid and M J Almalki and H M Al-Mekhlafi and K Altirkawi and N Alvis-Guzman and A K Amegah and S Amini and A M L Amit and Z Anbari and S Androudi and M Anjomshoa and F Ansari and C A T Antonio and J Arabloo and Z Arefi and O Aremu and B Armoon and A Arora and A Artaman and A Asadi and M Asadi-Aliabadi and A Ashraf-Ganjouei and R Assadi and B Ataeinia and S R Atre and B P A Quintanilla and M A Ayanore and S Azari and E Babaee and A Babazadeh and A Badawi and S Bagheri and M Bagherzadeh and N Baheiraei and A Balouchi and A Barac and Q Bassat and B T Baune and M Bayati and N Bedi and E Beghi and M Behzadifar and M Behzadifar and Y B Belay and B Bell and M L Bell and D A Berbada and R S Bernstein and N V Bhattacharjee and S Bhattarai and Z A Bhutta and A Bijani and S Bohlouli and N J K Breitborde and G Britton and A J Browne and S B Nagaraja and R Busse and Z A Butt and J Car and R Cardenas and C A Castaneda-Orjuela and E Cerin and W F Chanie and P Chatterjee and D T Chu and others}, doi = {10.1038/s41586-019-1545-0}, issn = {0028-0836}, year = {2019}, date = {2019-01-01}, journal = {Nature}, volume = {574}, number = {7778}, pages = {353-358}, abstract = {Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16642, title = {Antibody Responses to Fusobacterium nucleatum Proteins in Prediagnostic Blood Samples are not Associated with Risk of Developing Colorectal Cancer}, author = {J Butt and M Jenab and M Pawlita and K Overvad and A Tjonneland and A Olsen and M C Boutron-Ruault and F Carbonnel and F R Mancini and R Kaaks and T Kuhn and H Boeing and A Trichopoulou and A Karakatsani and D Palli and V M Pala and R Tumino and C Sacerdote and S Panico and B Bueno-de-Mesquita and C H Gils and R C H Vermeulen and E Weiderpass and J R Quiros and E J Duell and M J Sanchez and M Dorronsoro and J M Huerta and E Ardanaz and B Van Guelpen and S Harlid and A Perez-Cornago and M J Gunter and N Murphy and H Freisling and D Aune and T Waterboer and D J Hughes}, doi = {10.1158/1055-9965.Epi-19-0313}, issn = {1055-9965}, year = {2019}, date = {2019-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {28}, number = {9}, pages = {1552-1555}, abstract = {BACKGROUND: There is a lack of prospective data on the potential association of Fusobacterium nucleatum (F. nucleatum) and colorectal cancer risk. In this study, we assessed whether antibody responses to F. nucleatum are associated with colorectal cancer risk in prediagnostic serum samples in the European Prospective Investigation into Nutrition and Cancer (EPIC) cohort. METHODS: We applied a multiplex serology assay to simultaneously measure antibody responses to 11 F. nucleatum antigens in prediagnostic serum samples from 485 colorectal cancer cases and 485 matched controls. Conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI). RESULTS: We observed neither a statistically significant colorectal cancer risk association for antibodies to individual F. nucleatum proteins nor for combined positivity to any of the 11 proteins (OR, 0.81; 95% CI, 0.62-1.06). CONCLUSIONS: Antibody responses to F. nucleatum proteins in prediagnostic serum samples from a subset of colorectal cancer cases and matched controls within the EPIC study were not associated with colorectal cancer risk. IMPACT: Our findings in prospectively ascertained serum samples contradict the existing literature on the association of F. nucleatum with colorectal cancer risk. Future prospective studies, specifically detecting F. nucleatum in stool or tissue biopsies, are needed to complement our findings.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16713, title = {Genetic determinants of telomere length and risk of pancreatic cancer: A PANDoRA study}, author = {D Campa and M Matarazzi and W Greenhalf and M Bijlsma and K U Saum and C Pasquali and H Laarhoven and A Szentesi and F Federici and P Vodicka and N Funel and R Pezzilli and H B Bueno-de-Mesquita and L Vodickova and D Basso and O Obazee and T Hackert and P Soucek and K Cuk and J Kaiser and C Sperti and M Lovecek and G Capurso and B Mohelnikova-Duchonova and K T Khaw and A K Konig and J Kupcinskas and R Kaaks and F Bambi and L Archibugi and A Mambrini and G M Cavestro and S Landi and P Hegyi and J R Izbicki and D Gioffreda and C F Zambon and F Tavano and R Talar-Wojnarowska and K Jamroziak and T J Key and G D Fave and O Strobel and L Jonaitis and A Andriulli and R T Lawlor and F Pirozzi and V Katzke and C Valsuani and Y K Vashist and H Brenner and F Canzian}, doi = {10.1002/ijc.31928}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, volume = {144}, number = {6}, pages = {1275-1283}, abstract = {Telomere deregulation is a hallmark of cancer. Telomere length measured in lymphocytes (LTL) has been shown to be a risk marker for several cancers. For pancreatic ductal adenocarcinoma (PDAC) consensus is lacking whether risk is associated with long or short telomeres. Mendelian randomization approaches have shown that a score built from SNPs associated with LTL could be used as a robust risk marker. We explored this approach in a large scale study within the PANcreatic Disease ReseArch (PANDoRA) consortium. We analyzed 10 SNPs (ZNF676-rs409627, TERT-rs2736100, CTC1-rs3027234, DHX35-rs6028466, PXK-rs6772228, NAF1-rs7675998, ZNF208-rs8105767, OBFC1-rs9420907, ACYP2-rs11125529 and TERC-rs10936599) alone and combined in a LTL genetic score ("teloscore", which explains 2.2% of the telomere variability) in relation to PDAC risk in 2,374 cases and 4,326 controls. We identified several associations with PDAC risk, among which the strongest were with the TERT-rs2736100 SNP (OR = 1.54; 95%CI 1.35-1.76; p = 1.54 x 10(-10) ) and a novel one with the NAF1-rs7675998 SNP (OR = 0.80; 95%CI 0.73-0.88; p = 1.87 x 10(-6)}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16640, title = {Exogenous hormone use and cutaneous melanoma risk in women: The European Prospective Investigation into Cancer and Nutrition}, author = {I Cervenka and M Al Rahmoun and Y Mahamat-Saleh and A Fournier and M C Boutron-Ruault and G Severi and S Caini and D Palli and R Ghiasvand and M B Veierod and E Botteri and A Tjonneland and A Olsen and R T Fortner and R Kaaks and M B Schulze and S Panico and A Trichopoulou and C Dessinioti and K Niforou and S Sieri and R Tumino and C Sacerdote and B Bueno-de-Mesquita and T M Sandanger and S Colorado-Yohar and M J Sanchez and L Gil Majuelo and L Lujan-Barroso and E Ardanaz and S Merino and K Isaksson and S Butt and I Ljuslinder and M Jansson and R C Travis and K T Khaw and E Weiderpass and L Dossus and S Rinaldi and M Kvaskoff}, doi = {10.1002/ijc.32674}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, abstract = {Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in 1992 in 10 European countries. Information on exogenous hormone use at baseline was derived from country-specific self-administered questionnaires. We used Cox proportional hazards regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Over 1992-2015, 1,696 melanoma cases were identified among 334,483 women, whereof 770 cases among 134,758 postmenopausal women. There was a positive, borderline-significant association between OC use and melanoma risk (HR = 1.12, 95% CI = 1.00-1.26), with no detected heterogeneity across countries (phomogeneity = 0.42). This risk increased linearly with duration of use (ptrend = 0.01). Among postmenopausal women, ever use of MHT was associated with a nonsignificant increase in melanoma risk overall (HR = 1.14, 95% CI = 0.97-1.43), which was heterogeneous across countries (phomogeneity = 0.05). Our findings do not support a strong and direct association between exogenous hormone use and melanoma risk. In order to better understand these relations, further research should be performed using prospectively collected data including detailed information on types of hormone, and on sun exposure, which may act as an important confounder or effect modifier on these relations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16708, title = {Prevalence and correlates of physical inactivity among older adults in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2015}, author = {Y Y Chan and R Sooryanarayana and N Mohamad Kasim and K K Lim and S M Cheong and C C Kee and K H Lim and M A Omar and N A Ahmad and N N Mohd Hairi}, doi = {10.1016/j.archger.2018.11.012}, issn = {0167-4943}, year = {2019}, date = {2019-01-01}, journal = {Arch Gerontol Geriatr}, volume = {81}, pages = {74-83}, abstract = {Malaysia has an increasingly aging population. Despite the substantial benefits of physical activity for healthy aging, older adults are considered the most physically inactive segment of the Malaysian population. The purpose of this study was to determine the prevalence of physical inactivity among older adults in Malaysia and its correlates. We analysed data on adults aged \>/=60 years (n = 3790) from the National Health and Morbidity Survey (NHMS) 2015, a cross-sectional, nationwide population-based survey covering information on socio-demographic characteristics, physical activity and other lifestyle-related variables, health conditions, and functional limitations. Individuals included in this study were classified as physically active or physically inactive. Logistic regression was used to determine factors associated with physical inactivity. The overall prevalence of physical inactivity among older adults aged \>/=60 years old was 48.8%. Physical inactivity was significantly more prevalent among females, older age groups, Indians, those being single/widowed/divorced, those with no formal education, those who reported high sedentary time (\>/=7 h/day), those with diabetes, anaemia, and functional limitations (p \< 0.001). In fully adjusted analyses, females, older age, high household income (\>/=MYR4000), inadequate fruits and vegetables consumption (\<5 servings/day), high sedentary time, having diabetes, and having mobility impairment were all associated with physical inactivity. Approximately half of the Malaysian older population are physically inactive. Identifying the correlates of physical inactivity among Malaysian older adults will help to develop public health policies and interventions that encourage active living among older people and promote healthy aging in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16799, title = {Ultrasound-guided central venous vascular access\textemdashnovel needle navigation technology compared with conventional method: A randomized study}, author = {S C Chew and Z Y Beh and V R Hakumat Rai and M F Jamaluddin and C C Ng and K Chinna and M S Hasan}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85066870068\&doi=10.1177%2f1129729819852057\&partnerID=40\&md5=fa4b58550379377b1f3207cb7c5a8b29}, doi = {10.1177/1129729819852057}, year = {2019}, date = {2019-01-01}, journal = {Journal of Vascular Access}, abstract = {Purpose: Central venous catheter insertion is a common procedure in the intensive care setting. However, complications persist despite real-time ultrasound guidance. Recent innovation in needle navigation technology using guided positioning system enables the clinician to visualize the needle’s real-time position and trajectory as it approaches the target. We hypothesized that the guided positioning system would improve performance time in central venous catheter insertion. Methods: A prospective randomized study was conducted in a single-center adult intensive care unit. In total, 100 patients were randomized into two groups. These patients underwent internal jugular vein central venous catheter cannulation with ultrasound guidance (short-axis scan, out-of-plane needling approach) in which one group adopted conventional method, while the other group was aided with the guided positioning system. Outcomes were measured by procedural efficacy (success rate, number of attempts, time to successful cannulation), complications, level of operators’ experience, and their satisfaction. Results: All patients had successful cannulation on the first attempt except for one case in the conventional group. The median performance time for the guided positioning system method was longer (25.5 vs 15.5 s; p = 0.01). And 86% of the operators had more than 3-year experience in anesthesia. One post-insertion hematoma occurred in the conventional group. Only 88% of the operators using the guided positioning system method were satisfied compared to 100% in the conventional group. Conclusion: Ultrasound-guided central venous catheter insertion via internal jugular vein was a safe procedure in both conventional and guided positioning system methods. The guided positioning system did not confer additional benefit but was associated with slower performance time and lower satisfaction level among the experienced operators. © The Author(s) 2019.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16653, title = {Blood pressure and risk of cancer in the European Prospective Investigation into Cancer and Nutrition}, author = {S Christakoudi and A Kakourou and G Markozannes and I Tzoulaki and E Weiderpass and P Brennan and M Gunter and C C Dahm and K Overvad and A Olsen and A Tjonneland and M C Boutron-Ruault and A L Madika and G Severi and V Katzke and T Kuhn and M M Bergmann and H Boeing and A Karakatsani and G Martimianaki and P Thriskos and G Masala and S Sieri and S Panico and R Tumino and F Ricceri and A Agudo and D Redondo-Sanchez and S M Colorado-Yohar and O Mokoroa and O Melander and T Stocks and C Haggstrom and S Harlid and B Bueno-de-Mesquita and C H Gils and R C H Vermeulen and K T Khaw and N J Wareham and T Y N Tong and H Freisling and M Johansson and H Lennon and D Aune and E Riboli and D Trichopoulos and A Trichopoulou and K K Tsilidis}, doi = {10.1002/ijc.32576}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, abstract = {Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HRs) (95% confidence intervals) were estimated using multivariable Cox proportional hazards models, stratified by EPIC-participating center and age at recruitment, and adjusted for sex, education, smoking, body mass index, physical activity, diabetes and dietary (in women also reproductive) factors. The study included 307,318 men and women, with an average follow-up of 13.7 (standard deviation 4.4) years and 39,298 incident cancers. We confirmed the expected positive association with renal cell carcinoma: HR = 1.12 (1.08-1.17) per 10 mm Hg higher SBP and HR = 1.23 (1.14-1.32) for DBP. We additionally found positive associations for esophageal squamous cell carcinoma (SCC): HR = 1.16 (1.07-1.26) (SBP)}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16666, title = {Socioeconomic Effect of Education on Pancreatic Cancer Risk in Western Europe: An Update on the EPIC Cohorts Study}, author = {L Cirera and J M Huerta and M D Chirlaque and K Overvad and M Lindstrom and S Regner and A Tjonneland and M C Boutron-Ruault and V Rebours and G Fagherazzi and V A Katzke and H Boeing and E Peppa and A Trichopoulou and E Valanou and D Palli and S Grioni and S Panico and R Tumino and F Ricceri and C Gils and R C H Vermeulen and G Skeie and T Braaten and E Weiderpass and S Merino and M J Sanchez and N Larranaga and E Ardanaz and M Sund and K T Khaw and T J Key and M Jenab and S Naudin and N Murphy and D Aune and H Ward and E Riboli and B Bueno-de-Mesquita and C Navarro and E J Duell}, doi = {10.1158/1055-9965.Epi-18-1153}, issn = {1055-9965}, year = {2019}, date = {2019-01-01}, journal = {Cancer Epidemiol Biomarkers Prev}, volume = {28}, number = {6}, pages = {1089-1092}, abstract = {BACKGROUND: To analyze the potential effect of social inequality on pancreatic cancer risk in Western Europe, by reassessing the association within the European Prospective Investigation into Cancer and Nutrition (EPIC) Study, including a larger number of cases and an extended follow-up. METHODS: Data on highest education attained were gathered for 459,170 participants (70% women) from 10 European countries. A relative index of inequality (RII) based on adult education was calculated for comparability across countries and generations. Cox regression models were applied to estimate relative inequality in pancreatic cancer risk, stratifying by age, gender, and center, and adjusting for known pancreatic cancer risk factors. RESULTS: A total of 1,223 incident pancreatic cancer cases were included after a mean follow-up of 13.9 (+/-4.0) years. An inverse social trend was found in models adjusted for age, sex, and center for both sexes [HR of RII, 1.27; 95% confidence interval (CI), 1.02-1.59], which was also significant among women (HR, 1.42; 95% CI, 1.05-1.92). Further adjusting by smoking intensity, alcohol consumption, body mass index, prevalent diabetes, and physical activity led to an attenuation of the RII risk and loss of statistical significance. CONCLUSIONS: The present reanalysis does not sustain the existence of an independent social inequality influence on pancreatic cancer risk in Western European women and men, using an index based on adult education, the most relevant social indicator linked to individual lifestyles, in a context of very low pancreatic cancer survival from (quasi) universal public health systems. IMPACT: The results do not support an association between education and risk of pancreatic cancer.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16709, title = {Reproductive Factors, Exogenous Hormone Use, and Risk of B-Cell Non-Hodgkin Lymphoma in a Cohort of Women From the European Prospective Investigation Into Cancer and Nutrition}, author = {L Costas and L Lujan-Barroso and Y Benavente and N E Allen and P Amiano and E Ardanaz and C Besson and H Boeing and B Bueno-de-Mesquita and I Cervenka and R T Fortner and A Fournier and M Gunter and S Harlid and J M Huerta and M Jerkeman and K Jirstrom and R Kaaks and A Karakatsani and K T Khaw and A Kotanidou and E Lund and G Masala and A Mattiello and B Melin and V Menendez and N Murphy and A Nieters and K Overvad and E Riboli and C Sacerdote and M J Sanchez and J A Schmidt and S Sieri and A Tjonneland and A Trichopoulou and R Tumino and R Vermeulen and E Weiderpass and S Sanjose and A Agudo and D Casabonne}, doi = {10.1093/aje/kwy259}, issn = {0002-9262}, year = {2019}, date = {2019-01-01}, journal = {Am J Epidemiol}, volume = {188}, number = {2}, pages = {274-281}, abstract = {The role of hormonal factors in the etiology of lymphoid neoplasms remains unclear. Previous studies have yielded conflicting results, have lacked sufficient statistical power to assess many lymphoma subtypes, or have lacked detailed information on relevant exposures. Within the European Prospective Investigation Into Cancer and Nutrition cohort, we analyzed comprehensive data on reproductive factors and exogenous hormone use collected at baseline (1992-2000) among 343,458 women, including data on 1,427 incident cases of B-cell non-Hodgkin lymphoma (NHL) and its major subtypes identified after a mean follow-up period of 14 years (through 2015). We estimated hazard ratios and 95% confidence intervals using multivariable proportional hazards modeling. Overall, we observed no statistically significant associations between parity, age at first birth, breastfeeding, oral contraceptive use, or ever use of postmenopausal hormone therapy and risk of B-cell NHL or its subtypes. Women who had undergone surgical menopause had a 51% higher risk of B-cell NHL (based on 67 cases) than women with natural menopause (hazard ratio = 1.51, 95% confidence interval: 1.17, 1.94). Given that this result may have been due to chance, our results provide little support for the hypothesis that sex hormones play a role in lymphomagenesis.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16663, title = {Achieving cost-efficient management of drug supply via economic order quantity and minimum-maximum stock level}, author = {E K Dewi and M Dahlui and D Chalidyanto and T N Rochmah}, doi = {10.1080/14737167.2019.1633308}, issn = {1473-7167}, year = {2019}, date = {2019-01-01}, journal = {Expert Rev Pharmacoecon Outcomes Res}, pages = {1-6}, abstract = {Background: A good drug inventory planning system is important for an efficient budgeting, procurement, and cost control of drugs. When stagnant drugs in the inventory are too much, wastage due to expired and spoiled drugs could occur. These will not only cause loss of income but could also jeopardize healthcare service delivery. Research design and methods: This study aimed to determine the most efficient and effective management of stagnant and shortage drugs by comparing three pharmacy logistic methods; the economic order quantity (EOQ), minimum-maximum stock level (MMSL), and the traditional consumption of drug inventory, at RA Basoeni Hospital, Mojokerto. Drug inventory was analyzed to calculate the opportunity loss, opportunity cost, and proportions of both stagnant and shortage drugs. Results: We found that EOQ and MMSL performed best for control of stagnant drugs and shortage drugs, respectively. Both methods had proved as effective pharmacy logistic planning. In addition, EOQ produced the lowest opportunity cost for stagnant drugs besides the lowest opportunity loss for shortage drugs. Conclusion: The study concluded that EOQ is the most effective and efficient method to manage stagnant and shortage drugs at hospital pharmacy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16732, title = {Two truncating variants in FANCC and breast cancer risk}, author = {T D\"{o}rk and P Peterlongo and A Mannermaa and M K Bolla and Q Wang and J Dennis and T Ahearn and I L Andrulis and H Anton-Culver and V Arndt and K J Aronson and A Augustinsson and L E B Freeman and M W Beckmann and A Beeghly-Fadiel and S Behrens and M Bermisheva and C Blomqvist and N V Bogdanova and S E Bojesen and H Brauch and H Brenner and B Burwinkel and F Canzian and T L Chan and J Chang-Claude and S J Chanock and J Y Choi and H Christiansen and C L Clarke and F J Couch and K Czene and M B Daly and I dos-Santos-Silva and M Dwek and D M Eccles and A B Ekici and M Eriksson and D G Evans and P A Fasching and J Figueroa and H Flyger and L Fritschi and M Gabrielson and M Gago-Dominguez and C Gao and S M Gapstur and M Garc\'{i}a-Closas and J A Garc\'{i}a-S\'{a}enz and M M Gaudet and G G Giles and M S Goldberg and D E Goldgar and P Gu\'{e}nel and L Haeberle and C A Haiman and N Hr{a}kansson and P Hall and U Hamann and M Hartman and J Hauke and A Hein and P Hillemanns and F B L Hogervorst and M J Hooning and J L Hopper and T Howell and D Huo and H Ito and M Iwasaki and A Jakubowska and W Janni and E M John and A Jung and R Kaaks and D Kang and P M Kapoor and E Khusnutdinova and S W Kim and C M Kitahara and S Koutros and P Kraft and V N Kristensen and A Kwong and D Lambrechts and L L Marchand and J Li and S Lindstr\"{o}m and M Linet and W Y Lo and J Long and A Lophatananon and J Lubi\'{n}ski and M Manoochehri and S Manoukian and S Margolin and E Martinez and K Matsuo and D Mavroudis and A Meindl and others}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85071631153\&doi=10.1038%2fs41598-019-48804-y\&partnerID=40\&md5=984f789b353fa3508e4dedebb69a156f}, doi = {10.1038/s41598-019-48804-y}, year = {2019}, date = {2019-01-01}, journal = {Scientific Reports}, volume = {9}, number = {1}, abstract = {Fanconi anemia (FA) is a genetically heterogeneous disorder with 22 disease-causing genes reported to date. In some FA genes, monoallelic mutations have been found to be associated with breast cancer risk, while the risk associations of others remain unknown. The gene for FA type C, FANCC, has been proposed as a breast cancer susceptibility gene based on epidemiological and sequencing studies. We used the Oncoarray project to genotype two truncating FANCC variants (p.R185X and p.R548X) in 64,760 breast cancer cases and 49,793 controls of European descent. FANCC mutations were observed in 25 cases (14 with p.R185X, 11 with p.R548X) and 26 controls (18 with p.R185X, 8 with p.R548X). There was no evidence of an association with the risk of breast cancer, neither overall (odds ratio 0.77, 95%CI 0.44\textendash1.33}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16693, title = {Does Body Mass Index and Height Influence the Incident Risk of Ischemic Stroke in Newly Diagnosed Type 2 Diabetes Subjects?}, author = {D Duan and H Li and J Xu and L Wong and G Xu and F Kong and S Li and Q Gong and X Zhang and J Zhao and L Zhang and G Xu and W Xing and L Han}, doi = {10.1155/2019/2591709}, year = {2019}, date = {2019-01-01}, journal = {J Diabetes Res}, volume = {2019}, pages = {2591709}, abstract = {Objective: To estimate the incident risk of ischemic stroke (IS) in newly diagnosed type 2 diabetes (T2D) subjects according to different body mass index (BMI) and height categories. Methods: A total of 25,130 newly diagnosed T2D subjects were included in this study. All T2D subjects were enrolled consecutively from the Chronic Disease Surveillance System (CDSS) of Ningbo. Standardized incidence ratio (SIR) and its 95% confidence interval (95% CI) stratified by BMI categories and height quartiles were used to estimate the incident risk of IS in T2D subjects. Results: In total, 22,795 subjects completed the follow-up. Among them, 1268 newly diagnosed IS cases were identified, with 149,675 person-years. The SIRs of normal BMI (18.5-24.0 kg/m(2)), overweight (24.0-28.0 kg/m(2)), and obese (\>/=28.0 kg/m(2)) in overall subjects were 2.56 (95% CI 1.90-3.13), 2.13 (95% CI 1.90-3.13), and 1.87 (95% CI 1.29-2.43), respectively (P trend \< 0.01), comparing to the general population of Ningbo. For each 1 kg/m(2) increment in BMI, the SIR was 0.948 (95% CI 0.903-0.999). For height quartiles, the SIRs of male subjects in quartile 1 (\<160 cm), quartile 2 (161-165 cm), quartile 3 (165-170 cm), and quartile 4 (\>/=171 cm) were 2.27 (95% CI 1.99-2.56), 2.01 (95% CI 1.67-2.45), 1.37 (95% CI 1.05-1.68), and 0.91 (95% CI 0.40-1.32), respectively (P trend \< 0.01). While for female subjects, the SIRs in quartile 1 (\<155 cm), quartile 2 (156-160 cm), quartile 3 (161-165 cm), and quartile 4 (\>/=166 cm) were 3.57 (95% CI 3.11-3.49), 2.96 (95% CI 2.61-3.31), 1.94 (95% CI 1.51-2.36), and 1.71 (95% CI 0.95-2.47), respectively (P trend \< 0.01). Conclusion: Compared to the general population of Ningbo, T2D subjects had a higher incident risk of IS. Furthermore, the IS incident risk was not only higher in newly diagnosed T2D subjects with normal BMI but also lower in taller newly diagnosed T2D subjects.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16676, title = {Association of Selenoprotein and Selenium Pathway Genotypes with Risk of Colorectal Cancer and Interaction with Selenium Status}, author = {V Fedirko and M Jenab and C Meplan and J S Jones and W Zhu and L Schomburg and A Siddiq and S Hybsier and K Overvad and A Tjonneland and H Omichessan and V Perduca and M C Boutron-Ruault and T Kuhn and V Katzke and K Aleksandrova and A Trichopoulou and A Karakatsani and A Kotanidou and R Tumino and S Panico and G Masala and C Agnoli and A Naccarati and B Bueno-de-Mesquita and R C H Vermeulen and E Weiderpass and G Skeie and T H Nost and L Lujan-Barroso and J R Quiros and J M Huerta and M Rodriguez-Barranco and A Barricarte and B Gylling and S Harlid and K E Bradbury and N Wareham and K T Khaw and M Gunter and N Murphy and H Freisling and K Tsilidis and D Aune and E Riboli and J E Hesketh and D J Hughes}, doi = {10.3390/nu11040935}, issn = {2072-6643}, year = {2019}, date = {2019-01-01}, journal = {Nutrients}, volume = {11}, number = {4}, abstract = {Selenoprotein genetic variations and suboptimal selenium (Se) levels may contribute to the risk of colorectal cancer (CRC) development. We examined the association between CRC risk and genotype for single nucleotide polymorphisms (SNPs) in selenoprotein and Se metabolic pathway genes. Illumina Goldengate assays were designed and resulted in the genotyping of 1040 variants in 154 genes from 1420 cases and 1421 controls within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Multivariable logistic regression revealed an association of 144 individual SNPs from 63 Se pathway genes with CRC risk. However, regarding the selenoprotein genes, only TXNRD1 rs11111979 retained borderline statistical significance after adjustment for correlated tests (PACT = 0.10; PACT significance threshold was P \< 0.1). SNPs in Wingless/Integrated (Wnt) and Transforming growth factor (TGF) beta-signaling genes (FRZB, SMAD3, SMAD7) from pathways affected by Se intake were also associated with CRC risk after multiple testing adjustments. Interactions with Se status (using existing serum Se and Selenoprotein P data) were tested at the SNP, gene, and pathway levels. Pathway analyses using the modified Adaptive Rank Truncated Product method suggested that genes and gene x Se status interactions in antioxidant, apoptosis, and TGF-beta signaling pathways may be associated with CRC risk. This study suggests that SNPs in the Se pathway alone or in combination with suboptimal Se status may contribute to CRC development.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16780, title = {Holistic recommendations for future outdoor thermal comfort assessment in tropical Southeast Asia: A critical appraisal}, author = {C S Fong and N Aghamohammadi and L Ramakreshnan and N M Sulaiman and P Mohammadi}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85060740295\&doi=10.1016%2fj.scs.2019.101428\&partnerID=40\&md5=6691c35896d33d5b034fa76d4fc57164}, doi = {10.1016/j.scs.2019.101428}, year = {2019}, date = {2019-01-01}, journal = {Sustainable Cities and Society}, volume = {46}, abstract = {Global climate change, rapid urbanization and population explosion in major cities of Southeast Asia (SEA) are negatively impacting the well-being and liveability of the public in terms of deteriorating outdoor thermal comfort (OTC) levels. However, the available scholarly studies on OTC in the tropical region are insufficient. There is great potential for OTC studies to be used as indicators to measure the sustainable liveability of contemporary cities. As such, there is an immense need for more studies to be conducted in the tropical regions. However, the assessment approaches undertaken in the last decades clearly indicate that there is a need for improvisation. By considering this, this paper provides an overview of published studies that evaluated thermal comfort conditions in the outdoor setting in the tropical context of SEA. Methodological discrepancies and shortcomings are highlighted and discussed to propose a holistic approach for future OTC studies in SEA. The implementation of the proposed holistic approach in the upcoming studies will be beneficial for the improved reliability and integration of findings from studies conducted in various outdoor settings and localities within SEA. © 2019 Elsevier Ltd}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16702, title = {Religious Coping, Religiosity, Depression and Anxiety among Medical Students in a Multi-Religious Setting}, author = {B Francis and J S Gill and N Yit Han and C F Petrus and F L Azhar and Z Ahmad Sabki and M A Said and K Ong Hui and N Chong Guan and A H Sulaiman}, doi = {10.3390/ijerph16020259}, issn = {1660-4601}, year = {2019}, date = {2019-01-01}, journal = {Int J Environ Res Public Health}, volume = {16}, number = {2}, abstract = {Medical students are vulnerable to depression and anxiety due to the nature of their academic life. This study aimed to determine the prevalence of depressive and anxiety symptoms among medical students and the association between religious coping, religiosity and socio-demographic factors with anxiety and depressive symptoms. A cross sectional design was used for this study. Scales used were the Malay version of the Duke Religious Index (DUREL-M), the Malay version of the Brief Religious Coping Scale (Brief RCOPE) and the Malay version Hospital and Anxiety Depression Scale (HADS-M). 622 students participated in this study. They scored moderately on the organized (mean: 3.51) and non-organized religious (mean: 3.85) subscales of the DUREL, but had high intrinsic religiosity (mean: 12.18). The prevalence of anxiety and depressive symptoms were 4.7% and 17.4% respectively, which is lower than local as well as international data. Islam, negative religious coping and the presence of depressive symptoms were significantly associated with anxiety symptoms. Only the presence of anxiety symptoms was significantly associated with depressive symptoms. Negative religious coping, rather than positive religious coping, has significant association with depressive and anxiety symptoms. Redirecting focus towards negative religious coping is imperative to boost mental health outcomes among medical students.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16710, title = {Exploring causality of the association between smoking and Parkinson's disease}, author = {V Gallo and P Vineis and M Cancellieri and P Chiodini and R A Barker and C Brayne and N Pearce and R Vermeulen and S Panico and B Bueno-de-Mesquita and N Vanacore and L Forsgren and S Ramat and E Ardanaz and L Arriola and J Peterson and O Hansson and D Gavrila and C Sacerdote and S Sieri and T Kuhn and V A Katzke and Y T Schouw and A Kyrozis and G Masala and A Mattiello and R Perneczky and L Middleton and R Saracci and E Riboli}, doi = {10.1093/ije/dyy230}, issn = {0300-5771}, year = {2019}, date = {2019-01-01}, journal = {Int J Epidemiol}, volume = {48}, number = {3}, pages = {912-925}, abstract = {BACKGROUND: The aim of this paper is to investigate the causality of the inverse association between cigarette smoking and Parkinson's disease (PD). The main suggested alternatives include a delaying effect of smoking, reverse causality or an unmeasured confounding related to a low-risk-taking personality trait. METHODS: A total of 715 incident PD cases were ascertained in a cohort of 220 494 individuals from NeuroEPIC4PD, a prospective European population-based cohort study including 13 centres in eight countries. Smoking habits were recorded at recruitment. We analysed smoking status, duration, and intensity and exposure to passive smoking in relation to PD onset. RESULTS: Former smokers had a 20% decreased risk and current smokers a halved risk of developing PD compared with never smokers. Strong dose-response relationships with smoking intensity and duration were found. Hazard ratios (HRs) for smoking \<20 years were 0.84 [95% confidence interval (CI) 0.67-1.07], 20-29 years 0.73 (95% CI 0.56-0.96) and \>30 years 0.54 (95% CI 0.43-0.36) compared with never smokers. The proportional hazard assumption was verified, showing no change of risk over time, arguing against a delaying effect. Reverse causality was disproved by the consistency of dose-response relationships among former and current smokers. The inverse association between passive smoking and PD, HR 0.70 (95% CI 0.49-0.99) ruled out the effect of unmeasured confounding. CONCLUSIONS: These results are highly suggestive of a true causal link between smoking and PD, although it is not clear which is the chemical compound in cigarette smoking responsible for the biological effect.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16656, title = {Profiling of morphine and codeine in urine after the ingestion of curry containing poppy seed as an evidence for opiates defence in Malaysia}, author = {C Y Gan and Z Zainuddin and H Muhamad Noh and R Rahmat and F Mohd Akir and N H Mahad and N F Mohd Fazil and R Nasir and M Isahak and H A Samad}, doi = {10.1016/j.forsciint.2019.06.023}, issn = {0379-0738}, year = {2019}, date = {2019-01-01}, journal = {Forensic Sci Int}, volume = {302}, pages = {109865}, abstract = {Consumption of curry containing poppy seeds has raised an issue concerning the opiate content in the urine that might exceed the cut-off value (300ng/mL). The main objective of this study was to examine the morphine and codeine contents in the urine of the consumers after partaking poppy seed-enriched curry in. The volunteers were asked to partake: (a) a single meal and their urines were collected within 24h, or (b) Two meals a day for three consecutive days and their urines were collected within 72h. Two different dosages were also tested in this study: (a) low dosage: 1g/100ml curry (containing 138mug of morphine and 66mug of codeine) and (b) high dosage: 5g/100ml curry (containing 690mug of morphine and 330mug of codeine). The subjects were randomised into the groups using the method of stratified randomization with age and gender groups as covariates. A total of 6 subjects was allocated for each group and placebos were used as control. Results showed that all subjects who consumed low dosage of poppy seeds either in single meal or multiple meals experiment were found negative. However, 1 out of 6high dosage subjects was confirmed positive at a period of 3-6h after the consumption of curry in the single meal study. This outlier maybe due to the lack of water consumption after consuming the curry, thus the low volume of urine was collected and the opiate was concentrated in the urine. On the other hand, 5 out of 6high dosage subjects in the multiple meals experiment were found positive. Majority of these subjects were found positive on the second and third day of the experiment after the second curry meal was consumed. The outlier (negative) in this group might be due to the high consumption of water throughout the experiment and the subject's urine volumes and frequency of urine collection were much higher compared to other subjects. From the result of this study, it can be concluded that partaking high dosages of poppy seed in curry could give a positive response (\>300ng/ml+uncertainty of measurement) in the urine, and the water consumption after partaking curry has significant influence for the opiate contents in the urine.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16648, title = {A qualitative examination of barriers and solutions to renal transplantation in Malaysia: Key-informants' perspective}, author = {P Gan Kim Soon and S K Lim and S Rampal and T T Su}, doi = {10.1371/journal.pone.0220411}, issn = {1932-6203}, year = {2019}, date = {2019-01-01}, journal = {PLoS One}, volume = {14}, number = {8}, pages = {e0220411}, abstract = {INTRODUCTION: End-stage renal disease (ESRD) is increasing globally, and renal transplantation (RT) is the preferred renal replacement therapy to treat ESRD. Internationally, there are only a few countries with RT rates above 50 per million population (pmp), while most of the countries have RT rates between 30-40 pmp. The low- and middle-income countries (LMIC) makes up the majority for the RT rates below 20 pmp in which Malaysia belongs to despite its increasing ESRD rates. There is a need to explore the barriers to access RT with targeted solutions to improve the RT rates and service in LMIC. Thus, a qualitative study was undertaken in Malaysia to address this issue. METHOD: A qualitative methodological approach was performed between March-May 2018. Semi-structured interviews were used to explore current RT policy and service availability. Key-informants were identified from a detailed stakeholder analysis of RT system in Malaysia. Interviews were digitally audio-recorded, transcribed verbatim, coded with ATLAS.ti software and underwent thematic analysis thoroughly. RESULTS: Eight key-informants participated in the study. Barriers and related solutions were classified using the socio-ecological model (SEM). As reported, the barriers and solutions of RT in Malaysia are the results of a complex interplay of personal, cultural, and environmental factors. Key barriers are linked to public's attitude and perception towards RT and the unaccommodating practices in the healthcare fraternity for RT. Key-informants provided a systematic solution that shed light on how RT could be improved at each SEM level via effective communication, education and inter-agency collaboration. CONCLUSION: The SEM provided a framework to foster a better understanding of current practice, barriers, and solutions to RT in Malaysia. This study is the first to explore the barriers and related solutions to RT comprehensively as a whole. Implications of these findings could prompt a policy change for a better RT service delivery model not just for Malaysia but also for other LMIC. Further stakeholder engagement and evaluation of the systems are required to provide insight into best practices that will help to improve the RT rates and service in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16707, title = {Methodological issues in a prospective study on plasma concentrations of persistent organic pollutants and pancreatic cancer risk within the EPIC cohort}, author = {M Gasull and J Pumarega and H Kiviranta and P Rantakokko and O Raaschou-Nielsen and I A Bergdahl and T M Sandanger and F Goni and L Cirera and C Donat-Vargas and J Alguacil and M Iglesias and A Tjonneland and K Overvad and F R Mancini and M C Boutron-Ruault and G Severi and T Johnson and T Kuhn and A Trichopoulou and A Karakatsani and E Peppa and D Palli and V Pala and R Tumino and A Naccarati and S Panico and M Verschuren and R Vermeulen and C Rylander and T H Nost and M Rodriguez-Barranco and A Molinuevo and M D Chirlaque and E Ardanaz and M Sund and T Key and W Ye and M Jenab and D Michaud and G Matullo and F Canzian and R Kaaks and A Nieters and U Nothlings and S Jeurnink and V Chajes and M Matejcic and M Gunter and D Aune and E Riboli and A Agudo and C A Gonzalez and E Weiderpass and B Bueno-de-Mesquita and E J Duell and P Vineis and M Porta}, doi = {10.1016/j.envres.2018.11.027}, issn = {0013-9351}, year = {2019}, date = {2019-01-01}, journal = {Environ Res}, volume = {169}, pages = {417-433}, abstract = {BACKGROUND: The use of biomarkers of environmental exposure to explore new risk factors for pancreatic cancer presents clinical, logistic, and methodological challenges that are also relevant in research on other complex diseases. OBJECTIVES: First, to summarize the main design features of a prospective case-control study -nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort- on plasma concentrations of persistent organic pollutants (POPs) and pancreatic cancer risk. And second, to assess the main methodological challenges posed by associations among characteristics and habits of study participants, fasting status, time from blood draw to cancer diagnosis, disease progression bias, basis of cancer diagnosis, and plasma concentrations of lipids and POPs. Results from etiologic analyses on POPs and pancreatic cancer risk, and other analyses, will be reported in future articles. METHODS: Study subjects were 1533 participants (513 cases and 1020 controls matched by study centre, sex, age at blood collection, date and time of blood collection, and fasting status) enrolled between 1992 and 2000. Plasma concentrations of 22 POPs were measured by gas chromatography - triple quadrupole mass spectrometry (GC-MS/MS). To estimate the magnitude of the associations we calculated multivariate-adjusted odds ratios by unconditional logistic regression, and adjusted geometric means by General Linear Regression Models. RESULTS: There were differences among countries in subjects' characteristics (as age, gender, smoking, lipid and POP concentrations), and in study characteristics (as time from blood collection to index date, year of last follow-up, length of follow-up, basis of cancer diagnosis, and fasting status). Adjusting for centre and time of blood collection, no factors were significantly associated with fasting status. Plasma concentrations of lipids were related to age, body mass index, fasting, country, and smoking. We detected and quantified 16 of the 22 POPs in more than 90% of individuals. All 22 POPs were detected in some participants, and the smallest number of POPs detected in one person was 15 (median, 19) with few differences by country. The highest concentrations were found for p,p'-DDE, PCBs 153 and 180 (median concentration: 3371, 1023, and 810 pg/mL, respectively). We assessed the possible occurrence of disease progression bias (DPB) in eight situations defined by lipid and POP measurements, on one hand, and by four factors: interval from blood draw to index date, tumour subsite, tumour stage, and grade of differentiation, on the other. In seven of the eight situations results supported the absence of DPB. CONCLUSIONS: The coexistence of differences across study centres in some design features and participant characteristics is of relevance to other multicentre studies. Relationships among subjects' characteristics and among such characteristics and design features may play important roles in the forthcoming analyses on the association between plasma concentrations of POPs and pancreatic cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16658, title = {Mindfulness-based stress reduction for psychological distress among nurses: A systematic review}, author = {S F Ghawadra and K L Abdullah and W Y Choo and C K Phang}, doi = {10.1111/jocn.14987}, issn = {0962-1067}, year = {2019}, date = {2019-01-01}, journal = {J Clin Nurs}, volume = {28}, number = {21-22}, pages = {3747-3758}, abstract = {AIMS AND OBJECTIVES: To explore the studies that used interventions based on the Mindfulness-Based Stress Reduction (MBSR) for decreasing psychological distress among nurses. BACKGROUND: Because of the demanding nature of their work, nurses often have significantly high levels of stress, anxiety and depression. MBSR has been reported to be an effective intervention to decrease psychological distress. DESIGN: Systematic review. METHODS: The databases included were Science Direct, PubMed, EBSCO host, Springer Link and Web of Science from 2002 to 2018. Interventional studies published in English that used MBSR among nurses to reduce their psychological distress were retrieved for review. The PRISMA guideline was used in this systematic review. The included studies were assessed for quality using "The Quality Assessment Tool For Quantitative Studies (QATFQS)." RESULTS: Nine studies were found to be eligible and included in this review. Many benefits, including reduced stress, anxiety, depression, burnout and better job satisfaction, were reported in these studies. CONCLUSION: The adapted/brief versions of MBSR seem promising for reducing psychological distress in nurses. Future research should include randomised controlled trials with a larger sample size and follow-up studies. There should also be a focus on creative and effective ways of delivering MBSR to nurses. RELEVANCE TO CLINICAL PRACTICE: The results of this review are substantial for supporting the use of MBSR for nurses' psychological well-being.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16654, title = {Psychological distress and its association with job satisfaction among nurses in a teaching hospital}, author = {S F Ghawadra and K L Abdullah and W Y Choo and C K Phang}, doi = {10.1111/jocn.14993}, issn = {0962-1067}, year = {2019}, date = {2019-01-01}, journal = {J Clin Nurs}, volume = {28}, number = {21-22}, pages = {4087-4097}, abstract = {AIM AND OBJECTIVES: To determine the prevalence of psychological distress and its association with job satisfaction among nurses in a teaching hospital in Malaysia. BACKGROUND: Nurses constitute the majority of health care workers, and, compared with other professions, nursing profession is highly stressful and, hence, a cause of anxiety and depression. This may affect nurses' job satisfaction. METHOD: Using self-administered questionnaires, Depression Anxiety and Stress Scale (DASS-21) and Job Satisfaction Scale for Nurses (JSS), a cross-sectional study of 932 nurses from the inpatient departments of a teaching hospital was conducted in December 2017. Descriptive analyses and multiple logistic regressions were used for the analysis. The STROBE guideline was used in this study. RESULTS: The overall prevalence of psychological distress was 41%. The prevalence of stress, anxiety and depression were 14.4%, 39.3% and 18.8%, respectively. It was found that single and widowed nurses had a higher level of stress, anxiety and depression compared with married nurses. In addition, nurses in the age of 26-30 years had a higher level of depression than nurses in other age groups. Also, nurses who worked in the paediatric departments had a higher level of depression compared with nurses in other departments. The majority of the nurses were satisfied with their job at 92.0%. Those nurses who were not satisfied were found to be significantly associated with a high level of stress and depression. CONCLUSION: This study revealed that the level of stress, anxiety and depression is high. Stress and depression were found to be associated with nurses' low job satisfaction. RELEVANCE TO CLINICAL PRACTICE: Stress and depression can affect nurses' job satisfaction, it is important for nursing managers to institute strategies to address this issue.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16830, title = {Mapping disparities in education across low- and middle-income countries}, author = {N Graetz and L Woyczynski and K F Wilson and J B Hall and K H Abate and F Abd-Allah and O M Adebayo and V Adekanmbi and M Afshari and O Ajumobi and T Akinyemiju and F Alahdab and Z Al-Aly and J E A Rabanal and M Alijanzadeh and V Alipour and K Altirkawi and M Amiresmaili and N H Anber and C L Andrei and M Anjomshoa and C A T Antonio and J Arabloo and O Aremu and K K Aryal and M Asadi-Aliabadi and S Atique and M Ausloos and A Awasthi and B P A Quintanilla and S Azari and A Badawi and J A M Banoub and S L Barker-Collo and A Barnett and N Bedi and D A Bennett and N V Bhattacharjee and K Bhattacharyya and S Bhattarai and Z A Bhutta and A Bijani and B Bikbov and G Britton and R Burstein and Z A Butt and R C\'{a}rdenas and F Carvalho and C A Casta\~{n}eda-Orjuela and F Castro and E Cerin and J C Chang and M L Collison and C Cooper and M A Cork and F Daoud and R Das Gupta and N D Weaver and J W De Neve and K Deribe and B B Desalegn and A Deshpande and M Desta and M Dhimal and D Diaz and M T Dinberu and S Djalalinia and M Dubey and E Dubljanin and A R Dur\~{a}es and L Dwyer-Lindgren and L Earl and M E Kalan and Z El-Khatib and B Eshrati and M Faramarzi and M Fareed and A Faro and S M Fereshtehnejad and E Fernandes and I Filip and F Fischer and T Fukumoto and J A Garc\'{i}a and P S Gill and T K Gill and P N Gona and S V Gopalani and A Grada and Y Guo and R Gupta and V Gupta and A Haj-Mirzaian and A Haj-Mirzaian and R R Hamadeh and S Hamidi and M Hasan and H Y Hassen and D Hendrie and A Henok and others}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85077152844\&doi=10.1038%2fs41586-019-1872-1\&partnerID=40\&md5=2c5e0d446b8799d41620564ec4ee2a6d}, doi = {10.1038/s41586-019-1872-1}, year = {2019}, date = {2019-01-01}, journal = {Nature}, abstract = {Educational attainment is an important social determinant of maternal, newborn, and child health1\textendash3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4\textendash6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9\textendash11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but\textemdashto our knowledge\textemdashno analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries12\textendash14. By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations. © 2019, The Author(s).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16725, title = {Biodiesel Production from Waste Edible Oil with Heterogeneous Catalysts (Nanoclay-Based Nanocatalysts)}, author = {F Halek and N Aghamohammadi and F Mohamadi}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85069508497\&doi=10.1007%2fs13369-019-03986-5\&partnerID=40\&md5=4276c90f4e23424275ccb09a8cc2e5ff}, doi = {10.1007/s13369-019-03986-5}, year = {2019}, date = {2019-01-01}, journal = {Arabian Journal for Science and Engineering}, volume = {44}, number = {12}, pages = {9919-9924}, abstract = {The various benefits of biofuels versus fossil fuels due to recent global challenges and issues are the best approach toward low-cost economic production of renewable energy. This study is trying to obtain economic catalysts with easy fabrication technology. The synthesized catalysts were obtained using calcium oxide/nanoclay catalysts by an initial ion-exchange reaction of calcium oxide and nanoclays (montmorillonite). These catalysts have been synthesized for the first time by being stirred for 5 h at a temperature of 80 °C, and the colloidal supernatant is obtained and kept in an ultrasonic bath for 20 min. The solution was filtered, washed several times, the residual mixture on filter paper was dried in the oven at 50 °C for few hours, and the powder was calcined for 8 h in a furnace at 600 °C. After identification and characterization, using XRD, BET, and SEM, the results approved the formation of a new nanostructure in synthesized catalysts, which were suitable to be used in biodiesel production from waste oils with high free fatty acids content. The results of this study indicate that the catalysts production process is not complicated, and methyl ester production rates in all biodiesel samples were more than 97% (97.1\textendash98.8%). © 2019, King Fahd University of Petroleum \& Minerals.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16638, title = {Randomised controlled clinical trial of a structured cognitive rehabilitation in patients with attention deficit following mild traumatic brain injury: study protocol}, author = {N Hamzah and V Narayanan and N Ramli and N A Mustapha and N A Mohammad Tahir and L K Tan and M Danaee and N A Muhamad and A Drummond and R Nair and S Y Goh and M Mazlan}, doi = {10.1136/bmjopen-2018-028711}, issn = {2044-6055}, year = {2019}, date = {2019-01-01}, journal = {BMJ Open}, volume = {9}, number = {9}, pages = {e028711}, abstract = {OBJECTIVES: To measure the clinical, structural and functional changes of an individualised structured cognitive rehabilitation in mild traumatic brain injury (mTBI) population. SETTING: A single centre study, Malaysia. PARTICIPANTS: Adults aged between 18 and 60 years with mTBI as a result of road traffic accident, with no previous history of head trauma, minimum of 9 years education and abnormal cognition at 3 months will be included. The exclusion criteria include pre-existing chronic illness or neurological/psychiatric condition, long-term medication that affects cognitive/psychological status, clinical evidence of substance intoxication at the time of injury and major polytrauma. Based on multiple estimated calculations, the minimum intended sample size is 50 participants (Cohen's d effect size=0.35; alpha level of 0.05; 85% power to detect statistical significance; 40% attrition rate). INTERVENTIONS: Intervention group will receive individualised structured cognitive rehabilitation. Control group will receive the best patient-centred care for attention disorders. Therapy frequency for both groups will be 1 hour per week for 12 weeks. OUTCOME MEASURES: Primary: Neuropsychological Assessment Battery-Screening Module (S-NAB) scores. Secondary: Diffusion Tensor Imaging (DTI) parameters and Goal Attainment Scaling score (GAS). RESULTS: Results will include descriptive statistics of population demographics, CogniPlus cognitive program and metacognitive strategies. The effect of intervention will be the effect size of S-NAB scores and mean GAS T scores. DTI parameters will be compared between groups via repeated measure analysis. Correlation analysis of outcome measures will be calculated using Pearson's correlation coefficient. CONCLUSION: This is a complex clinical intervention with multiple outcome measures to provide a comprehensive evidence-based treatment model. ETHICS AND DISSEMINATION: The study protocol was approved by the Medical Research Ethics Committee UMMC (MREC ID NO: 2016928-4293). The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER: NCT03237676.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16726, title = {Correction to: The Prevalence and Associated Factors of Depression, Anxiety and Stress of First Year Undergraduate Students in a Public Higher Learning Institution in Malaysia (Journal of Child and Family Studies, (2019), 28, 12, (3545-3557), 10.1007/s10826-019-01537-y)}, author = {N S A Hamzah and N D N Farid and A Yahya and C Chin and T T Su and S R L Rampal and M Dahlui}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85074041143\&doi=10.1007%2fs10826-019-01588-1\&partnerID=40\&md5=a5a3393fe73c8fcd3e73ae92c5039c66}, doi = {10.1007/s10826-019-01588-1}, year = {2019}, date = {2019-01-01}, journal = {Journal of Child and Family Studies}, volume = {28}, number = {12}, pages = {3582}, abstract = {The original version of this article unfortunately contained mistakes. 1. On page 7, the heading should read as “Discussions”. 2. In Table 4, page 6 at Geographical location, anxiety section under the column heading “Total No (%)” the value 314 (36.0) should read as 314 (26.0) for the row Central Region. 3. On page 11, the first paragraph starting as “With regards limitations” should read as “With regards to limitations”. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16624, title = {Development and Validation of an Evaluation Tool to Measure the Effectiveness of a Smoking Cessation Training among Healthcare Providers in Malaysia: The Providers' Smoking Cessation Training Evaluation (ProSCiTE)}, author = {S I Hasan and F Mohd Hairi and A S Amer Nordin and M Danaee}, doi = {10.3390/ijerph16214297}, issn = {1660-4601}, year = {2019}, date = {2019-01-01}, journal = {Int J Environ Res Public Health}, volume = {16}, number = {21}, abstract = {Background: In line with Article 14 of the Framework Convention for Tobacco Control, we have witnessed vast developments in smoking cessation training for healthcare providers, offering help for smokers. However, there is no specific evaluation tool to monitor and evaluate the effectiveness of these programs for future enhancement and sustainability. Objective: To develop and validate a new tool for evaluating smoking cessation training programs for healthcare providers called the Providers' Smoking Cessation Training Evaluation (ProSCiTE). Methods: The 74-item ProSCiTE tool was developed based on a review of the literature and an expert panel review. The tool was validated in a sample of 403 healthcare providers using a cross-sectional study design from July to December 2016. Content validity was assessed by the Scale-Content Validity Index (S-CVI). The construct validity of the ProSCiTE was analyzed using exploratory factor analysis (EFA) to confirm psychometric properties. Internal consistency reliability was determined using Cronbach's alpha. Results: The content validity showed that the S-CVI ranged from 0.82 to 1.00 for consistency, representativeness, relevancy, and the clarity of each construct, resulting in 67 items for the questionnaire. The construct validity of the ProSCiTE (based on eigenvalues and factor loadings to confirm the four-factor structure (attitude, self-efficacy, behavior, and barriers) with 54.74% total variance) was acceptable (Kaiser-Mayer-Olkin = 0.923; Bartlett's test of sphericity was significant, p \< 0.001). The internal consistency reliability of the four-factor structure was very good, with Cronbach's alpha values at 0.89, 0.94, 0.95, and 0.90, respectively. Conclusions: This study showed that 67 items of the ProSCiTE demonstrated good content and construct validity, as well as a high internal consistency reliability for the measurement of knowledge, attitudes, self-efficacy, behavior, and barriers to smoking cessation interventions among healthcare providers. Therefore, the ProSCiTE is a valid and reliable research tool with which to evaluate the effectiveness of smoking cessation training programs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16651, title = {Outcome and Presentation of Heart Failure in Breast Cancer Patients; Findings from a Swedish register-based study}, author = {E Hedayati and A Papakonstantinou and S A M Gernaat and R Altena and J S Brand and J Alfredsson and N Bhoo-Pathy and J Herrmann and C Linde and U Dahlstrom and J Bergh and L Hubbert}, doi = {10.1093/ehjqcco/qcz039}, issn = {2058-1742}, year = {2019}, date = {2019-01-01}, journal = {Eur Heart J Qual Care Clin Outcomes}, abstract = {AIMS: Heart failure (HF) patients diagnosed with breast cancer (BC) may have a higher risk of death, and different HF presentation and treatment than patients without BC. METHODS AND RESULTS: 14998 women with incident HF (iHF) or prevalent HF (pHF) enrolled in the Swedish HF Registry within and after one month since HF diagnosis, respectively, between 2008-2013. Patients were linked with the National Patient-, Cancer-, and Cause-of-Death Registry. 294 iHF and 338 pHF patients with BC were age-matched to 1470 iHF and 1690 pHF patients without BC. Comorbidity and treatment characteristics were compared using chi-squared tests for categories. Cox proportional hazard models assessed the hazard ratio (HR) and 95% confidence intervals (95%CI) of all-cause and cardiovascular mortality among HF patients with and without BC. In the pHF group, BC patients had less often myocardial infarction (47.6% vs. 55.1%, P \< 0.01) and received less often aspirin (11.8% vs. 16.2%}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16682, title = {A Stepwise Approach to a National Hepatitis C Screening Strategy in Malaysia to Meet the WHO 2030 Targets: Proposed Strategy, Coverage, and Costs}, author = {L Hiebert and R Hecht and S Soe-Lin and R Mohamed and F H Shabaruddin and S M Syed Mansor and M Dahlui and A Azzeri and S A McDonald}, doi = {10.1016/j.vhri.2018.12.005}, issn = {2212-1099}, year = {2019}, date = {2019-01-01}, journal = {Value Health Reg Issues}, volume = {18}, pages = {112-120}, abstract = {BACKGROUND: In Malaysia, more than 330 000 individuals are estimated to be chronically infected with hepatitis C virus (HCV), but less than 2% have been treated to date. OBJECTIVES: To estimate the required coverage and costs of a national screening strategy to inform the launch of an HCV elimination program. METHODS: We designed an HCV screening strategy based on a "stepwise" approach. This approach relied on targeting of people who inject drugs in the early years, with delayed onset of widespread general population screening. Annual coverage requirements and associated costs were estimated to ensure that the World Health Organization elimination treatment targets were met. RESULTS: In total, 6 million individuals would have to be screened between 2018 and 2030. Targeting of people who inject drugs in the early years would limit annual screening coverage to less than 1 million individuals from 2018 to 2026. General population screening would have to be launched by 2026. Total costs were estimated at MYR 222 million ($58 million). Proportional to coverage targets, 60% of program costs would fall from 2026 to 2030. CONCLUSIONS: This exercise was one of the first attempts to conduct a detailed analysis of the required screening coverage and costs of a national HCV elimination strategy. These findings suggest that the stepwise approach could delay the onset of general population screening by more than 5 years after the program's launch. This delay would allow additional time to mobilize investments required for a successful general population screening program and also minimize program costs. This strategy prototype could inform the design of effective screening strategies in other countries.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16715, title = {CA19-9 and apolipoprotein-A2 isoforms as detection markers for pancreatic cancer: a prospective evaluation}, author = {K Honda and V A Katzke and A Husing and S Okaya and H Shoji and K Onidani and A Olsen and A Tjonneland and K Overvad and E Weiderpass and P Vineis and D Muller and K Tsilidis and D Palli and V Pala and R Tumino and A Naccarati and S Panico and K Aleksandrova and H Boeing and H B Bueno-de-Mesquita and P H Peeters and A Trichopoulou and P Lagiou and K T Khaw and N Wareham and R C Travis and S Merino and E J Duell and M Rodriguez-Barranco and M D Chirlaque and A Barricarte and V Rebours and M C Boutron-Ruault and F Romana Mancini and P Brennan and G Scelo and J Manjer and M Sund and D Ohlund and F Canzian and R Kaaks}, doi = {10.1002/ijc.31900}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, volume = {144}, number = {8}, pages = {1877-1887}, abstract = {Recently, we identified unique processing patterns of apolipoprotein A2 (ApoA2) in patients with pancreatic cancer. Our study provides a first prospective evaluation of an ApoA2 isoform ("ApoA2-ATQ/AT"), alone and in combination with carbohydrate antigen 19-9 (CA19-9), as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19-9 and ApoA2-ATQ/AT in 156 patients with pancreatic cancer and 217 matched controls within the European EPIC cohort, using plasma samples collected up to 60 months prior to diagnosis. The detection discrimination statistics were calculated for risk scores by strata of lag-time. For CA19-9, in univariate marker analyses, C-statistics to distinguish future pancreatic cancer patients from cancer-free individuals were 0.80 for plasma taken \</=6 months before diagnosis, and 0.71 for \>6-18 months; for ApoA2-ATQ/AT, C-statistics were 0.62, and 0.65, respectively. Joint models based on ApoA2-ATQ/AT plus CA19-9 significantly improved discrimination within \>6-18 months (C = 0.74 vs. 0.71 for CA19-9 alone}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16626, title = {Circulating miR-3197 and miR-2116-5p as novel biomarkers for diabetic retinopathy}, author = {H Ji and Q Yi and L Chen and L Wong and Y Liu and G Xu and J Zhao and T Huang and B Li and Y Yang and W Li and L Han and S Duan}, doi = {10.1016/j.cca.2019.10.036}, issn = {0009-8981}, year = {2019}, date = {2019-01-01}, journal = {Clin Chim Acta}, abstract = {Diabetic retinopathy (DR) is the leading cause of vision loss among older adults. The goal of this case-control study was to identify circulating miRNAs for the diagnosis of DR. The miRNeasy Serum/Plasma Kit was used to extract serum miRNAs. The muParaflo MicroRNA microarray was used to detect the expression levels of the miRNAs. The miRWalk algorithm was applied to predict the target genes of the miRNAs, which were further confirmed by the dual luciferase reporter gene system in HEK293T cells. A microarray was performed between 5 DR cases and 5 age-, sex-, body mass index-, and duration of diabetes-matched type 2 diabetic (T2DM) controls. The quantitative reverse transcription polymerase chain reaction technique was used to validate the differentially expressed circulating miRNAs in 45 DR cases and 45 well-matched controls. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the circulating miRNAs as diagnostic biomarkers for DR. Our microarray analysis screened out miR-2116-5p and miR-3197 as significantly up-regulated in DR cases compared with the controls. Furthermore, two miRNAs were validated in the 45 DR cases and 45 controls. The ROC analysis suggested that both miR-3197 and miR-2116-5p distinguished DR cases from controls. An additional dual-luciferase reporter gene assay confirmed that notch homolog 2 (NOTCH2) was the target gene of miR-2116-5p. Both miR-3197 and miR-2116-5p were identified as promising diagnostic biomarkers for DR. Future research is still needed to explore the molecular mechanisms of miR-3197 and miR-2116-5p in the pathogenesis of DR.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16769, title = {Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes}, author = {L V Jones and A Ray and F M Moy and B S Buckley}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85066832714\&doi=10.1002%2f14651858.CD009613.pub4\&partnerID=40\&md5=700f93979245780cff0ae7b6c2271f95}, doi = {10.1002/14651858.CD009613.pub4}, year = {2019}, date = {2019-01-01}, journal = {Cochrane Database of Systematic Reviews}, volume = {2019}, number = {5}, abstract = {Background There are a number of ways of monitoring blood glucose in women with diabetes during pregnancy, with self-monitoring of blood glucose (SMBG) recommended as a key component of the management plan. No existing systematic reviews consider the benefits/ effectiveness of different techniques of blood glucose monitoring on maternal and infant outcomes among pregnant women with pre-existing diabetes. The effectiveness of the various monitoring techniques is unclear. This review is an update of a review that was first published in 2014 and subsequently updated in 2017. Objectives To compare techniques of blood glucose monitoring and their impact on maternal and infant outcomes among pregnant women with pre-existing diabetes. Search methods For this update, we searched Cochrane Pregnancy and Childbirth’s Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (1 November 2018), and reference lists of retrieved studies. Selection criteria Randomised controlled trials (RCTs) and quasi-RCTs comparing techniques of blood glucose monitoring including SMBG, continuous glucose monitoring (CGM), automated telemedicine monitoring or clinic monitoring among pregnant women with pre-existing diabetes mellitus (type 1 or type 2). Trials investigating timing and frequency of monitoring were also eligible for inclusion. RCTs using a cluster-randomised design were eligible for inclusion but none were identified. Data collection and analysis Two review authors independently assessed study eligibility, extracted data and assessed the risk of bias of included studies. Data were checked for accuracy. The quality of the evidence was assessed using the GRADE approach. Main results This review update includes a total of 12 trials (863) women (792 women with type 1 diabetes and 152 women with type 2 diabetes). The trials took place in Europe, the USA and Canada. Three of the 12 included studies are at low risk of bias, eight studies are at moderate risk of bias, and one study is at high risk of bias. Four trials reported that they were provided with the continuous glucose monitors free of charge or at a reduced cost by the manufacturer. Continuous glucose monitoring (CGM) versus intermittent glucose monitoring, (four studies, 609 women) CGM may reduce hypertensive disorders of pregnancy (pre-eclampsia and pregnancy-induced hypertension) (risk ratio (RR) 0.58, 95% confidence interval (CI) 0.39 to 0.85; 2 studies, 384 women; low-quality evidence), although it should be noted that only two of the four relevant studies reported data for this composite outcome. Conversely, this did not translate into a clear reduction for pre-eclampsia (RR 0.65, 95% CI 0.39 to 1.08; 4 studies, 609 women, moderate-quality evidence). There was also no clear reduction in caesarean section (average RR 0.94, 95% CI 0.75 to 1.18; 3 studies, 427 women; I2 = 41%; moderate-quality evidence) or large-for-gestational age (average RR 0.84, 95% CI 0.57 to 1.26; 3 studies, 421 women; I2 = 70%; low-quality evidence) with CGM. There was not enough evidence to assess perinatal mortality (RR 0.82, 95% CI 0.05 to 12.61, 71 infants, 1 study; low-quality evidence), or mortality or morbidity composite (RR 0.80, 95% CI 0.61 to 1.06; 1 study, 200 women) as the evidence was based on single studies of low quality. CGM appears to reduce neonatal hypoglycaemia (RR 0.66, 95% CI 0.48 to 0.93; 3 studies, 428 infants). Neurosensory disability was not reported. Other methods of glucose monitoring For the following five comparisons, self-monitoring versus a different type of self-monitoring (two studies, 43 women); self-monitoring at home versus hospitalisation (one study, 100 women), pre-prandial versus post-prandial glucose monitoring (one study, 61 women), automated telemedicine monitoring versus conventional system (three studies, 84 women), and constant CGM versus intermittent CGM (one study, 25 women), it is uncertain whether any of the interventions has any impact on any of our GRADE outcomes (hypertensive disorders of pregnancy, caesarea section, large-for-gestational age) because the quality of the evidence was found to be very low. This was due to evidence largely being derived from single trials, with design limitations and limitations with imprecision (wide CIs, small sample sizes, and few events). There was not enough evidence to assess perinatal mortality and neonatal mortality and morbidity composite. Other important outcomes, such as neurosensory disability, were not reported in any of these comparisons. Authors’ conclusions Two new studies (406 women) have been incorporated to one of the comparisons for this update. Although the evidence suggests that CGM in comparison to intermittent glucose monitoring may reduce hypertensive disorders of pregnancy, this did not translate into a clear reduction for pre-eclampsia, and so this result should be viewed with caution. No differences were observed for other primary outcomes for this comparison. The evidence base for the effectiveness of other monitoring techniques analysed in the other five comparisons is weak and based on mainly single studies with very low-quality evidence. Additional evidence from large well-designed randomised trials is required to inform choices of other glucose monitoring techniques and to confirm the effectiveness of CGM. © 2019 The Cochrane Collaboration.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16809, title = {Diagnosing metabolic syndrome using genetically optimised Bayesian ARTMAP}, author = {H A Kakudi and C K Loo and F M Moy and N Masuyama and K Pasupa}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85056546127\&doi=10.1109%2fACCESS.2018.2880224\&partnerID=40\&md5=236c2a1edae3550f2323218d7a6dda55}, doi = {10.1109/ACCESS.2018.2880224}, year = {2019}, date = {2019-01-01}, journal = {IEEE Access}, volume = {7}, pages = {8437-8453}, abstract = {Metabolic Syndrome (MetS) constitutes of metabolic abnormalities that lead to non-communicable diseases, such as type II diabetes, cardiovascular diseases, and cancer. Early and accurate diagnosis of this abnormality is required to prevent its further progression to these diseases. This paper aims to diagnose the risk of MetS using a new non-clinical approach called 'genetically optimized Bayesian adaptive resonance theory mapping' (GOBAM). We evolve the Bayesian adaptive resonance theory mapping (BAM) by using genetic algorithm to optimize the parameters of BAM and its training input sequence. We use the GOBAM algorithm to classify individuals as either being at risk of MetS or not at risk of MetS with a related posterior probability, which ranges between 0 and 1. A data set of 11 237 Malaysians from the CLUSTer study stratified by age and gender into four subcategories was used to evaluate the proposed GOBAM algorithm. The comparative evaluation of our results suggested that the GOBAM performs significantly better than other classical adaptive resonance theory mapping models on the area under the receiver operating characteristic curves (AUC) and others criteria. Our algorithm gives an AUC of 86.42 %, 87.04 %, 91.08 %, and 89.24 % for the young female, middle aged female, young male, and middle-aged male subcategories, respectively. The proposed model can be used to support medical practitioners in accurate and early diagnosis of MetS. © 2013 IEEE.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16801, title = {The Incidence of Agenesis of Palmaris Longus Muscle Among Multiracial Medical Students of University Malaya, Malaysia}, author = {N M Kassim and I S Zulkafli and R M Zamin and M A Salim and M Danaee and S R M Zin}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85075362630\&doi=10.1007%2fs12262-019-02026-8\&partnerID=40\&md5=114b24ae64f2d8e94c71dc3ac19a80de}, doi = {10.1007/s12262-019-02026-8}, year = {2019}, date = {2019-01-01}, journal = {Indian Journal of Surgery}, abstract = {Palmaris longus (PL) is the most superficial flexor muscle of the wrist. Agenesis of this muscle does not result in disability but its presence plays a significant role in reconstructive plastic surgery as a donor tendon for grafting. The awareness of the incidence of PL occurrence in a population is therefore desirable. In the present study, 457 multiracial medical students (220 Malays, 198 Chinese and 39 Indians) of University of Malaya, Malaysia, ages between 18 to 22 years, were examined for the presence or absence of the PL tendon using Schaeffer’s test. This study demonstrated the overall difference in occurrence rate of PL among the multiracial students which indirectly represent its overall pattern in Malaysian population, as the students originate from various states of this country. The data collected were then analyzed using non-parametric test to determine pattern of occurrence and incidence of agenesis of this muscle with regard to ethnicity, laterality, and gender. The highest incidence of unilateral and bilateral PL agenesis was observed in Indian students despite being the smallest race among the three groups studied. This study contradicts with previous findings that concluded Malays to be the group with the highest incidence of unilateral PL agenesis. This contradiction therefore justifies the need to construct a larger cohort study, which covers more diverse ethnic groups in Malaysia including the indigenous groups in Sabah and Sarawak to obtain the true incidence rate of PL agenesis in Malaysia. © 2019, Association of Surgeons of India.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16771, title = {Seroprevalence of borrelia burgdorferi among the indigenous people (Orang asli) of peninsular malaysia}, author = {C S Khor and H Hassan and N F Mohd-Rahim and J R Chandren and N Siti-Sarah and J Johari and L Shih-Keng and J Abd-Jamil and J J Khoo and L Hai-Yen and B L Pike and W L Ping and Y Ai-Lian Lim and S Abubakar}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85070460372\&doi=10.3855%2fjidc.11001\&partnerID=40\&md5=76d3b515238ac4864d47f95a2f303e88}, doi = {10.3855/jidc.11001}, year = {2019}, date = {2019-01-01}, journal = {Journal of Infection in Developing Countries}, volume = {13}, number = {5}, pages = {449-454}, abstract = {Introduction: Lyme disease has been well-described in the North America and European countries. However, information is still very limited in the developing countries including Malaysia. The Orang Asli (OA), the indigenous people of Peninsular Malaysia reside mostly in the forest and forest fringe areas abundant with the vector for Lyme disease. Here, we described the seroprevalence of Borellia burgdorferi (B. burgdorferi) among the OA and demographic variables that could be associated with seroprevalence. Methodology: A total of 16 OA villages distributed across 8 states in Peninsular Malaysia participated in this study. Sera obtained from 904 OA volunteers were screened for anti-B. burgdorferi IgG antibodies. ELISA results obtained and demographic information collected were analysed to identify possible variables associated with seroprevalence. Results: A total of 73 (8.1%) OA tested positive for anti-B. burgdorferi IgG antibodies. Among all the variables examined, village of residence (p = 0.045) was the only significant predictor for seropositivity. High (\> 10.0%) prevalence was associated with three OA villages. Those living in one particular village were 1.65 times more likely to be seropositive as compared to other OA villages. Age, gender, marital status, household size, level of education, monthly household income and occupation were not significant predictors for seropositivity. Conclusion: Results of the present study support earlier findings that B. burgdorferi infection among Malaysians is currently under-recognized. Further studies will be needed at these locations to confirm the presence of Lyme disease among these populations. © 2019 Khor et al.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16742, title = {Body shape, fear of falling, physical performance, and falls among individuals aged 55 years and above}, author = {S H Kioh and S Mat and S B Kamaruzzaman and F Ibrahim and M S Mokhtar and N N Hairi and R G Cumming and P K Myint and M P Tan and MELoR investigators}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85069944669\&doi=10.1007%2fs41999-019-00220-1\&partnerID=40\&md5=736d6517c3638e9e335693905fa2d7df}, doi = {10.1007/s41999-019-00220-1}, year = {2019}, date = {2019-01-01}, journal = {European Geriatric Medicine}, volume = {10}, number = {5}, pages = {801-808}, abstract = {Purpose: To evaluate the relationship between waist-to-hip ratio (WHR) and fall-related outcomes in community-dwelling individuals aged 55 and above. Methods: Cross-sectional data obtained from the first wave of the Malaysian Elders Longitudinal Research (MELoR) study were utilized for this study. Participants aged 55 years and over were recruited using simple random sampling from the electoral rolls of three local parliamentary constituencies. Socio-demographics, falls history and medical history were obtained through home-based computer-assisted interviews while anthropometric measurements, including WHR, and physical performance were obtained during hospital-based health checks. WHR was categorized into three arbitrary categories stratified by gender. Results: Data on both falls and WHR were available for 1335 participants, mean age ± standard deviation (SD) = 68.4 ± 7.1 years. Logistic regression analyses using dummy variables revealed that individuals within the higher WHR group were significantly more likely to report a history of fall in the preceding 12 months adjusted odds ratio (aOR) [95% confidence interval (CI)] = 1.78 (1.18\textendash2.67), fear of falling [aOR (95% CI) = 1.58 (1.08\textendash2.32)], impaired timed-up-and-go [2.14 (1.44\textendash3.17)] and reduced functional reach [1.68 (1.18\textendash2.38)] compared to those with lower WHR. A higher WHR remained independently associated with increased risk of falls compared to those with lower WHR after additional adjustment for fear of falling and functional performance. Conclusion: Our finding suggests WHR as an independent risk factor for higher risk of fall which may indicate body shape as a potentially modifiable risk factor for falls in adults in aged 55 years and over. © 2019, © 2019, European Geriatric Medicine Society.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16631, title = {Predicted basal metabolic rate and cancer risk in the European Prospective Investigation into Cancer and Nutrition}, author = {N Kliemann and N Murphy and V Viallon and H Freisling and K K Tsilidis and S Rinaldi and F R Mancini and G Fagherazzi and M C Boutron-Ruault and H Boeing and M B Schulze and G Masala and V Krogh and C Sacerdote and M S Magistris and B Bueno-de-Mesquita and E Weiderpass and T Kuhn and R Kaaks and P Jakszyn and D Redondo-Sanchez and P Amiano and M D Chirlaque and A B Gurrea and U Ericson and I Drake and T H Nost and D Aune and A M May and A Tjonneland and C C Dahm and K Overvad and R Tumino and J R Quiros and A Trichopoulou and A Karakatsani and C La Vecchia and L M Nilsson and E Riboli and I Huybrechts and M J Gunter}, doi = {10.1002/ijc.32753}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, abstract = {Emerging evidence suggests that a metabolic profile associated with obesity may be a more relevant risk factor for some cancers than adiposity per se. Basal metabolic rate (BMR) is an indicator of overall body metabolism and may be a proxy for the impact of a specific metabolic profile on cancer risk. Therefore, we investigated the association of predicted BMR with incidence of 13 obesity-related cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). BMR at baseline was calculated using the WHO/FAO/UNU equations and the relationships between BMR and cancer risk were investigated using multivariable Cox proportional hazards regression models. A total of 141,295 men and 317,613 women, with a mean follow-up of 14 years were included in the analysis. Overall, higher BMR was associated with a greater risk for most cancers that have been linked with obesity. However, among normal weight participants, higher BMR was associated with elevated risks of esophageal adenocarcinoma (hazard ratio per 1-standard deviation change in BMR [HR1-SD ]: 2.46; 95% CI 1.20; 5.03) and distal colon cancer (HR1-SD : 1.33; 95% CI 1.001; 1.77) among men and with proximal colon (HR1-SD : 1.16; 95% CI 1.01; 1.35), pancreatic (HR1-SD : 1.37; 95% CI 1.13; 1.66), thyroid (HR1-SD : 1.65; 95% CI 1.33; 2.05), postmenopausal breast (HR1-SD : 1.17; 95% CI 1.11; 1.22) and endometrial (HR1-SD : 1.20; 95% CI 1.03; 1.40) cancers in women. These results indicate that higher BMR may be an indicator of a metabolic phenotype associated with risk of certain cancer types, and may be a useful predictor of cancer risk independent of body fatness.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16641, title = {In-depth examination of issues surrounding the reasons for child marriage in Kelantan, Malaysia: a qualitative study}, author = {A Kohno and M Dahlui and N D Nik Farid and S H Ali and T Nakayama}, doi = {10.1136/bmjopen-2018-027377}, issn = {2044-6055}, year = {2019}, date = {2019-01-01}, journal = {BMJ Open}, volume = {9}, number = {9}, pages = {e027377}, abstract = {OBJECTIVE: To examine individual, familial, community and societal issues surrounding the reasons for child marriage in Kelantan, Malaysia. DESIGN: Qualitative study by means of semistructured interviews with women and key informants, using social-ecological model as a conceptual framework. SETTING: Interviews were conducted in Kota Bharu district, Kelantan, a northeast state in Peninsular Malaysia. PARTICIPANTS: Eighteen women of reproductive age (18 to 44 years old) that experienced their first marriage below the age of 18, as well as five key informants, consisting of a government officer, a community leader, an officer from religious department and two mothers. The women were recruited from a reproductive health clinic. The key informants who had specialised knowledge related to child marriage were selectively chosen. RESULTS: Three themes emerged that aligned with the social-ecological model: immaturity in decision-making, family poverty and religious and cultural norms. CONCLUSIONS: The findings imply that sex education and awareness-building activities regarding the consequences of child marriage must be implemented to eradicate child marriage in Malaysia. Such implementation must be coordinated as a team-based approach involving experts in such fields as law, religion, psychology, social-welfare and public health. In order to increase the awareness of child marriage consequences, the target for awareness must extend not only to the adolescent girls and their families, but also to the community and society at large by clearly communicating the negative consequences of and addressing the drivers for child marriage.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16623, title = {From Evidence to Policy: Economic Evaluations of Healthcare in Malaysia - A Systematic Review}, author = {K N Ku Abd Rahim and H F Kamaruzaman and M Dahlui and S E Wan Puteh}, doi = {10.1016/j.vhri.2019.09.002}, issn = {2212-1099}, year = {2019}, date = {2019-01-01}, journal = {Value Health Reg Issues}, volume = {21}, pages = {91-99}, abstract = {OBJECTIVE: To identify and describe the various economic evaluation studies in Malaysia and to determine the range of incremental cost-effectiveness ratios (ICERs) as reported in these studies. METHODS: A comprehensive search of the scientific electronic databases was conducted (Medline, EBM Reviews, Embase, and hand search) to identify all published economic evaluation studies related to Malaysian healthcare. Two researchers assessed the quality of selected studies using the Critical Appraisal Skills Programme (CASP) checklist and Quality of Health Economic Studies instrument. The assessment was also reviewed by expert members of the Technical Advisory Committee of Health Technology Economic Evaluations (TACHTEE). RESULTS: A total of 64 full-text articles were assessed for eligibility and included in this systematic review. Thirty studies were partial economic evaluations; the full economic evaluations included 17 cost-effectiveness analyses and 17 cost-utility analyses. From all the reported ICERs, the majority (68%) were categorized as highly cost-effective (ICER of less than 1 gross domestic product (GDP) per capita per quality-adjusted life-years or disability-adjusted life-years gained). CONCLUSION: This review identifies information gaps and loopholes in health economics research in Malaysia. Additionally, this study provides the information that the majority of published interventions in Malaysia fell within the cost-effectiveness threshold of 1 GDP per capita per quality-adjusted life-years or disability-adjusted life-years gained.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16646, title = {Pre-diagnostic plasma bile acid levels and colon cancer risk: A prospective study}, author = {T Kuhn and M Stepien and M Lopez-Nogueroles and A D Machado and D Sookthai and T Johnson and M Roca and A Husing and S G Maldonado and A J Cross and N Murphy and H Freisling and S Rinaldi and A Scalbert and V Fedirco and G Severi and M C Boutron-Ruault and F R Mancini and S A Sowah and H Boeing and P Jakszyn and M J Sanchez and S Merino and S Colorado-Yohar and A Barricarte and K T Khaw and J A Schmidt and A Perez-Cornago and A Trichopoulou and A Karakatsani and P Thriskos and D Palli and C Agnoli and R Tumino and C Sacerdote and S Panico and B Bueno-de-Mesquita and C H Gils and A Heath and M J Gunter and E Riboli and A Lahoz and M Jenab and R Kaaks}, doi = {10.1093/jnci/djz166}, issn = {0027-8874}, year = {2019}, date = {2019-01-01}, journal = {J Natl Cancer Inst}, abstract = {BACKGROUND: Bile acids have been proposed to promote colon carcinogenesis. However, there are limited prospective data on circulating bile acid levels and colon cancer risk in humans. METHODS: Associations between pre-diagnostic plasma levels of 17 primary, secondary and tertiary bile acid metabolites (conjugated and unconjugated) and colon cancer risk were evaluated in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Bile acid levels were quantified by tandem mass spectrometry in samples from 569 incident colon cancer cases and 569 matched controls. Multivariable logistic regression analyses were used to estimate odds ratios (ORs) for colon cancer risk across quartiles of bile acid concentrations. RESULTS: Positive associations were observed between colon cancer risk and plasma levels of 7 conjugated bile acid metabolites, i.e. primary bile acids glycocholic acid (ORQuartile 4 vs. Quartile 1=2.22,95 % confidence interval[CI]=1.52, 3.26), taurocholic acid (OR = 1.78, 95%CI=1.23, 2.58), glycochenodeoxycholic acid (OR = 1.68, 95%CI=1.13, 2.48), taurochenodeoxycholic acid (OR = 1.62, 95%CI=1.11-2.36), and glycohyocholic acid (OR = 1.65, 95%CI=1.13, 2.40) as well as the secondary bile acids glycodeoxycholic acid (OR = 1.68, 95%CI=1.12, 2.54) and taurodeoxycholic acid (OR = 1.54, 95%CI=1.02, 2.31). By contrast, unconjugated bile acids and tertiary bile acids were not associated with risk. CONCLUSIONS: This prospective study showed that pre-diagnostic levels of certain conjugated primary and secondary bile acids were positively associated with risk of colon cancer. Our findings support experimental data to suggest that a high bile acid load is colon cancer promotive.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16683, title = {Significant factors influencing inadvertent hypothermia in pediatric anesthesia}, author = {L L Lai and M H See and S Rampal and K S Ng and L Chan}, doi = {10.1007/s10877-019-00259-2}, issn = {1387-1307}, year = {2019}, date = {2019-01-01}, journal = {J Clin Monit Comput}, volume = {33}, number = {6}, pages = {1105-1112}, abstract = {Thermal imbalances are very common during surgery. Hypothermia exposes the patient to post-operative shivering, cardiac dysfunction, coagulopathy, bleeding, wound infection, delayed anesthesia recovery, prolonged hospital stay and increased hospitalization cost. There are many factors contributing to intraoperative hypothermia. This is a prospective cohort study conducted through observation and measurement of pediatric surgical patients' temperature. Convenience sampling methods were used in this study. Initial skin temperature and core temperature at 10 min, 30 min,1 h, 2 h, 3 h, 4 h, 5 h, 6 h and at the end of surgery were recorded. Body temperature was monitored from time of transfer to the operating table until recovery and discharge to the respective pediatric ward. The overall incidence of intraoperative hypothermia was still very high at about 46.6% even though active and passive temperature management were carried out during surgery. Patient's age, body weight, duration of surgery, type of surgery, intraoperative blood loss, type of anesthesia and operating room temperature were factors that contributed to intraoperative hypothermia. Hypothermia is common in surgery, especially in major and long duration surgery. Intraoperative hypothermia can be life threatening if it is not handled carefully. Various methods are used before, during and after surgery to maintain a patient's body temperature within the normothermia range. The use of an active warming device like the Bair Hugger(R) air-forced warming system seems to be a good method for reducing the risk of intraoperative hypothermia and effectively maintaining body temperature for all major and minor surgeries.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16614, title = {Linking the effects of helminth infection, diet and the gut microbiota with human whole-blood signatures}, author = {S C Lee and M S Tang and A V Easton and J C Devlin and L L Chua and I Cho and F M Moy and T F Khang and Y A L Lim and P Loke}, doi = {10.1371/journal.ppat.1008066}, issn = {1553-7366}, year = {2019}, date = {2019-01-01}, journal = {PLoS Pathog}, volume = {15}, number = {12}, pages = {e1008066}, abstract = {Helminth infection and dietary intake can affect the intestinal microbiota, as well as the immune system. Here we analyzed the relationship between fecal microbiota and blood profiles of indigenous Malaysians, referred to locally as Orang Asli, in comparison to urban participants from the capital city of Malaysia, Kuala Lumpur. We found that helminth infections had a larger effect on gut microbial composition than did dietary intake or blood profiles. Trichuris trichiura infection intensity also had the strongest association with blood transcriptional profiles. By characterizing paired longitudinal samples collected before and after deworming treatment, we determined that changes in serum zinc and iron levels among the Orang Asli were driven by changes in helminth infection status, independent of dietary metal intake. Serum zinc and iron levels were associated with changes in the abundance of several microbial taxa. Hence, there is considerable interplay between helminths, micronutrients and the microbiota on the regulation of immune responses in humans.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16644, title = {Gravid oviposition sticky trap and dengue non-structural 1 antigen test for early surveillance of dengue in multi-storey dwellings: study protocol of a cluster randomized controlled trial}, author = {J W K Liew and S Selvarajoo and W Tan and R Ahmad Zaki and I Vythilingam}, doi = {10.1186/s40249-019-0584-y}, issn = {2049-9957}, year = {2019}, date = {2019-01-01}, journal = {Infect Dis Poverty}, volume = {8}, number = {1}, pages = {71}, abstract = {BACKGROUND: Dengue is a global disease, transmitted by the Aedes vectors. In 2018, there were 80 615 dengue cases with 147 deaths in Malaysia. Currently, the nationwide surveillance programs are dependent on Aedes larval surveys and notifications of lab-confirmed human infections. The existing, reactive programs appear to lack sensitivity and proactivity. More efficient dengue vector surveillance/control methods are needed. METHODS: A parallel, cluster, randomized controlled, interventional trial is being conducted for 18 months in Damansara Damai, Selangor, Malaysia, to determine the efficacy of using gravid oviposition sticky (GOS) trap and dengue non-structural 1 (NS1) antigen test for early surveillance of dengue among Aedes mosquitoes to reduce dengue outbreaks. Eight residential apartments were randomly assigned into intervention and control arms. GOS traps are set at the apartments to collect Aedes weekly, following which dengue NS1 antigen is detected in these mosquitoes. When a dengue-positive mosquito is detected, the community will be advised to execute vector search-and-destroy and protective measures. The primary outcome concerns the the percentage change in the (i) number of dengue cases and (ii) durations of dengue outbreaks. Whereas other outcome measures include the change in density threshold of Aedes and changes in dengue-related knowledge, attitude and practice among cluster inhabitants. DISCUSSION: This is a proactive and early dengue surveillance in the mosquito vector that does not rely on notification of dengue cases. Surveillance using the GOS traps should be able to efficiently provide sufficient coverage for multistorey dwellings where population per unit area is likely to be higher. Furthermore, trapping dengue-infected mosquitoes using the GOS trap, helps to halt the dengue transmission carried by the mosquito. It is envisaged that the results of this randomized controlled trial will provide a new proactive, cheap and targeted surveillance tool for the prevention and control of dengue outbreaks. TRIAL REGISTRATION: This is a parallel-cluster, randomized controlled, interventional trial, registered at ClinicalTrials.gov (ID: NCT03799237), on 8th January 2019 (retrospectively registered).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16668, title = {A Qualitative Study of HIV "Test-and-Treat" Experience Among Men Who Have Sex With Men in Malaysia}, author = {S H Lim and H Alias and J K W Kien and M Akbar and A Kamarulzaman and L P Wong}, doi = {10.1521/aeap.2019.31.3.193}, issn = {0899-9546}, year = {2019}, date = {2019-01-01}, journal = {AIDS Educ Prev}, volume = {31}, number = {3}, pages = {193-205}, abstract = {This study aimed to examine the barriers and facilitators to HIV testing and treatment among Malaysian MSM. Between June 2014 and December 2015, in-depth interviews were conducted in 20 HIV-positive MSM recruited from a teaching hospital and NGO in Kuala Lumpur. Thematic analysis was used to identify, analyze, and report themes. Most participants investigated their HIV status after long period of sickness. Others sought testing upon partner's diagnosis and some were diagnosed via blood donation. Barriers to testing include personal (perceived good health, fear of positive result, denial); social and structural factors (stigmatization by health providers and family, lack of information about free HIV testing and long wait time). Barriers to treatment comprise personal factors (perceived HIV as incurable and treatment as complicated), social factors (HIV and homosexual stigma), and cost. Promoting benefits of regular testing and early treatment is needed to improve HIV care continuum among MSM in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16620, title = {Clinic and patient variation in intermediate clinical outcomes for type 2 diabetes: a multilevel analysis}, author = {Y M F Lim and S H Ang and N H Nasir and F Ismail and S A Ismail and S Sivasampu}, doi = {10.1186/s12875-019-1045-1}, issn = {1471-2296}, year = {2019}, date = {2019-01-01}, journal = {BMC Fam Pract}, volume = {20}, number = {1}, pages = {158}, abstract = {BACKGROUND: Variation at different levels of diabetes care has not yet been quantified for low- and middle-income countries. Understanding this variation and its magnitude is important to guide policy makers in designing effective interventions. This study aims to quantify the variation in the control of glycated haemoglobin (HbA1c), systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C) for type 2 diabetes (T2D) patients at the clinic and patient level and determine patient and clinic factors associated with control of these outcomes in T2D. METHODS: This is a cross-sectional study within the baseline data from the impact evaluation of the Enhanced Primary Health Care (EnPHC) intervention on 40 public clinics in Malaysia. Patients aged 30 and above, diagnosed with T2D, had a clinic visit for T2D between 01 Nov 2016 and 30 April 2017 and had at least one HbA1c, SBP and LDL-C measurement within 1 year from the date of visit were included for analysis. Multilevel linear regression adjusting for patient and clinic characteristics was used to quantify variation at the clinic and patient levels for each outcome. RESULTS: Variation in intermediate clinical outcomes in T2D lies predominantly (93% and above) at the patient level. The strongest predictors for poor disease control in T2D were the proxy measures for disease severity including duration of diabetes, presence of microvascular complications, being on insulin therapy and number of antihypertensives. Among the three outcomes, HbA1c and LDL-C results provide greatest opportunity for improvement. CONCLUSION: Clinic variation in HbA1c, SBP and LDL-C accounts for a small percentage from total variation. Findings from this study suggest that standardised interventions need to be applied across all clinics, with a focus on customizing therapy based on individual patient characteristics.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16637, title = {Factors influencing intention to obtain the HPV vaccine and acceptability of 2-, 4- and 9-valent HPV vaccines: A study of undergraduate female health sciences students in Fujian, China}, author = {Y Lin and Z Lin and F He and Z Hu and G D Zimet and H Alias and L P Wong}, doi = {10.1016/j.vaccine.2019.09.026}, issn = {0264-410x}, year = {2019}, date = {2019-01-01}, journal = {Vaccine}, volume = {37}, number = {44}, pages = {6714-6723}, abstract = {BACKGROUND: Little research has been conducted on the intention to obtain HPV vaccine now that the vaccine is approved for use in China. Acceptance of the three HPV vaccines, which differ in valency and price, has never been investigated. METHODS: An online cross-sectional survey assessing female undergraduate students' intention to obtain the HPV vaccine and their acceptability of 2-, 4- and 9-valent HPV vaccines (2vHPV, 4vHPV, and 9vHPV, respectively). RESULTS: Of a total of 997 complete responses, 55.2% reported intent to obtain the HPV vaccine. Some of the significant factors exerting influence on intent to obtain HPV vaccination were high knowledge score (OR=1.469, 95% CI:1.087-1.987), perceived high risk of HPV infection (OR=1.466, 95%CI:1.017-2.114), perception of no serious side effects (OR=1.562, 95%CI:1.150-2.121), and mass media exposure to HPV vaccination information (OR=2.196, 95%CI: 1.625-2.966). Socioeconomic status indicators did not significantly influence intent to obtain the HPV vaccine. A higher proportion of respondents were willing to pay for 2vHPV (78.6%) and 4vHPV (68.0%) compared with 9vHPV (49.3%). Socioeconomic status indicators were the strongest correlates of acceptability for all the three vaccines. Exposure to mass media reporting about HPV vaccination is the factor which exerts the most influence on acceptance of 9vHPV after socioeconomic status indicators. CONCLUSIONS: It is important to improve knowledge and health beliefs, and to establish a mass media marketing strategy to promote HPV vaccination in order to enhance HPV vaccine uptake. Undergraduate female students should be provided with detailed information about the different valency vaccine choices to help them make informed decisions about immunization.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16657, title = {Breaking down the barriers: Understanding migrant workers' access to healthcare in Malaysia}, author = {T Loganathan and D Rui and C W Ng and N S Pocock}, doi = {10.1371/journal.pone.0218669}, issn = {1932-6203}, year = {2019}, date = {2019-01-01}, journal = {PLoS One}, volume = {14}, number = {7}, pages = {e0218669}, abstract = {BACKGROUND: Malaysia is widely credited to have achieved universal health coverage for citizens. However, the accessibility of healthcare services to migrant workers is questionable. Recently, medical fees for foreigners at public facilities were substantially increased. Mandatory health insurance only covers public hospital admissions and excludes undocumented migrants. This study explores barriers to healthcare access faced by documented and undocumented migrant workers in Malaysia. METHODS: We use qualitative data from 17 in-depth interviews conducted with key informants from civil society organisations, trade unions, academia, medical professionals, as well as migrant workers and their representatives. We interviewed doctors working in public hospitals and private clinics frequented by migrants. Data were analysed using thematic analysis. RESULTS: We found that healthcare services in Malaysia are often inaccessible to migrant workers. Complex access barriers were identified, many beyond the control of the health sector. Major themes include affordability and financial constraints, the need for legal documents like valid passports and work permits, language barriers, discrimination and xenophobia, physical inaccessibility and employer-related barriers. Our study suggests that government mandated insurance for migrant workers is insufficient in view of the recent increase in medical fees. The perceived close working relationship between the ministries of health and immigration effectively excludes undocumented migrants from access to public healthcare facilities. Language barriers may affect the quality of care received by migrant workers, by inadvertently resulting in medical errors, while preventing them from giving truly informed consent. CONCLUSIONS: We propose instituting migrant-friendly health services at public facilities. We also suggest implementing a comprehensive health insurance to enable healthcare access and financial risk protection for all migrant workers. Non-health sector solutions include the formation of a multi-stakeholder migration management body towards a comprehensive national policy on labour migration which includes health.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16716, title = {Socioeconomic Differences in Smoking and Cessation Across a Period of Rapid Economic Growth in an Upper-Middle-Income Country}, author = {J Mariapun and N N Hairi and C W Ng}, doi = {10.1093/ntr/nty203}, issn = {1462-2203}, year = {2019}, date = {2019-01-01}, journal = {Nicotine Tob Res}, volume = {21}, number = {11}, pages = {1539-1546}, abstract = {INTRODUCTION: Higher smoking rates and lower cessation rates among the poor compared to the rich are evident in high-income countries. In low and middle-income countries (LMICs), many of which are in the early stages of tackling the tobacco epidemic, more knowledge is required of the socioeconomic inequalities in smoking. This is especially the case for upper-middle-income countries, where smoking prevalence is highest. This study examines trends in the socioeconomic gradient in smoking and cessation among adults across a period of rapid economic development in Malaysia, an LMIC with an upper-middle-income economy. METHODS: The socioeconomic trends in smoking were analyzed using data from cross-sectional National Health and Morbidity Surveys for the years 1996, 2006, and 2011. Household per capita income was used as a measure of socioeconomic position. As a measure of inequality, the concentration index that quantified the degree of socioeconomic inequality in a health outcome was computed. Smoking was assessed in current and former smokers. The study population was examined by gender, region, and age group. RESULTS: This study found a trend of an increasingly higher smoking prevalence among the poor and higher cessation rates among the rich. With the exception of younger women in Peninsular Malaysia, the socioeconomic gradient in current smoking is concentrated among the poor. For former smokers, especially men, distributions across the years were mostly concentrated among the rich. CONCLUSION: It is important to ensure that health policies, programs, and interventions consider the potential impact of the socioeconomic patterning in smoking on equity in health. IMPLICATIONS: Findings on the socioeconomic gradient in smoking and cessation from Malaysia across a period of rapid economic development will contribute to addressing the paucity of knowledge on the socioeconomic gradient of smoking and cessation in other progressing LMICs. This study provides evidence from an upper-middle-income country, of an increasing trend of smoking among the poor and an increasing trend of cessation rates among the rich, particularly for men. We found opposing trends for younger adult women in the more developed, Peninsular Malaysia. More rich young women were found to have taken up smoking compared to socioeconomically less advantaged young women.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16619, title = {Ethnic differences in the prevalence, socioeconomic and health related risk factors of knee pain and osteoarthritis symptoms in older Malaysians}, author = {S Mat and M H Jaafar and C T Ng and S Sockalingam and J Raja and S B Kamaruzzaman and A V Chin and A A Abbas and C K Chan and N N Hairi and S Othman and R G Cumming and N P Tey and M P Tan}, doi = {10.1371/journal.pone.0225075}, issn = {1932-6203}, year = {2019}, date = {2019-01-01}, journal = {PLoS One}, volume = {14}, number = {11}, pages = {e0225075}, abstract = {Knee pain is often underreported, underestimated and undertreated. This study was conducted to estimate the prevalence, burden and further identify socioeconomic factors influencing ethnic differences in knee pain and symptoms of OA among older adults aged 55 years and over in Greater Kuala Lumpur (the capital city of Malaysia). The sample for the Malaysian Elders Longitudinal Research (MELoR) was selected using stratified random sampling, by age and ethnicity from the electoral rolls of three parliamentary constituencies. Information on knee pain was available in 1226 participants, mean age (SD) 68.96 (1.57) years (409 Malay, 416 Chinese, 401 Indian). The crude and weighted prevalence of knee pain and self-reported knee OA symptoms were 33.3% and 30.8% respectively. There were significant ethnic differences in knee pain (crude prevalence: Malays 44.6%, Chinese 23.5% and Indians 31.9%, p\<0.001). The presence of two or more non-communicable diseases (NCD) attenuated the increased risk of knee pain among the ethnic Indians compared to the ethnic Chinese. The prevalence of knee pain remained significantly higher among the ethnic Malays after adjustment for confounders. While the prevalence of knee pain in our older population appears similar to that reported in other published studies in Asia, the higher prevalence among the ethnic Malays has not previously been reported. Further research to determine potential genetic susceptibility to knee pain among the ethnic Malays is recommended.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16613, title = {Factors Determining the Increased Risk of Falls in Individuals With Knee Pain in the Malaysian Elders Longitudinal Research (MELoR) Study}, author = {S Mat and A H Razack and J Lim and S Y Khong and S B Kamaruzzaman and A V Chin and A A Abbas and N N Hairi and S Othman and M P Tan}, doi = {10.3389/fmed.2019.00277}, issn = {2296-858X (Print) 2296-858x}, year = {2019}, date = {2019-01-01}, journal = {Front Med (Lausanne)}, volume = {6}, pages = {277}, abstract = {Objectives: While the negative impact of falls in older persons has been recognized, the association between knee pains and falls remains inconclusive due to underreporting and undertreatment of knee pain. This study was conducted to evaluate the relationship between knee pain and knee pain severity with falls risk and to further determine factors which influence this potential relationship. Design: This was cross-sectional study from the Malaysian Elders Longitudinal Research (MELoR) study. Setting: Urban community dwellers in a middle-income South East Asian country. Participants: One thousand two hundred twelve of a representative sample of community dwelling older persons aged 55 years and older. Outcome measures: Falls in the preceding 12 months and knee pain were collected during a home-based computer-assisted interview. Physical and functional performance were measured using the Timed Up and Go test and the Katz and Lawton scales, respectively. Psychological status was determined using the Depression Anxiety and Stress Scale (DASS-21). Results: Of the 1,212 participants included in this analysis, knee pain was present in 402 (33.17%) individuals (124 (30.85%) mild, 210 (52.24%) moderate, 68 (16.92%) severe). The presence of knee pain was associated with increased risk of falls [odds Ratio, OR(95% confidence interval, CI): 1.81 (1.37-2.38)]. Severe knee pain was an independent predictor for falls after adjustment for functional impairment and psychological status. Mild, moderate, and severe knee pain had a specific indirect effect on falls through reducing functional impairment, which in turn increases their psychological concern. Conclusion: Future studies should explore this relationship prospectively and evaluate whether interventions which alleviate psychological concerns and improve function will reduce falls risk in those with mild to moderate knee pain.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16703, title = {Author Correction: Germline variation at 8q24 and prostate cancer risk in men of European ancestry}, author = {M Matejcic and E J Saunders and T Dadaev and M N Brook and K Wang and X Sheng and A A A Olama and F R Schumacher and S A Ingles and K Govindasami and S Benlloch and S I Berndt and D Albanes and S Koutros and K Muir and V L Stevens and S M Gapstur and C M Tangen and J Batra and J Clements and H Gronberg and N Pashayan and J Schleutker and A Wolk and C West and L Mucci and P Kraft and G Cancel-Tassin and K D Sorensen and L Maehle and E M Grindedal and S S Strom and D E Neal and F C Hamdy and J L Donovan and R C Travis and R J Hamilton and B Rosenstein and Y J Lu and G G Giles and A S Kibel and A Vega and J T Bensen and M Kogevinas and K L Penney and J Y Park and J L Stanford and C Cybulski and B G Nordestgaard and H Brenner and C Maier and J Kim and M R Teixeira and S L Neuhausen and K De Ruyck and A Razack and L F Newcomb and D Lessel and R Kaneva and N Usmani and F Claessens and P A Townsend and M Gago-Dominguez and M J Roobol and F Menegaux and K T Khaw and L A Cannon-Albright and H Pandha and S N Thibodeau and D J Schaid and F Wiklund and S J Chanock and D F Easton and R A Eeles and Z Kote-Jarai and D V Conti and C A Haiman}, doi = {10.1038/s41467-019-08293-z}, issn = {2041-1723}, year = {2019}, date = {2019-01-01}, journal = {Nat Commun}, volume = {10}, number = {1}, pages = {382}, abstract = {The original version of this Article contained an error in the spelling of the author Manuela Gago-Dominguez, which was incorrectly given as Manuela G. Dominguez. This has now been corrected in both the PDF and HTML versions of the Article.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16687, title = {Factors associated with online sexually transmissible infection information seeking among young people in Malaysia: an observational study}, author = {S M Mohamad Shakir and L P Wong and K L Abdullah and P Adam}, doi = {10.1071/sh17198}, issn = {1448-5028}, year = {2019}, date = {2019-01-01}, journal = {Sex Health}, volume = {16}, number = {2}, pages = {158-171}, abstract = {Background The Internet is an important resource of information about sexually transmissible infections (STIs) among young people. Little is known of the facilitators of online STI information seeking. This study aimed to identify the factors associated with online STI information seeking among youth in Malaysia. METHODS: A cross-sectional online survey was conducted among Malaysian youth aged 18-25 years who were recruited through social media. RESULTS: Among 1530 respondents who completed the survey, 57.1% sought online STI information in the past 12 months mostly from general Internet websites, health websites, and Facebook. Respondents' overall STI knowledge was low. Young people who had higher STI knowledge (OR = 2.47, 95% CI = 1.87-3.25}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16628, title = {Online STI information seeking behaviour and condom use intentions among young Facebook users in Malaysia}, author = {S M Mohamad Shakir and L P Wong and K Lim Abdullah and P Adam}, doi = {10.1093/heapro/daz108}, issn = {0957-4824}, year = {2019}, date = {2019-01-01}, journal = {Health Promot Int}, abstract = {The Internet has opened pathways for youth to find sexual health information which was not easily available to them in the past. Studies have shown that seeking sexual health information online may potentially influence an individuals' decision-making to change their sexual health behaviours. However, there is a gap in research on the associations of seeking online sexually transmitted infection (STI) information with STI prevention among young people, particularly in Malaysia. This study investigated the associations of seeking STI information online with the intentions of condom use among young adult online users in Malaysia. A cross-sectional online survey was conducted among Malaysian youth aged 18-25 years old who were recruited through Facebook. In total, 1530 respondents completed the survey, identifying 874 respondents who had sought STI information online. The majority of respondents had intentions to use condoms as protection against STI. Respondents who sought online STI information were significantly more likely to have the intention to use condoms compared to respondents who did not seek online STI information (OR = 1.33, 95% CI = 1.01-1.76}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16697, title = {Using high frequency and low-intensity ultrasound to enhance activated sludge characteristics}, author = {P Mohammadi and N Karami and A A Zinatizadeh and F Falahi and N Aghamohammadi and A Almasi}, doi = {10.1016/j.ultsonch.2019.01.030}, issn = {1350-4177}, year = {2019}, date = {2019-01-01}, journal = {Ultrason Sonochem}, volume = {54}, pages = {274-280}, abstract = {In this study, high-frequency ultrasound wave (1.8MHz) at low intensity was applied to improve activated sludge settleability at high MLSS concentration. The effect of irradiation intensity, sonication mode, MLSS concentration and sample volume on the physical characteristics of sludge in a pilot scale settling column were investigated for optimizing the conditions. The obtained results showed that high-frequency ultrasound decreased the height of sludge (44%) and effluent turbidity (82.2%) and increased sludge settling velocity about 3 times at high biomass concentration. Irradiation intensity of 0.4w/cm(2) and sonication mode with interval times of 10s showed the best results on the performance of the system at MLSS concentration of 8000mg/L with a sample volume of 3L.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16695, title = {Determinants of Diet and Physical Activity in Malaysian Adolescents: A Systematic Review}, author = {S Mohammadi and M Y Jalaludin and T T Su and M Dahlui and M N Azmi Mohamed and H Abdul Majid}, doi = {10.3390/ijerph16040603}, issn = {1660-4601}, year = {2019}, date = {2019-01-01}, journal = {Int J Environ Res Public Health}, volume = {16}, number = {4}, abstract = {The increased prevalence of unhealthy eating habits and sedentary lifestyles among Malaysian adolescents has become a public health concern. The aim of this systematic review was to summarize evidence from observational studies related to diet and physical activity (PA) among Malaysian adolescents (13(-)18 years) and to recognize the associations between determinants of diet and PA and diet and PA behaviours. A systematic search for observational studies published from August 1990 through August 2017 was conducted via PubMed, Science Direct, Cochrane and Web of Science. A total of 18 studies met the inclusion criteria; these were independently extracted by two reviewers. Gender and ethnicity were the most commonly studied correlates of diet and PA; males were more physically active and they tended to have poorer diet quality and higher energy and macronutrient intakes in comparison to females; Malay adolescents had a lower diet quality and Chinese adolescents spent less time in PA compared to other ethnicities. However, the significance of these associations was often small or inconsistent. This review highlights the lack of longitudinal observational studies but summarizes the best available evidence for policymakers and public health practitioners to improve the diet and the level of PA in Malaysian adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16690, title = {Dietary and physical activity patterns related to cardio-metabolic health among Malaysian adolescents: a systematic review}, author = {S Mohammadi and M Y Jalaludin and T T Su and M Dahlui and M N A Mohamed and H A Majid}, doi = {10.1186/s12889-019-6557-z}, issn = {1471-2458}, year = {2019}, date = {2019-01-01}, journal = {BMC Public Health}, volume = {19}, number = {1}, pages = {251}, abstract = {BACKGROUND: A sedentary lifestyle and an unhealthy diet are major factors in the increasing prevalence of obesity among Malaysian adolescents. The purpose of this systematic review is to compile the evidence from observational and intervention studies among Malaysian adolescents to evaluate the associations between diet and physical activity (PA) as determinants of cardio-metabolic risk factors. METHODS: A systematic search of Medline via the PubMed, Science Direct, Cochrane Review and Web of Science databases was conducted for studies on the associations between diet and PA factors and cardio-metabolic risk factors among Malaysian adolescents aged 13-18 years that were published until 31 August 2017. The search results were independently screened and extracted by two reviewers. RESULTS: From over 2,410 references retrieved, 20 full texts articles were screened as potentially relevant. Seventeen (16 cross-sectional and one intervention) met the inclusion criteria for data extraction and analysis. All 17 studies were rated as poor quality and the majority had made insufficient adjustment for confounders. As regards the effect of diet and PA on cardio-metabolic health, the intakes of energy (n = 4) and macronutrients (n = 3) and meal frequency (n = 5) were the most commonly studied dietary factors, while the PA score and level were the most commonly studied PA factors. In addition, BMI and body weight were the most common cardio-metabolic health outcomes. The studies showed that obese and overweight adolescents consume significantly more energy and macronutrients. They are also more likely to skip their daily meals compared to their normal weight peers. In most studies, the direction of the PA effect on body weight was unclear. Some studies found that higher PA is associated with a lower risk of overweight and obesity. However, the associations are often small or inconsistent, with few studies controlling for confounding factors. CONCLUSIONS: This review identified a lack of evidence and well-conducted prospective studies on the effect of diet and PA on cardio-metabolic health of Malaysian adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16616, title = {The Effectiveness of Educational Intervention in Improving Primary Health-Care Service Providers' Knowledge, Identification, and Management of Elder Abuse and Neglect: A Systematic Review}, author = {F H Mohd Mydin and C W Yuen and S Othman}, doi = {10.1177/1524838019889359}, issn = {1524-8380}, year = {2019}, date = {2019-01-01}, journal = {Trauma Violence Abuse}, pages = {1524838019889359}, abstract = {Elder abuse and neglect (EAN) occurrence is expected to increase in many countries due to rapidly aging populations, yet it is still unrecognized and underreported. Gaps were identified in the knowledge and skills to intervene EAN among health-care service providers. It is still unclear whether educating health-care service providers on EAN improve the identification and management of EAN cases. A systematic review was conducted on the effectiveness of educational intervention designed to improve primary health-care service providers' (PHSPs) knowledge, attitude, and practice in managing EAN cases. We performed a comprehensive and systematic search for original studies in the following major electronic databases (ScienceDirect, PubMed, EMBASE, and CINAHL) and specialist registers (Cochrane Central Controlled Trials Register) with a set of search terms. Studies included were randomized controlled trials (RCTs) and observational studies on EAN education intervention that aimed to improve knowledge, attitude, and management skills of the PHSPs. There were no publication period restrictions until June 2018 and written in English. Overall, three RCTs and 10 observational studies were selected. These studies were grouped based on the type of the study, methodological quality (six moderate risk of bias and seven serious risk of bias), and the type of educational intervention (seven face-to-face educational intervention, two educational videos, two simulation-based training, and two online educational training). The education programs in the selected studies range from brief didactic to experiential learning. EAN educational intervention among primary care service providers potentially result in increasing awareness and knowledge on EAN. However, there is a lack of evidence on the changes of attitude and practice.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16625, title = {Perceptions on radioprotective garment usage and underlying reasons for non-adherence among medical radiation workers from public hospitals in a middle-income Asian setting: A qualitative exploration}, author = {S F Mohd Ridzwan and N Bhoo-Pathy and M Isahak and L H Wee}, doi = {10.1016/j.heliyon.2019.e02478}, issn = {2405-8440 (Print) 2405-8440}, year = {2019}, date = {2019-01-01}, journal = {Heliyon}, volume = {5}, number = {9}, pages = {e02478}, abstract = {Background: Radioprotective garments protect medical radiation workers from exposure to radiation at workplace. However, previous studies have found poor adherence to the use of radioprotective garments. Objectives: We explored the perceptions and practices related to the use of radioprotective garments among medical radiation workers in public hospitals, and sought to understand the reasons for non-adherence. Design and setting: A qualitative approach was applied by conducting face-to-face in-depth interviews with 18 medical radiation workers from three university hospitals using a semi-structured interview guide. Results: Five themes emerged with respect to perceptions on the use of radioprotective garments: (i) the dilemmas in practising radiation protection, (ii) indication of workers' credibility, (iii) physical appearance of radioprotective garments, (iv) practicality of radioprotective garment use, and (v) impact on workflow. Actual lack of radioprotective garment use was attributed to inadequate number of thyroid shield and other garments, radioprotective garments' unsightly appearance including being dirty and defective, impracticality of using radioprotective garments for some nuclear medicine procedures, disruption of workflow because of workers' limited movements, attitudes of workers, and organisational influences. Conclusion: Medical radiation workers demonstrated a definitive practice of using radioprotective aprons, but often neglected to use thyroid shields and other garments. Availability and hygiene are reported as the core issues, while unclear guidelines on practical use of radioprotective garments appear to lead to confusion among medical radiation workers. To the best of our knowledge, this is the first qualitative study of its kind from a middle-income Asian setting.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16649, title = {Dispensation of antiretroviral therapy and methadone maintenance therapy at the same facility in a low-barrier setting linked to optimal adherence to HIV treatment}, author = {N A Mohd Salleh and N Fairbairn and S Nolan and R Barrios and J Shoveller and L Richardson and M J Milloy}, doi = {10.1111/hiv.12777}, issn = {1464-2662}, year = {2019}, date = {2019-01-01}, journal = {HIV Med}, volume = {20}, number = {9}, pages = {606-614}, abstract = {OBJECTIVES: We sought to examine the association between dispensation of methadone maintenance therapy (MMT) and antiretroviral therapy (ART) at the same facility, across multiple low-barrier dispensing outlets, and achieving optimal adherence to ART among people who use illicit drugs (PWUD). METHODS: We used data from the AIDS Care Cohort to Evaluate Exposure to Survival Services (ACCESS) study, a long-running study of a community-recruited cohort of HIV-positive PWUD, linked to comprehensive HIV clinical records in Vancouver, Canada, a setting of no-cost, universal access to HIV care. The longitudinal relationship between MMT-ART dispensation at the same facility and the odds of \>/= 95% ART adherence was analysed using multivariable generalized linear mixed-effects modelling. We conducted a further analysis using a marginal structural mode with inverse probability of treatment weights as a sensitivity analysis. RESULTS: This study included data on 1690 interviews of 345 ART- and MMT-exposed participants carried out between June 2012 and December 2017. In the final multivariable model, MMT-ART dispensation, compared with nondispensation at the same facility, was associated with greater odds of achieving \>/= 95% adherence [adjusted odds ratio (AOR) 1.56; 95% confidence interval (CI) 1.26-1.96]. A marginal structural model estimated a 1.48 (95% CI 1.15-1.80) greater odds of \>/= 95% adherence among participants who reported MMT-ART dispensation at the same facility compared with those who did not. CONCLUSIONS: The odds of achieving optimal adherence to ART were 56% higher during periods in which MMT and ART medications were dispensed at the same facility, in a low-barrier setting. Our findings highlight the need to consider a simpler integrated approach with medication dispensation at the same facility in low-threshold settings.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16681, title = {Acceptability of Women Self-Sampling versus Clinician-Collected Samples for HPV DNA Testing: A Systematic Review}, author = {K Morgan and M Azzani and S L Khaing and Y L Wong and T T Su}, doi = {10.1097/lgt.0000000000000476}, issn = {1089-2591}, year = {2019}, date = {2019-01-01}, journal = {J Low Genit Tract Dis}, volume = {23}, number = {3}, pages = {193-199}, abstract = {OBJECTIVES: Female self-sampling for human papillomavirus (HPV) DNA testing is an alternative screening method that can potentially increase cervical cancer screening coverage. This review addresses the acceptability of HPV DNA testing using self-sampling compared with conventional clinician-collected sampling. Barriers to and others factors associated with acceptability of either method were also examined. METHODS: The following electronic resources were searched: Medline @EBSCOHOST(Medline), Embase, PubMed, and CINAHL databases. Manual searches were also conducted. The main outcome of interest was the acceptability of HPV DNA testing by self-sampling in comparison with clinician-collected sampling. RESULTS: In total, 23 articles were included in this systematic review. The majority (19 studies) were quantitative intervention studies and 4 studies were qualitative observational studies. Eleven studies reported a preference for self-sampling by women compared with clinician-collected sampling (64.7%-93%). The remaining studies found that women preferred clinician-collected sampling because mainly of respondents' lack of confidence in their ability to complete self-sampling correctly. In most articles reviewed, the studied associated factors, such as demographic factors (age, marital status, and ethnicity), socioeconomic factors (income, education level), reproductive factors (condom use, number of children, current use of contraception, and number of partners), and habits (smoking status) were not found to be significantly associated with preference. CONCLUSIONS: Both methods of sampling were found to be acceptable to women. Self-sampling is cost-effective and could increase the screening coverage among underscreened populations. However, more information about the quality, reliability, and accuracy of self-sampling is needed to increase women's confidence about using to this method.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16792, title = {Clinical text classification research trends: Systematic literature review and open issues}, author = {G Mujtaba and L Shuib and N Idris and W L Hoo and R G Raj and K Khowaja and K Shaikh and H F Nweke}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85053829021\&doi=10.1016%2fj.eswa.2018.09.034\&partnerID=40\&md5=567d1483bd0c9be6999fcfae0f618f7e}, doi = {10.1016/j.eswa.2018.09.034}, year = {2019}, date = {2019-01-01}, journal = {Expert Systems with Applications}, volume = {116}, pages = {494-520}, abstract = {The pervasive use of electronic health databases has increased the accessibility of free-text clinical reports for supplementary use. Several text classification approaches, such as supervised machine learning (SML) or rule-based approaches, have been utilized to obtain beneficial information from free-text clinical reports. In recent years, many researchers have worked in the clinical text classification field and published their results in academic journals. However, to the best of our knowledge, no comprehensive systematic literature review (SLR) has recapitulated the existing primary studies on clinical text classification in the last five years. Thus, the current study aims to present SLR of academic articles on clinical text classification published from January 2013 to January 2018. Accordingly, we intend to maximize the procedural decision analysis in six aspects, namely, types of clinical reports, data sets and their characteristics, pre-processing and sampling techniques, feature engineering, machine learning algorithms, and performance metrics. To achieve our objective, 72 primary studies from 8 bibliographic databases were systematically selected and rigorously reviewed from the perspective of the six aspects. This review identified nine types of clinical reports, four types of data sets (i.e., homogeneous\textendashhomogenous, homogenous\textendashheterogeneous, heterogeneous\textendashhomogenous, and heterogeneous\textendashheterogeneous), two sampling techniques (i.e., over-sampling and under-sampling), and nine pre-processing techniques. Moreover, this review determined bag of words, bag of phrases, and bag of concepts features when represented by either term frequency or term frequency with inverse document frequency, thereby showing improved classification results. SML-based or rule-based approaches were generally employed to classify the clinical reports. To measure the performance of these classification approaches, we used precision, recall, F-measure, accuracy, AUC, and specificity in binary class problems. In multi-class problems, we primarily used micro or macro-averaging precision, recall, or F-measure. Lastly, open research issues and challenges are presented for future scholars who are interested in clinical text classification. This SLR will definitely be a beneficial resource for researchers engaged in clinical text classification. © 2018 Elsevier Ltd}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16643, title = {Association Between Soft Drink Consumption and Mortality in 10 European Countries}, author = {A Mullee and D Romaguera and J Pearson-Stuttard and V Viallon and M Stepien and H Freisling and G Fagherazzi and F R Mancini and M C Boutron-Ruault and T Kuhn and R Kaaks and H Boeing and K Aleksandrova and A Tjonneland and J Halkjaer and K Overvad and E Weiderpass and G Skeie and C L Parr and J R Quiros and A Agudo and M J Sanchez and P Amiano and L Cirera and E Ardanaz and K T Khaw and T Y N Tong and J A Schmidt and A Trichopoulou and G Martimianaki and A Karakatsani and D Palli and C Agnoli and R Tumino and C Sacerdote and S Panico and B Bueno-de-Mesquita and W M M Verschuren and J M A Boer and R Vermeulen and S Ramne and E Sonestedt and B Guelpen and P L Holgersson and K K Tsilidis and A K Heath and D Muller and E Riboli and M J Gunter and N Murphy}, doi = {10.1001/jamainternmed.2019.2478}, issn = {2168-6106}, year = {2019}, date = {2019-01-01}, journal = {JAMA Intern Med}, abstract = {Importance: Soft drinks are frequently consumed, but whether this consumption is associated with mortality risk is unknown and has been understudied in European populations to date. Objective: To examine the association between total, sugar-sweetened, and artificially sweetened soft drink consumption and subsequent total and cause-specific mortality. Design, Setting, and Participants: This population-based cohort study involved participants (n = 451743 of the full cohort) in the European Prospective Investigation into Cancer and Nutrition (EPIC), an ongoing, large multinational cohort of people from 10 European countries (Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom), with participants recruited between January 1, 1992, and December 31, 2000. Excluded participants were those who reported cancer, heart disease, stroke, or diabetes at baseline; those with implausible dietary intake data; and those with missing soft drink consumption or follow-up information. Data analyses were performed from February 1, 2018, to October 1, 2018. Exposure: Consumption of total, sugar-sweetened, and artificially sweetened soft drinks. Main Outcomes and Measures: Total mortality and cause-specific mortality. Hazard ratios (HRs) and 95% CIs were estimated using multivariable Cox proportional hazards regression models adjusted for other mortality risk factors. Results: In total, 521 330 individuals were enrolled. Of this total, 451743 (86.7%) were included in the study, with a mean (SD) age of 50.8 (9.8) years and with 321081 women (71.1%). During a mean (range) follow-up of 16.4 (11.1 in Greece to 19.2 in France) years, 41693 deaths occurred. Higher all-cause mortality was found among participants who consumed 2 or more glasses per day (vs consumers of \<1 glass per month) of total soft drinks (hazard ratio [HR], 1.17; 95% CI, 1.11-1.22; P \< .001), sugar-sweetened soft drinks (HR, 1.08; 95% CI, 1.01-1.16; P = .004), and artificially sweetened soft drinks (HR, 1.26; 95% CI, 1.16-1.35; P \< .001). Positive associations were also observed between artificially sweetened soft drinks and deaths from circulatory diseases (\>/=2 glasses per day vs \<1 glass per month; HR, 1.52; 95% CI, 1.30-1.78; P \< .001) and between sugar-sweetened soft drinks and deaths from digestive diseases (\>/=1 glass per day vs \<1 glass per month; HR, 1.59; 95% CI, 1.24-2.05; P \< .001). Conclusions and Relevance: This study found that consumption of total, sugar-sweetened, and artificially sweetened soft drinks was positively associated with all-cause deaths in this large European cohort; the results are supportive of public health campaigns aimed at limiting the consumption of soft drinks.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16719, title = {Heterogeneity of Colorectal Cancer Risk Factors by Anatomical Subsite in 10 European Countries: A Multinational Cohort Study}, author = {N Murphy and H A Ward and M Jenab and J A Rothwell and M C Boutron-Ruault and F Carbonnel and M Kvaskoff and R Kaaks and T Kuhn and H Boeing and K Aleksandrova and E Weiderpass and G Skeie and K B Borch and A Tjonneland and C Kyro and K Overvad and C C Dahm and P Jakszyn and M J Sanchez and L Gil and J M Huerta and A Barricarte and J R Quiros and K T Khaw and N Wareham and K E Bradbury and A Trichopoulou and C La Vecchia and A Karakatsani and D Palli and S Grioni and R Tumino and F Fasanelli and S Panico and B Bueno-de-Mesquita and P H Peeters and B Gylling and R Myte and K Jirstrom and J Berntsson and X Xue and E Riboli and A J Cross and M J Gunter}, doi = {10.1016/j.cgh.2018.07.030}, issn = {1542-3565}, year = {2019}, date = {2019-01-01}, journal = {Clin Gastroenterol Hepatol}, volume = {17}, number = {7}, pages = {1323-1331.e6}, abstract = {BACKGROUND \& AIMS: Colorectal cancer located at different anatomical subsites may have distinct etiologies and risk factors. Previous studies that have examined this hypothesis have yielded inconsistent results, possibly because most studies have been of insufficient size to identify heterogeneous associations with precision. METHODS: In the European Prospective Investigation into Cancer and Nutrition study, we used multivariable joint Cox proportional hazards models, which accounted for tumors at different anatomical sites (proximal colon, distal colon, and rectum) as competing risks, to examine the relationships between 14 established/suspected lifestyle, anthropometric, and reproductive/menstrual risk factors with colorectal cancer risk. Heterogeneity across sites was tested using Wald tests. RESULTS: After a median of 14.9 years of follow-up of 521,330 men and women, 6291 colorectal cancer cases occurred. Physical activity was related inversely to proximal colon and distal colon cancer, but not to rectal cancer (P heterogeneity = .03). Height was associated positively with proximal and distal colon cancer only, but not rectal cancer (P heterogeneity = .0001). For men, but not women, heterogeneous relationships were observed for body mass index (P heterogeneity = .008) and waist circumference (P heterogeneity = .03), with weaker positive associations found for rectal cancer, compared with proximal and distal colon cancer. Current smoking was associated with a greater risk of rectal and proximal colon cancer, but not distal colon cancer (P heterogeneity = .05). No heterogeneity by anatomical site was found for alcohol consumption, diabetes, nonsteroidal anti-inflammatory drug use, and reproductive/menstrual factors. CONCLUSIONS: The relationships between physical activity, anthropometry, and smoking with colorectal cancer risk differed by subsite, supporting the hypothesis that tumors in different anatomical regions may have distinct etiologies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16675, title = {The Association of Breakfast Frequency and Cardiovascular Disease (CVD) Risk Factors among Adolescents in Malaysia}, author = {N Mustafa and H Abd Majid and Z Toumpakari and H A Carroll and M Yazid Jalaludin and N Al Sadat and L Johnson}, doi = {10.3390/nu11050973}, issn = {2072-6643}, year = {2019}, date = {2019-01-01}, journal = {Nutrients}, volume = {11}, number = {5}, abstract = {Breakfast frequency is associated with cardiovascular disease (CVD) risk in Western populations, possibly via the types of food eaten or the timing of food consumption, but associations in Malaysian adolescents are unknown. While the timing of breakfast is similar, the type of food consumed at breakfast in Malaysia differs from Western diets, which allows novel insight into the mechanisms underlying breakfast-CVD risk associations. We investigated foods eaten for breakfast and associations between breakfast frequency and CVD risk factors in the Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs). Breakfast (frequency of any food/drink reported as breakfast in 7-day diet history interviews) and CVD risk factors (body mass index (BMI), waist circumference, fasting blood glucose, triacylglycerol, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and systolic and diastolic blood pressure) were cross-sectionally associated using linear regression adjusting for potential confounders (n = 795, age 13 years). Twelve percent of adolescents never ate breakfast and 50% ate breakfast daily, containing mean (SD) 400 (+/-127) kilocalories. Commonly consumed breakfast foods were cereal-based dishes (primarily rice), confectionery (primarily sugar), hot/powdered drinks (primarily Milo), and high-fat milk (primarily sweetened condensed milk). After adjustment, each extra day of breakfast consumption per week was associated with a lower BMI (-0.34 kg/m(2), 95% confidence interval (CI) -0.02, -0.66), and serum total (-0.07 mmol/L 95% CI -0.02, -0.13) and LDL (-0.07 mmol/L 95% CI -0.02, -0.12) cholesterol concentrations. Eating daily breakfast in Malaysia was associated with slightly lower BMI and total and LDL cholesterol concentrations among adolescents. Longitudinal studies and randomized trials could further establish causality.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16660, title = {Dietary intake, physical activity and muscle strength among adolescents: the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study}, author = {A K Ng and N N Hairi and M Y Jalaludin and H A Majid}, doi = {10.1136/bmjopen-2018-026275}, issn = {2044-6055}, year = {2019}, date = {2019-01-01}, journal = {BMJ Open}, volume = {9}, number = {6}, pages = {e026275}, abstract = {OBJECTIVE: To examine the role of dietary intake and physical activity in muscle strength among adolescents. DESIGN: Cross-sectional analysis. SETTING: The Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study. PARTICIPANTS: Fifteen-year-old secondary school children who have given consent and who participated in the MyHeART study in 2014. PRIMARY OUTCOME MEASURE: Muscle strength was measured in relation to dietary intake (energy and macronutrients) and physical activity by using a hand grip dynamometer. RESULTS: Among the 1012 participants (395 male; 617 female), the hand grip strength of the males was higher than that of the females (27.08 kg vs 18.63 kg; p\<0.001). Also, males were more active (2.43vs2.12; p\<0.001) and consumed a higher amount of energy (2047 kcal vs 1738 kcal; p\<0.001), carbohydrate (280.71 g vs 229.31 g; p\<0.001) and protein (1.46 g/kg body weight (BW) vs 1.35 g/kg BW; p\<0.168). After controlling for ethnicity, place of residency and body mass index, there was a positive relationship between hand grip strength and the intake of energy (r=0.14; p=0.006), carbohydrate (r=0.153; p=0.002) and fat (r=0.124; p=0.014) and the physical activity score (r=0.170; p=0.001) and a negative relationship between hand grip strength and the intake of protein (r=-0.134; p=0.008), for males. However, this was not observed among females. CONCLUSIONS: Energy, carbohydrate and fat intakes and physical activity score were positively correlated with hand grip strength while protein intake was negatively correlated with hand grip strength in males but not in females.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16612, title = {TG : HDL-C Ratio Is a Good Marker to Identify Children Affected by Obesity with Increased Cardiometabolic Risk and Insulin Resistance}, author = {A K Nur Zati Iwani and M Y Jalaludin and R M Wan Mohd Zin and M Z Fuziah and J Y H Hong and Y Abqariyah and A H Mokhtar and W N Wan Mohamud}, doi = {10.1155/2019/8586167}, issn = {1687-8337 (Print) 1687-8337}, year = {2019}, date = {2019-01-01}, journal = {Int J Endocrinol}, volume = {2019}, pages = {8586167}, abstract = {Metabolic syndrome (MetS) is an important predictor of cardiovascular diseases in adulthood. This study aims to examine the clinical utility of triglyceride to high-density lipoprotein ratio (TG : HDL-C) in identifying cardiometabolic risk and insulin resistance (IR) among children with obesity, in comparison with MetS as defined by the International Diabetes Federation (IDF). Data of 232 children with obesity aged 10-16 years were obtained from our study, MyBFF@school study, conducted between January and December 2014. Children were divided into tertiles of TG : HDL-C ratio. The minimum value of the highest tertile was 1.11. Thus, elevated TG : HDL-C ratio was defined as TG : HDL-C \>/=1.11. Children with MetS were categorized based on the definition established by the IDF. Out of 232 children, 23 (9.9%) had MetS, out of which 5.6% were boys. Almost twofold of boys and girls had elevated TG : HDL-C ratio compared to MetS: 13.8% vs. 5.6% and 13.8% vs. 4.3%, respectively. Children with elevated TG : HDL-C ratio had lower fasting glucose compared to children with MetS (boys = 5.15 +/- 0.4 vs. 6.34 +/- 2.85 mmol/l}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16699, title = {Cause-specific mortality estimates for Malaysia in 2013: results from a national sample verification study using medical record review and verbal autopsy}, author = {A Omar and S S Ganapathy and M F M Anuar and Y Y Khoo and C Jeevananthan and S Maria Awaluddin and J L M Yn and C Rao}, doi = {10.1186/s12889-018-6384-7}, issn = {1471-2458}, year = {2019}, date = {2019-01-01}, journal = {BMC Public Health}, volume = {19}, number = {1}, pages = {110}, abstract = {BACKGROUND: Mortality indicators are essential for monitoring population health. Although Malaysia has a functional death registration system, the quality of information on causes of death still needs improvement, since approximately 30% of deaths are classified to poorly defined causes. This study was conducted to verify registered causes in a sample of deaths in 2013 and utilise the findings to estimate cause-specific mortality indicators for Malaysia in 2013. METHODS: This is a cross-sectional study involving a nationally representative sample of 14,497 deaths distributed across 19 districts. Registered causes of deaths were verified using standard medical record review protocols for hospital deaths, and locally adapted international standard verbal autopsy procedures for deaths outside hospitals. The findings were used to measure the validity and reliability of the registration data, as well as to establish plausible cause-specific mortality fractions for hospital and non-hospital deaths, which were subsequently used as the basis for estimating national cause-specific mortality indicators. RESULTS: The overall response rate for the study was 67%. Verified causes of 5041 hospital deaths and 3724 deaths outside hospitals were used to derive national mortality estimates for 2013 by age, sex and cause. The study was able to reclassify most of the ill-defined deaths to a specific cause. The leading causes of deaths for males were Ischaemic Heart Disease (15.4%), Cerebrovascular diseases (13.7%), Chronic Obstructive Pulmonary Disease (8.5%) and Road Traffic Accident (8.0%). Among females, the leading causes were Cerebrovascular diseases (18.3%), Ischaemic Heart Disease (12.7%), Lower Respiratory Infections (11.5%) and Diabetes Mellitus (7.2%). CONCLUSIONS: Investigation of registered causes of death using verbal autopsy and medical record review yielded adequate information to enable estimation of cause-specific mortality indicators in Malaysia. Strengthening the national mortality statistics system must be made a priority as it is a core data source for policy and evaluation of the public health and healthcare sectors in Malaysia.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16629, title = {Determinants of shisha use among secondary school students in Sudan}, author = {M Othman and N Aghamohammadi and N D Nik Farid}, doi = {10.1186/s12889-019-7748-3}, issn = {1471-2458}, year = {2019}, date = {2019-01-01}, journal = {BMC Public Health}, volume = {19}, number = {1}, pages = {1390}, abstract = {BACKGROUND: Shisha smoking has re-emerged in the Middle East in the last two decades and has spread rapidly in these communities. Information about shisha smoking in adolescents in Sudan is deficient. Hence, the aim of this study is to estimate the prevalence of shisha smoking among adolescents and determine the associated factors. METHODS: This study is a school based cross sectional study among secondary school students in Khartoum State - Sudan that targets both male and female students aged 14-17 years. A total of 3387 students from 29 public and private schools were selected by multi stage random sampling. The participants completed an anonymous self-administered questionnaire which was based on Arabic version of the Global Youth Tobacco Survey (GYTS). RESULTS: The response rate was 100% in schools and among participants, 57.3% were females and 51.6% were from public schools. The overall prevalence of those who had ever smoked shisha was 13.4%, and among male students the prevalence was 16.8%, while it was 10.9% in females. The associated factors were poor academic performance OR 2.90 CI 95% (1.21-6.94), friends smoking shisha OR 2.39 CI 95% (1.65-3.45), friends smoking cigarettes OR 2.76 CI 95% (1.90-4.01), peer pressure to smoke shisha OR 13.76 CI 95% (7.86-24.07) and unexpectedly restriction of selling shisha to minors OR 2.21 CI 95% (1.28-3.82). CONCLUSION: The prevalence of those who had ever smoked shisha is among the lowest in Middle East region; therefore, regular surveillance system is needed. A well-structured peer based comprehensive tobacco control programmes that are supported by strict and rigorous anti-tobacco regulations which control both commercial and social resources of tobacco are needed to contain this issue among adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16714, title = {Development of a Sexually Transmitted Disease Client-friendly Unit at a Primary Care Clinic in Malaysia: Lessons Learnt}, author = {S B Pannir Selvam and E M Khoo and S Y Chow and P F Wong and S S Mohsin and A Abdullah and W Y Choo}, doi = {10.1097/olq.0000000000000918}, issn = {0148-5717}, year = {2019}, date = {2019-01-01}, journal = {Sex Transm Dis}, volume = {46}, number = {2}, pages = {143-145}, abstract = {Management of sexually transmitted diseases and human immunodeficiency virus is challenging due to the social stigma attached. We describe the development of a client-friendly sexually transmitted disease service in a primary care clinic in Malaysia with a special focus on key populations. Challenges and key lessons learnt from its development and implementation are discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16622, title = {A nutrient-wide association study for risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition and the Netherlands Cohort Study}, author = {N Papadimitriou and D Muller and P A Brandt and M Geybels and C J Patel and M J Gunter and D S Lopez and T J Key and A Perez-Cornago and P Ferrari and P Vineis and E Weiderpass and H Boeing and A Agudo and M J Sanchez and K Overvad and T Kuhn and R T Fortner and D Palli and I Drake and A Bjartell and C Santiuste and B H Bueno-de-Mesquita and V Krogh and A Tjonneland and D F Lauritzen and A B Gurrea and J R Quiros and P Stattin and A Trichopoulou and G Martimianaki and A Karakatsani and E Thysell and I Johansson and F Ricceri and R Tumino and N Larranaga and K T Khaw and E Riboli and I Tzoulaki and K K Tsilidis}, doi = {10.1007/s00394-019-02132-z}, issn = {1436-6207}, year = {2019}, date = {2019-01-01}, journal = {Eur J Nutr}, abstract = {PURPOSE: The evidence from the literature regarding the association of dietary factors and risk of prostate cancer is inconclusive. METHODS: A nutrient-wide association study was conducted to systematically and comprehensively evaluate the associations between 92 foods or nutrients and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox proportional hazard regression models adjusted for total energy intake, smoking status, body mass index, physical activity, diabetes and education were used to estimate hazard ratios and 95% confidence intervals for standardized dietary intakes. As in genome-wide association studies, correction for multiple comparisons was applied using the false discovery rate (FDR \< 5%) method and suggested results were replicated in an independent cohort, the Netherlands Cohort Study (NLCS). RESULTS: A total of 5916 and 3842 incident cases of prostate cancer were diagnosed during a mean follow-up of 14 and 20 years in EPIC and NLCS, respectively. None of the dietary factors was associated with the risk of total prostate cancer in EPIC (minimum FDR-corrected P, 0.37). Null associations were also observed by disease stage, grade and fatality, except for positive associations observed for intake of dry cakes/biscuits with low-grade and butter with aggressive prostate cancer, respectively, out of which the intake of dry cakes/biscuits was replicated in the NLCS. CONCLUSIONS: Our findings provide little support for an association for the majority of the 92 examined dietary factors and risk of prostate cancer. The association of dry cakes/biscuits with low-grade prostate cancer warrants further replication given the scarcity in the literature.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16615, title = {Biochar amendment improves alpine meadows growth and soil health in Tibetan plateau over a three year period}, author = {M K Rafiq and Y Bai and R Aziz and M T Rafiq and O Masek and R T Bachmann and S Joseph and M Shahbaz and A Qayyum and Z Shang and M Danaee and R Long}, doi = {10.1016/j.scitotenv.2019.135296}, issn = {0048-9697}, year = {2019}, date = {2019-01-01}, journal = {Sci Total Environ}, pages = {135296}, abstract = {Previous biochar research has primarily focused on agricultural annual cropping systems with very little attention given to highly fragile, complex and diverse natural alpine grassland ecosystems. The present study investigated the effect of biochar on the growth of alpine meadows and soil health. This study was conducted in the Qinghai Tibetan Plateau over a three year period to investigate the effect of three rice husk biochar application rates alone and combination with high and low NPK fertilizer dosages on alpine meadow productivity, soil microbial diversity as well as pH, carbon and nitrogen content at 0-10 cm and 10-20 cm depth. At the end of the 3rd year soil samples were analysed and assessed by combined analysis of variance. The results showed that biochar application in combination with nitrogen (N), phosphorus (P) and potassium (K) fertilizer had a significant increase in fresh and dry biomass during the second and third year of the study as compared to control and alone biochar application (p \</= 0.05). Biochar alone and in combination with NPK fertilizer resulted in a significant increase in the soil pH and carbon contents of the soil. XPS results, the SEM imaging and EDS analysis of aged biochar demonstrated that the biochar has undergone complex changes over the 3 years as compared to fresh biochar. This research suggests that biochar has positive effect on alpine meadow growth and soil health and may be an effective tool for alpine meadow restoration.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16776, title = {A qualitative exploration on the awareness and knowledge of stakeholders towards Urban Heat Island phenomenon in Greater Kuala Lumpur: Critical insights for urban policy implications}, author = {L Ramakreshnan and N Aghamohammadi and C S Fong and A Ghaffarianhoseini and L P Wong and R M Noor and N R Hanif and W N Azriyati Wan Abd Aziz and N M Sulaiman and N Hassan}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85062262912\&doi=10.1016%2fj.habitatint.2019.02.007\&partnerID=40\&md5=81ede28eb51ae1ccd593e1ef1a8d6c2b}, doi = {10.1016/j.habitatint.2019.02.007}, year = {2019}, date = {2019-01-01}, journal = {Habitat International}, volume = {86}, pages = {28-37}, abstract = {Despite its notable role in the exacerbation of urban climate, Urban Heat Island (UHI) was poorly addressed, communicated and integrated into local urban policies of many developing countries. Such scenario often queried the level of UHI understanding amongst the key players who were involved in urban policy formulation. Hence, a qualitative study using Focus Group Discussions (FGD) was designed to investigate the awareness and knowledge level of stakeholders such as policy makers and practitioners in Greater Kuala Lumpur (GKL), an expanding socio-economic hub of a developing tropical country. The findings demonstrated a variable lack of awareness and knowledge about the concept of UHI, its status in GKL as well as organizational engagement in adaptation and mitigation initiatives among the study participants. Essentially, policy makers illustrated a facile awareness and knowledge towards UHI issues whereas practitioners displayed a more robust portfolio of factual understanding regarding the corresponding issues. In line with National Urbanization Policy's (NUP) aspiration to optimize urban developments that provide high quality of life, this study sheds some light on the exigency for UHI awareness creation and capacity building among the policy makers. This study also provides impactful prepositions for the articulation of necessary actions towards evidence-based urban policy formulation in future. © 2019}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16798, title = {Empirical study on temporal variations of canopy-level Urban Heat Island effect in the tropical city of Greater Kuala Lumpur}, author = {L Ramakreshnan and N Aghamohammadi and C S Fong and A Ghaffarianhoseini and L P Wong and N M Sulaiman}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85056642789\&doi=10.1016%2fj.scs.2018.10.039\&partnerID=40\&md5=087997d806059c4a959aedef306c8ee2}, doi = {10.1016/j.scs.2018.10.039}, year = {2019}, date = {2019-01-01}, journal = {Sustainable Cities and Society}, volume = {44}, pages = {748-762}, abstract = {A very few studies have evaluated and understood the temporal dynamics of UHI in many expanding tropical cities. Hence, this study investigated the temporal variations of canopy-level UHI in selected urban stations, namely Petaling Jaya (PJ) and Subang (SUB), of Greater Kuala Lumpur (GKL) using 2016’s hourly data set obtained from meteorological observatories. The association between meteorological factors and UHI Intensity (UHII) is evaluated using linear regression models and Pearson correlation analysis. The findings revealed positive thermal contrasts between urban and sub-urban stations with maximum UHII during dry, southwest monsoon season in PJ (June: 1.68 °C) and SUB (August: 1.29 °C) stations respectively. PJ station exhibited a distinct diurnal cycle with the maximum nocturnal UHII of 1.71 °C at about 8 p.m. after sunset under ideal meteorological conditions. The results also demonstrated that UHI events occurred more frequently at nights in urban stations in the magnitude range of 0\textendash2 °C. Cooling at all urban sites starts around 2\textendash3 p.m. with the highest rate of 0.73 °C/h and 0.96 °C/h in PJ and SUB stations. Meanwhile, relative humidity displayed a low positive correlation (r = 0.37, p ≥ 0.05) and a high negative correlation (r = −0.79, p \< 0.05) with UHII in PJ and SUB stations respectively. The influence of wind speed on UHII is weak (r = −0.44, p \< 0.05) in PJ station and strong (r = 0.83, p \< 0.05) in SUB station. Overall, this study can be regarded as one of the comprehensive observational investigations of canopy-level UHI in a tropical city that provide vital inputs to enrich the tropical urban climate literacy. © 2018 Elsevier Ltd}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16802, title = {A preliminary insight into the environmental awareness of community in the vicinity of batik manufacturing units in Kelantan, Malaysia}, author = {L Ramakreshnan and A Rajandra and N Aghamohammadi and C S Fong and S Nalatambi}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85068748591\&doi=10.1007%2fs10708-019-10046-w\&partnerID=40\&md5=dc8b2a4ff279343b235ca131e9000272}, doi = {10.1007/s10708-019-10046-w}, year = {2019}, date = {2019-01-01}, journal = {GeoJournal}, abstract = {In response to a significant contribution of batik industries towards water pollution in Kelantan, this study sought to examine the environmental awareness of the community staying in the vicinity of batik manufacturing units in Kelantan. In this cross-sectional study, 160 participants were administered with interviewer-assisted questionnaire surveys between November 2013 and December 2013. Information pertaining to the participants’ awareness of the batik manufacturing process, nature and disposal of dyes as well as the associated environmental and health impacts due to improper wastewater discharges were recorded. Chi square and multivariate binary logistic regression model was deployed to determine the significance between the socio-demographic variables and the items assessed to explore their environmental awareness. Despite a limited awareness on the batik manufacturing process and chemical properties of dyes, more than half of the study participants were more likely to be aware of the dye disposal methods utilized by the manufacturing units as well as the environmental and health impacts of the wastewater discharges in their neighbourhood. Among the socio-demographic variables, having a formal education recorded a significant association with the nature of dye, dye disposal method, environmental and health impacts due to improper dye disposal. In a nutshell, this study contributed useful empirical insights on the current environmental awareness levels of the community near the batik manufacturing units in Kelantan to devise interventions for the cultivation of community-based surveillance. © 2019, Springer Nature B.V.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16746, title = {In-vitro cytotoxicity of Trigona itama honey against human lung adenocarcinoma epithelial cell line (A549)}, author = {S N M Salim and L Ramakreshnan and C S Fong and R A Wahab and M S B A Rasad}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85070295604\&doi=10.1016%2fj.eujim.2019.100955\&partnerID=40\&md5=db642e53b8863f7f00bcea608559d374}, doi = {10.1016/j.eujim.2019.100955}, year = {2019}, date = {2019-01-01}, journal = {European Journal of Integrative Medicine}, volume = {30}, abstract = {Introduction: Many efforts have been made to identify natural alternatives to reduce the side effects of cytotoxic drugs in cancer treatment. With this in mind, the current study aimed to investigate the cytotoxicity effects of one of the multifloral Malaysian honey, Kelulut honey (Trigona itama), as a potential natural anticancer agent in stimulating apoptosis and cell cycle arrest to a human lung adenocarcinoma epithelial cell line (A549). Methods: The cells were treated with various concentrations of T. itama honey for 24, 48 and 72 h. The cytotoxicity and cell viability were determined using trypan blue exclusion assay (TBEA) and flow cytometric analysis. Results: The moisture content in the analysed honey was 14.3 ± 0.8%, which was within the accepted international standard. The pH, electrical conductivity and proline content were 3.17 ± 0.02, 0.47 mS/cm - 0.55 mS/cm and 19.1 mg/kg 20.2 mg/kg respectively. The findings demonstrated a significant dose and time-dependent inhibitory effect of T. itama honey with the maximum cytotoxic effects observed at 72 h with 20% concentration of T. itama honey, indicating 100% growth inhibition. Meanwhile, IC50 of T. itama honey treatment for A549 cells was determined as 0.62% v/v. Moreover, T. itama honey had a promising cytotoxic effect and proven capable of inducing cell cycle arrest at G2/M phase at 72 h of exposure with IC50 concentration. Conclusion: This study provided prefatory evidence on T. itama honey's significant anticancer activity against human lung cancer cell lines. © 2019 Elsevier GmbH}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16630, title = {Organisational antecedents of workplace victimisation: The role of organisational climate, culture, leadership, support, and justice in predicting junior doctors' exposure to bullying at work}, author = {E Z Samsudin and M Isahak and S Rampal and I Rosnah and M I Zakaria}, doi = {10.1002/hpm.2926}, issn = {0749-6753}, year = {2019}, date = {2019-01-01}, journal = {Int J Health Plann Manage}, abstract = {Workplace bullying is a pervasive phenomenon among junior doctors that may negatively impact their training and abilities to deliver quality healthcare, yet evidence on the factors of bullying among them remains lacking. This study examined the role of organisational climate, culture, leadership, support, and justice in junior doctors' exposure to workplace bullying on the basis of the work environment hypothesis, which suggests that workplace psychosocial factors are the main antecedents of bullying at work. Multilevel analysis of a universal sample (n = 1074) of junior doctors working in the central zone of Malaysia, using mixed effects logistic regression, was conducted. Analysis indicates that junior doctors working in departments with neutral and positive organisational climate, moderate and high degree of clan culture, moderate and high degree of adhocracy culture, moderate degree of hierarchy culture, moderate degree of production and achievement-oriented leadership style, moderate and high degree of organisational support, moderate degree of procedural justice, moderate and high degree of interactional justice, and high degree of distributive justice have lower odds of bullying compared with their counterparts. The results present evidence that all aspects of the organisation influence junior doctors' exposure to bullying and should be considered when developing antibullying initiatives targeted at them.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16634, title = {The systematic cultural adaptation of a UK public health cancer awareness raising programme for Malaysia: the Be Cancer Alert Campaign}, author = {D Schliemann and T T Su and D Paramasivam and S Somasundaram and N S B Ibrahim Tamin and M Dahlui and S Y Loh and M Donnelly}, doi = {10.1093/tbm/ibz134}, issn = {1613-9860}, year = {2019}, date = {2019-01-01}, journal = {Transl Behav Med}, volume = {9}, number = {6}, pages = {1087-1099}, abstract = {Increasingly, policy and research attention is being directed toward improving global health in low- and middle-income countries. This study investigated the cultural adaptation of a UK-designed and developed evidence-based mass media campaign with the aim of improving colorectal cancer and breast cancer awareness in Malaysia. Guided by the heuristic framework of cultural adaptation, a multidisciplinary team adapted the UK Be Cancer Aware programme for implementation in the Malaysian context. The approach included five steps: (a) information gathering and needs assessment; (b) preliminary design; (c) preliminary testing; (d) refinement; and (e) final trial. Key findings from the information gathering stage related to the need to take into account differences in ethnicity, religion, and beliefs about cancer. Discussions with experts indicated that particular words were not acceptable in Malay culture and that specific aspects were "taboo" (e.g., showing pictures of breasts in relation to breast cancer on TV). Stage 3 of the analysis revealed that the presentation of cancer survivors rather than health professionals on programme materials was preferred by Malaysians and that there was a poor level of awareness about colorectal cancer. The results were used systematically to adapt two culturally suitable cancer awareness mass media campaigns for implementation in Malaysia. The developed materials were in line with government priorities and took into account the local health care system structure. The establishment of a partnership with key stakeholders (e.g., the Ministry of Health and the lead patient advocacy organization) and the application of a systematic approach to address cultural factors and resource constraints contribute to the successful implementation of public health programmes in global health settings.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16704, title = {Author Correction: Association analyses of more than 140,000 men identify 63 new prostate cancer susceptibility loci}, author = {F R Schumacher and A A A Olama and S I Berndt and S Benlloch and M Ahmed and E J Saunders and T Dadaev and D Leongamornlert and E Anokian and C Cieza-Borrella and C Goh and M N Brook and X Sheng and L Fachal and J Dennis and J Tyrer and K Muir and A Lophatananon and V L Stevens and S M Gapstur and B D Carter and C M Tangen and P J Goodman and Jr. Thompson I. M. and J Batra and S Chambers and L Moya and J Clements and L Horvath and W Tilley and G P Risbridger and H Gronberg and M Aly and T Nordstrom and P Pharoah and N Pashayan and J Schleutker and T L J Tammela and C Sipeky and A Auvinen and D Albanes and S Weinstein and A Wolk and N Hakansson and C M L West and A M Dunning and N Burnet and L A Mucci and E Giovannucci and G L Andriole and O Cussenot and G Cancel-Tassin and S Koutros and L E Beane Freeman and K D Sorensen and T F Orntoft and M Borre and L Maehle and E M Grindedal and D E Neal and J L Donovan and F C Hamdy and R M Martin and R C Travis and T J Key and R J Hamilton and N E Fleshner and A Finelli and S A Ingles and M C Stern and B S Rosenstein and S L Kerns and H Ostrer and Y J Lu and H W Zhang and N Feng and X Mao and X Guo and G Wang and Z Sun and G G Giles and M C Southey and R J MacInnis and L M FitzGerald and A S Kibel and B F Drake and A Vega and A Gomez-Caamano and R Szulkin and M Eklund and M Kogevinas and J Llorca and G Castano-Vinyals and K L Penney and M Stampfer and J Y Park and T A Sellers and H Y Lin and J L Stanford and C Cybulski and others}, doi = {10.1038/s41588-018-0330-6}, issn = {1061-4036}, year = {2019}, date = {2019-01-01}, journal = {Nat Genet}, volume = {51}, number = {2}, pages = {363}, abstract = {In the version of this article initially published, the name of author Manuela Gago-Dominguez was misspelled as Manuela Gago Dominguez. The error has been corrected in the HTML and PDF version of the article.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16618, title = {Dietary Practices and Meal Patterns among Overweight and Obese School Children in Malaysia: Baseline Data from a School-Based Intervention Study}, author = {R Selamat and J Raib and N A Abdul Aziz and N Zulkafly and A N Ismail and Mohamad W WNA and N I N Nasruddin and M Y Jalaludin and F Md Zain and Z Ishak and A Yahya and A H Mokhtar}, doi = {10.1080/03670244.2019.1694922}, issn = {0367-0244}, year = {2019}, date = {2019-01-01}, journal = {Ecol Food Nutr}, pages = {1-16}, abstract = {This study aimed to determine dietary practices and meal patterns among Malaysian overweight and obese school children at baseline. This study was part of a school-based obesity intervention study, My Body is Fit and Fabulous at School (MyBFF@school). It involved 1045 primary and 1041 secondary overweight and obese school children from a randomly selected 23 out of 1196 primary and 15 out of 416 secondary government schools in central Peninsular Malaysia. The results showed a significantly higher of adequate intake (4-8 servings/day) of cereals and grains among primary (54.7%) than secondary school children (48.2%). About 28.2% of primary and 32.6% of secondary school children had consumed adequate fruit (2 servings/day), while a very low percentage of both primary (5.0%) and secondary (3.6%) school children consumed adequate vegetables (3 servings/day). As for the meal patterns, school children in both primary and secondary were not taking breakfast regularly (mean+/-SD for primary: 3.16 +/- 2.61 days/week vs secondary: 2.97 +/- 2.52 days/week). There was also a significantly higher mean frequency of primary school children brought plain water to school than the secondary school children. In conclusion, urgent actions to address improper dietary practices and meal patterns of overweight and obese school children in Malaysia are warranted.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16722, title = {Coffee and tea consumption and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition}, author = {A Sen and N Papadimitriou and P Lagiou and A Perez-Cornago and R C Travis and T J Key and N Murphy and M Gunter and H Freisling and I Tzoulaki and D C Muller and A J Cross and D S Lopez and M Bergmann and H Boeing and C Bamia and A Kotanidou and A Karakatsani and A Tjonneland and C Kyro and M Outzen and M L Redondo and V Cayssials and M D Chirlaque and A Barricarte and M J Sanchez and N Larranaga and R Tumino and S Grioni and D Palli and S Caini and C Sacerdote and B Bueno-de-Mesquita and T Kuhn and R Kaaks and L M Nilsson and R Landberg and P Wallstrom and I Drake and B H Bech and K Overvad and D Aune and K T Khaw and E Riboli and D Trichopoulos and A Trichopoulou and K K Tsilidis}, doi = {10.1002/ijc.31634}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, volume = {144}, number = {2}, pages = {240-250}, abstract = {The epidemiological evidence regarding the association of coffee and tea consumption with prostate cancer risk is inconclusive, and few cohort studies have assessed these associations by disease stage and grade. We examined the associations of coffee (total, caffeinated and decaffeinated) and tea intake with prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 142,196 men, 7,036 incident prostate cancer cases were diagnosed over 14 years of follow-up. Data on coffee and tea consumption were collected through validated country-specific food questionnaires at baseline. We used Cox proportional hazards regression models to compute hazard ratios (HRs) and 95% confidence intervals (CI). Models were stratified by center and age, and adjusted for anthropometric, lifestyle and dietary factors. Median coffee and tea intake were 375 and 106 mL/day, respectively, but large variations existed by country. Comparing the highest (median of 855 mL/day) versus lowest (median of 103 mL/day) consumers of coffee and tea (450 vs. 12 mL/day) the HRs were 1.02 (95% CI, 0.94-1.09) and 0.98 (95% CI, 0.90-1.07) for risk of total prostate cancer and 0.97 (95% CI, 0.79-1.21) and 0.89 (95% CI, 0.70-1.13) for risk of fatal disease, respectively. No evidence of association was seen for consumption of total, caffeinated or decaffeinated coffee or tea and risk of total prostate cancer or cancer by stage, grade or fatality in this large cohort. Further investigations are needed to clarify whether an association exists by different preparations or by concentrations and constituents of these beverages.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16811, title = {Lipid Fraction Derived From MRI In- and Opposed-Phase Sequence as a Novel Biomarker for Predicting Survival Outcome of Glioma}, author = {P Seow and V Narayanan and R J Romelean and J H D Wong and M T Win and H Chandran and K Chinna and K Rahmat and N Ramli}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85066234369\&doi=10.1016%2fj.acra.2019.04.015\&partnerID=40\&md5=7453265cc3e8cd636829dff2113740d1}, doi = {10.1016/j.acra.2019.04.015}, year = {2019}, date = {2019-01-01}, journal = {Academic Radiology}, abstract = {Rationale and Purpose: Our study evaluated the capability of magnetic resonance imaging in- and opposed-phase (IOP)derived lipid fraction as a novel prognostic biomarker of survival outcome in glioma. Materials and Methods: We analyzed 46 histologically proven glioma (WHO grades II\textendashIV)patients using standard 3T magnetic resonance imaging brain tumor protocol and IOP sequence. Lipid fraction was derived from the IOP sequence signal-loss ratio. The lipid fraction of solid nonenhancing region of glioma was analyzed, using a three-group analysis approach based on volume under surface of receiver-operating characteristics to stratify the prognostic factors into three groups of low, medium, and high lipid fraction. The survival outcome was evaluated, using Kaplan-Meier survival analysis and Cox regression model. Results: Significant differences were seen between the three groups (low, medium, and high lipid fraction groups)stratified by the optimal cut-off point for overall survival (OS)(p ≤ 0.01)and time to progression (p ≤ 0.01)for solid nonenhancing region. The group with high lipid fraction had five times higher risk of poor survival and earlier time to progression compared to the low lipid fraction group. The OS plot stratified by lipid fraction also had a strong correlation with OS plot stratified by WHO grade (R = 0.61, p \< 0.01), implying association to underlying histopathological changes. Conclusion: The lipid fraction of solid nonenhancing region showed potential for prognostication of glioma. This method will be a useful adjunct in imaging protocol for treatment stratification and as a prognostic tool in glioma patients. © 2019 The Association of University Radiologists}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16662, title = {A systematic review of depression literacy: Knowledge, help-seeking and stigmatising attitudes among adolescents}, author = {S Singh and R A Zaki and N D N Farid}, doi = {10.1016/j.adolescence.2019.06.004}, issn = {0140-1971}, year = {2019}, date = {2019-01-01}, journal = {J Adolesc}, volume = {74}, pages = {154-172}, abstract = {INTRODUCTION: Depression is a common mental health disorder and affects many adolescents worldwide. Depression literacy can improve mental health outcomes. The aim of this study was to collate and analyse the extant evidence on depression literacy among adolescents, with particular focus on tools used to examine depression literacy and the findings on components of depression literacy. METHODS: Nine electronic databases and 1 grey literature source were searched for studies published in English between January 2006 and December 2018 and involving adolescents aged 10-19 years. We included studies that reported on components of depression literacy such as knowledge, help-seeking and stigmatising attitudes. We excluded qualitative studies. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their characteristics. The data were descriptively analysed and appraised using the Newcastle-Ottawa Scale (NOS), Cochrane Collaboration's tool and the Quality Assessment Tool for Quantitative Studies (QATSQ). RESULTS AND CONCLUSION: Fifty of the 14,626 references identified met the inclusion criteria. Depression literacy was most commonly (58%) assessed using tools that utilize a vignette-based methodology. A lack of uniformity in reporting of depression literacy was noted. Adolescents were poor at recognising depression, likely to seek help from informal sources and tended to attach stigma to depression. The implications of the findings are discussed and suggestions made for future research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16672, title = {The role of plasma microseminoprotein-beta in prostate cancer: an observational nested case-control and Mendelian randomization study in the European prospective investigation into cancer and nutrition}, author = {K Smith Byrne and P N Appleby and T J Key and M V Holmes and G K Fensom and A Agudo and E Ardanaz and H Boeing and H B Bueno-de-Mesquita and M D Chirlaque and R Kaaks and N Larranaga and D Palli and A Perez-Cornago and J R Quiros and F Ricceri and M J Sanchez and G Tagliabue and K K Tsilidis and R Tumino and R T Fortner and P Ferrari and E Riboli and H Lilja and R C Travis}, doi = {10.1093/annonc/mdz121}, issn = {0923-7534}, year = {2019}, date = {2019-01-01}, journal = {Ann Oncol}, volume = {30}, number = {6}, pages = {983-989}, abstract = {BACKGROUND: Microseminoprotein-beta (MSP), a protein secreted by the prostate epithelium, may have a protective role in the development of prostate cancer. The only previous prospective study found a 2% reduced prostate cancer risk per unit increase in MSP. This work investigates the association of MSP with prostate cancer risk using observational and Mendelian randomization (MR) methods. PATIENTS AND METHODS: A nested case-control study was conducted with the European Prospective Investigation into Cancer and Nutrition (EPIC) with 1871 cases and 1871 matched controls. Conditional logistic regression analysis was used to investigate the association of pre-diagnostic circulating MSP with risk of incident prostate cancer overall and by tumour subtype. EPIC-derived estimates were combined with published data to calculate an MR estimate using two-sample inverse-variance method. RESULTS: Plasma MSP concentrations were inversely associated with prostate cancer risk after adjusting for total prostate-specific antigen concentration [odds ratio (OR) highest versus lowest fourth of MSP = 0.65, 95% confidence interval (CI) 0.51-0.84}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16721, title = {Physical Activity and Health-Related Quality of Life Among Low-Income Adults in Metropolitan Kuala Lumpur}, author = {T T Su and M Azzani and A P Adewale and N Thangiah and R Zainol and H Majid}, doi = {10.2188/jea.JE20170183}, issn = {0917-5040}, year = {2019}, date = {2019-01-01}, journal = {J Epidemiol}, volume = {29}, number = {2}, pages = {43-49}, abstract = {BACKGROUND: The aim of this research is to assess the level of physical activity (PA) in relation to different socio-economic factors and to examine the effect of the recommended level of PA on the domains of quality of life (QoL) among residents of low-income housing in the metropolitan area of Kuala Lumpur, Malaysia. METHODS: This was a cross-sectional study that included 680 respondents from community housing projects. Reported PA was assessed using the Global Physical Activity Questionnaire (GPAQ) short form version 2. The SF-12v2 was administered to assess the health-related QoL (HRQoL) among the study population. Respondents were grouped into "active" and "insufficient" groups according to reported weekly PA level. One-way analysis of variance, analysis of co-variance, and multiple linear regression were used in the analysis. RESULTS: Overall, 17.6% (95% CI, 14.3-20.9) of the respondents did not achieve the recommended levels of PA (\>/=600 metabolic equivalent [MET]-minutes week(-1)). Level of achieving recommended PA was higher among younger participants, females, members belonging to nuclear families, and in self-employed participants. The group that fulfilled recommended PA levels (active) has higher levels of QoL in all domains except physical functioning. CONCLUSIONS: Almost one out of five low-income urban residents were physically inactive. In addition, individuals who attained recommended PA levels had better scores on some domains of HRQOL than those who did not. Our findings call for tailor-made public health interventions to improve PA levels among the general population and particularly for low-income residents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16700, title = {The Effectiveness of a Voice Care Program Among Primary School Teachers in Northeastern Malaysia}, author = {E R Sundram and B Norsa'adah and H Mohamad and F M Moy and N R N Husain and M N Shafei}, doi = {10.5001/omj.2019.08}, issn = {1999-768X (Print) 1999-768x}, year = {2019}, date = {2019-01-01}, journal = {Oman Med J}, volume = {34}, number = {1}, pages = {49-55}, abstract = {Objectives: We sought to determine the effectiveness of a voice care program among primary school teachers in a northeastern district in Malaysia. Methods: We conducted a randomized community trial in eight primary schools in a northeastern district in Malaysia. The self-administered and validated Malay-Voice Handicap Index-10 (M-VHI-10) questionnaire was used to assess overall voice handicap scores pre-intervention and eight weeks post-intervention. Teachers with a score of five or more (n = 86) were randomized into intervention (n = 41) and control groups (n = 45). The intervention group received portable voice amplifiers and vocal hygiene instruction, which was delivered by lectures and a booklet. The control group was not prescribed any intervention. Results: The sociodemographic, lifestyle, and occupational characteristics of the teachers (except maximum number of students per class) were similar between both groups. The baseline M-VHI-10 scores between both groups were also comparable. After the intervention phase, there was a significant effect observed in the total M-VHI-10 scores (p = 0.021, F-stat (df): 5.33 (1,79)) between both groups after controlling for the maximum number of students per class. Conclusions: Our results support the use of voice amplification in adjunct with vocal hygiene instruction as a prevention and treatment modality to reduce voice handicap among teachers. Our study demonstrated encouraging evidence on the low-cost voice care program as well as the success of group and workplace-based approaches in the school setting.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16636, title = {Validity and Reliability of a Nutrition Screening Tool in Identifying Malnutrition Among Hospitalized Adult Patients}, author = {P C Tah and C C Kee and H A Majid}, doi = {10.1002/ncp.10416}, issn = {0884-5336}, year = {2019}, date = {2019-01-01}, journal = {Nutr Clin Pract}, abstract = {BACKGROUND: Malnutrition among hospitalized patients is closely associated with various medical complications. This study aimed to determine the validity and reliability of a 3-Minute Nutrition Screening (3-MinNS) tool in identifying the risk of malnutrition among hospitalized patients that can be administered by healthcare professionals. METHODS: A cross-sectional study was conducted between January and December 2012. A total of 350 adult patients in a teaching hospital were screened for risk of malnutrition using 3-MinNS and Subjective Global Assessment (SGA). To assess interrater reliability, each patient was screened for risk of malnutrition using 3-MinNS by 2 different nurses on 2 different occasions within 24 hours after admission. To assess the validity of 3-MinNS, the level of risk of malnutrition identified by the nurses using 3-MinNS was compared with the risk of malnutrition as assessed by a dietitian using SGA within 48 hours after the patients' enrolment into the study. The sensitivity, specificity, and predictive values were calculated in detecting patients at risk of malnutrition. Interrater reliability was determined using kappa statistics. RESULTS: Using SGA, the estimated prevalence of moderate to severe malnutrition was 36.3% (127/350). There was 94% proportional agreement between 2 nurses using 3-MinNS, and interrater reliability was substantial (kappa = 0.79, P \< .001). The analysis showed that 3-MinNS had moderate sensitivity (61.4%-68.5%) but high specificity (95.1%). CONCLUSIONS: The 3-MinNS is a reliable and valid screening tool for use by healthcare professionals for identifying newly admitted medical and surgical patients who are at risk of malnutrition.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16645, title = {A study to determine the educational objectives and outcomes for pre-registration Diploma nursing program: A modified Delphi}, author = {K Tan and M C Chong and L P Wong}, doi = {10.1016/j.nepr.2019.08.002}, issn = {1471-5953}, year = {2019}, date = {2019-01-01}, journal = {Nurse Educ Pract}, volume = {39}, pages = {80-89}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16673, title = {Ethnic differences in lifetime cumulative incidence of syncope: the Malaysian elders longitudinal research (MELoR) study}, author = {M P Tan and Y Y Ho and A V Chin and N Saedon and I Z Abidin and K H Chee and H M Khor and C H Goh and N N Hairi and S Othman and S B Kamaruzzaman}, doi = {10.1007/s10286-019-00610-2}, issn = {0959-9851}, year = {2019}, date = {2019-01-01}, journal = {Clin Auton Res}, abstract = {PURPOSE: To determine the lifetime cumulative incidence of syncope, potential ethnic differences and factors associated with syncope using the Malaysian elders longitudinal research (MELoR) study first wave dataset. METHODS: The MELoR study recruited community-dwelling adults aged 55 years and over, selected through stratified random sampling from three parliamentary constituencies. The baseline data collected during the first wave was obtained through face-to-face interviews in participants' homes using computer-assisted questionnaires. During their baseline assessments, participants were asked whether they had ever experienced a blackout in their lifetime and if they had experienced a blackout in the preceding 12 months. RESULTS: Information on blackouts and ethnicity were available for 1530 participants. The weight-adjusted lifetime cumulative incidence of syncope for the overall population aged 55 years and above was 27.7%. The estimated lifetime cumulative incidence according to ethnic groups was 34.6% for Malays, 27.8% for Indians and 23.7% for Chinese. The estimated 12-month incidence of syncope was 6.1% overall, equating to 11.7% for Malays, 8.7 % for Indians and 2.3% for Chinese. Both Malay [odds ratio (OR) 1.46; 95% confidence interval (CI) 1.10-1.95 and OR 3.62, 95% CI 1.96-6.68] and Indian (OR 1.34; 95% CI 1.01-1.80 and OR 3.31, 1.78-6.15) ethnicities were independently associated with lifetime and 12-month cumulative incidence of syncope, respectively, together with falls, dizziness and myocardial infarction. CONCLUSION: Ethnic differences exist for lifetime cumulative incidence of syncope in community-dwelling individuals aged 55 years and over in an urban area in Southeast Asia. Future studies should now seek to determine potential genetic, cultural and lifestyle differences which may predispose to syncope.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16611, title = {Transition of Care in Paediatric Surgery: Current practices and perspectives of paediatric surgeons in Malaysia}, author = {S K Tan and A Sanmugam and M Danaee and T M Ramanujam and M A Nallusamy and Z Zahari and T R Rao}, doi = {10.18295/squmj.2019.19.04.011}, issn = {2075-051x}, year = {2019}, date = {2019-01-01}, journal = {Sultan Qaboos Univ Med J}, volume = {19}, number = {4}, pages = {e352-e358}, abstract = {Objectives: Transition of care (TOC) from paediatric to adult care is still at an early stage in Malaysia. This study aimed to explore current practices and perspectives regarding TOC among paediatric surgeons in Malaysia. Methods: This study was carried out between June and December 2017. All 48 paediatric surgeons currently working in Malaysia were invited to participate in a questionnaire-based survey to assess demographic characteristics and practices and perspectives regarding TOC. Results: A total of 38 paediatric surgeons participated in the survey (response rate: 79.2%). Overall, 97.4% did not have an organised TOC model in their institution, with most (65.8%) caring for paediatric patients with complex surgical conditions until adulthood. Although the majority (86.8%) felt that care should be transitioned to adult surgeons with appropriate credentials, most surgeons (84.2%) nevertheless preferred to be involved in the management of adolescent patients after transition. However, there was no consensus regarding the most suitable age to begin the transition. Years of experience as a paediatric surgeon and place of practice did not affect overall TOC practice scores (P \>0.050 each). The presence of adult comorbidities was considered the most common reason to initiate TOC (81.6%), while the lack of TOC guidelines was perceived to be the greatest barrier (84.2%). Conclusion: This study provides a better understanding of TOC from the point of view of paediatric surgeons in Malaysia. However, further studies involving other stakeholders (i.e. patients and adult surgeons) are needed to help formulate a suitable and successful TOC model in this setting.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16652, title = {Social support and depression among community dwelling older adults in Asia: a systematic review}, author = {T A M Tengku Mohd and R M Yunus and F Hairi and N N Hairi and W Y Choo}, doi = {10.1136/bmjopen-2018-026667}, issn = {2044-6055}, year = {2019}, date = {2019-01-01}, journal = {BMJ Open}, volume = {9}, number = {7}, pages = {e026667}, abstract = {OBJECTIVES: This review aims to: (1) explore the social support measures in studies examining the association between social support and depression among community-dwelling older adults in Asia and (2) the evidence of association. DESIGN: A systematic review was conducted using electronic databases of CINAHL, PubMed, PsychINFO, Psychology and Behavioural Sciences Collection, SocINDEX and Web of Science for articles published until the 11th of January 2018. ELIGIBILITY CRITERIA: All observational studies investigating the association between social support and depression among community-dwelling older adults in Asia were included. PARTICIPANTS: Older adults aged 60 years and more who are living in the community. EXPOSURE MEASURES: Social support. OUTCOME MEASURES: Depression. RESULTS: We retrieved16 356 records and screened 66 full-text articles. Twenty-four observational studies were included in the review. They consisted of five cohort studies and 19 cross-sectional studies. Social support was found to be measured by multiple components, most commonly through a combination of structural and functional constructs. Perceived social support is more commonly measured compared with received social support. Good overall social support, having a spouse or partner, living with family, having a large social network, having more contact with family and friends, having emotional and instrumental support, good support from family and satisfaction with social support are associated with less depressive symptoms among community-dwelling older adults in Asia. CONCLUSIONS: There were 20 different social support measures and we applied a framework to allow for better comparability. Our findings emphasised the association between good social support and decrease depression among older adults. Compared with western populations, family support has a greater influence on depression among community-dwelling older adults in Asia. This indicates that the family institution needs to be incorporated into designed programmes and interventions when addressing depression in the Asian context. TRIAL : registration number : CRD42017074897.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16686, title = {Effect of Blastocystis sp. in dengue patients-Increase in the treatment cost and exacerbation of symptoms}, author = {G Thergarajan and S Kumar and S Bhassu and Sfbs Omar and S Rampal}, doi = {10.1371/journal.pone.0211034}, issn = {1932-6203}, year = {2019}, date = {2019-01-01}, journal = {PLoS One}, volume = {14}, number = {3}, pages = {e0211034}, abstract = {Increasing incidences of dengue have become a global health threat with major clinical manifestation including high fever and gastrointestinal symptoms. These symptoms were also expressed among Blastocystis sp. infected individuals, a parasite commonly seen in human stools. This parasite has been previously reported to replicate faster upon exposure to high temperature. The present study is a hospitalized-based cross-sectional study involved the collection of faecal sample from dengue patients. Stool examination was done by in vitro cultivation to isolate Blastocystis sp. Growth pattern of all the positive isolates were analyzed to identify the multiplication rate of Blastocystis sp. isolated from dengue patients. Distribution of Blastocystis sp. among dengue patients was 23.6%. Dengue patients who were positive for Blastocystis sp. infection denoted a significantly higher fever rate reaching 38.73 degrees C (p\<0.05) compared to the non-Blastocystis sp. infected patients (38.44 degrees C). It was also found that Blastocystis sp. infected patients complained of frequenting the toilet more than five times a day (p\<0.05) compared to those who were non-Blastocystis sp. infected. At the same time, the duration of hospitalization was significantly longer (p\<0.05) for Blastocystis sp. infected dengue patients compared to the non-Blastocystis sp. infected patients. Besides, Blastocystis sp. isolated from dengue patients (in vivo thermal stress) showed a higher growth rate compared to the non-dengue isolated which was exposed to high temperature (in vitro thermal stress). Our findings suggest that presence of Blastocystis sp. during dengue infection could trigger the increase of temperature which could be due to highly elevated pro inflammatory cytokines by both parasitic and virus infection. This could justify why the temperature in Blastocystis sp. infected dengue patients is higher compared to the non-Blastocystis sp. infected patients. Higher temperature could have triggered a greater parasite multiplication rate that contributed to the aggravation of the gastrointestinal symptoms.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16785, title = {Effect of Blastocystis sp. In dengue patients\textemdashIncrease in the treatment cost and exacerbation of symptoms}, author = {G Thergarajan and S Kumar and S Bhassu and S F B S Omar and S Rampal}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85063254279\&doi=10.1371%2fjournal.pone.0211034\&partnerID=40\&md5=a48004beadf8282779a894541a492363}, doi = {10.1371/journal.pone.0211034}, year = {2019}, date = {2019-01-01}, journal = {PLoS ONE}, volume = {14}, number = {3}, abstract = {Increasing incidences of dengue have become a global health threat with major clinical manifestation including high fever and gastrointestinal symptoms. These symptoms were also expressed among Blastocystis sp. infected individuals, a parasite commonly seen in human stools. This parasite has been previously reported to replicate faster upon exposure to high temperature. The present study is a hospitalized-based cross-sectional study involved the collection of faecal sample from dengue patients. Stool examination was done by in vitro cultivation to isolate Blastocystis sp. Growth pattern of all the positive isolates were analyzed to identify the multiplication rate of Blastocystis sp. isolated from dengue patients. Distribution of Blastocystis sp. among dengue patients was 23.6%. Dengue patients who were positive for Blastocystis sp. infection denoted a significantly higher fever rate reaching 38.73C (p\<0.05) compared to the non-Blastocystis sp. infected patients (38.44C). It was also found that Blastocystis sp. infected patients complained of frequenting the toilet more than five times a day (p\<0.05) compared to those who were non-Blastocystis sp. infected. At the same time, the duration of hospitalization was significantly longer (p\<0.05) for Blastocystis sp. infected dengue patients compared to the non-Blastocystis sp. infected patients. Besides, Blastocystis sp. isolated from dengue patients (in vivo thermal stress) showed a higher growth rate compared to the non-dengue isolated which was exposed to high temperature (in vitro thermal stress). Our findings suggest that presence of Blastocystis sp. during dengue infection could trigger the increase of temperature which could be due to highly elevated pro inflammatory cytokines by both parasitic and virus infection. This could justify why the temperature in Blastocystis sp. infected dengue patients is higher compared to the non-Blastocystis sp. infected patients. Higher temperature could have triggered a greater parasite multiplication rate that contributed to the aggravation of the gastrointestinal symptoms. © 2019 Thergarajan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16655, title = {Financial toxicity and its associations with health-related quality of life among urologic cancer patients in an upper middle-income country}, author = {C Y Ting and G C Teh and K L Yu and H Alias and H M Tan and L P Wong}, doi = {10.1007/s00520-019-04975-y}, issn = {0941-4355}, year = {2019}, date = {2019-01-01}, journal = {Support Care Cancer}, abstract = {PURPOSE: This study examined the prevalence of financial toxicity (FT) and associated factors among urologic cancer patients. The association between FT and health-related quality of life (HRQoL) was also investigated. METHODS: A total of 429 respondents diagnosed with urologic cancers (prostate cancer, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed using a structured questionnaire. Objective and subjective FT were measured by catastrophic health expenditure (healthcare-cost-to-income ratio greater than 40%) and the Personal Financial Well-being Scale, respectively. HRQoL was measured with the Functional Assessment of Cancer Therapy - General 7 Items scale. RESULTS: Objective and subjective FT were experienced by 16.1 and 47.3% of the respondents, respectively. Respondents who sought treatment at a private hospital and had out-of-pocket health expenditures were more likely to experience objective FT, after adjustment for covariates. Respondents who were female and had a monthly household income less than MYR 5000 were more likely to experience average to high subjective FT. Greater objective FT (OR = 2.75, 95% CI 1.09-6.95) and subjective FT (OR = 4.68, 95% CI 2.63-8.30) were associated with poor HRQoL. CONCLUSIONS: The significant association between both objective and subjective FT and HRQoL highlights the importance of reducing FT among urologic cancer patients. Subjective FT was found to have a greater negative impact on HRQoL.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16804, title = {Prevalence and determinants of pathological internet use among undergraduate students in a public university in Malaysia}, author = {W T Tong and M A Islam and W Y Low and W Y Choo and A Abdullah}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85065082132\&partnerID=40\&md5=157fcd29d36b626dad33c409f12b6323}, year = {2019}, date = {2019-01-01}, journal = {Journal of Behavioral Science}, volume = {14}, number = {1}, pages = {63-83}, abstract = {Pathological Internet Use (PIU) affects one's physical and mental health, and university students are at risk as they are more likely to develop PIU. This study determines the prevalence of PIU and its associated factors among students in a public university in Malaysia. This cross-sectional study was conducted among 1023 undergraduate students in 2015. The questionnaire comprised of items from the Young's Diagnostic Questionnaire to assess PIU and items related to socio-demography, psychosocial, lifestyle and co-morbidities. Anonymous paper-based data collection method was adopted. Mean age of the respondents was 20.73 ± 1.49 years old. The prevalence of pathological Internet user was 28.9% mostly Chinese (31%), 22 years old and above (31.0%), in Year 1 (31.5%), and those who perceived themselves to be from family from higher socio-economic status (32.5%). The factors found statistically significant (p \< 0.05) with PIU were Internet use for three or more hours for recreational purpose (OR: 3.89; 95% CI:1.33 - 11.36), past week of Internet use for pornography purpose (OR: 2.52; 95% CI:1.07 - 5.93), having gambling problem (OR: 3.65; 95% CI:1.64 - 8.12), involvement in drug use in the past 12 months (OR: 6.81; 95% CI:1.42 - 32.77) and having moderate/severe depression (OR: 4.32; 95% CI:1.83 - 10.22). University authorities need to be aware of the prevalence so that interventions can be developed to prevent adverse outcomes. Interventions should focus on screening students for PIU, creating awareness on the negative effects of PIU and promoting healthy and active lifestyle and restricting students' access to harmful websites. © Behavioral Science Research Institute.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16617, title = {Cardiometabolic Risk Factors and Physical Activity Patterns Maximizing Fitness and Minimizing Fatness Variation in Malaysian Adolescents: A Novel Application of Reduced Rank Regression}, author = {Z Toumpakari and R Jago and L D Howe and H A Majid and A Papadaki and S Mohammadi and M Y Jalaludin and M Dahlui and M N A Mohamed and T T Su and L Johnson}, doi = {10.3390/ijerph16234662}, issn = {1660-4601}, year = {2019}, date = {2019-01-01}, journal = {Int J Environ Res Public Health}, volume = {16}, number = {23}, abstract = {Patterns of physical activity (PA) that optimize both fitness and fatness may better predict cardiometabolic health. Reduced rank regression (RRR) was applied to identify combinations of the type (e.g., football vs. skipping), location and timing of activity, explaining variation in cardiorespiratory fitness (CRF) and Body Mass Index (BMI). Multivariable regressions estimated longitudinal associations of PA pattern scores with cardiometabolic health in n = 579 adolescents aged 13-17 years from the Malaysian Health and Adolescent Longitudinal Research Team study. PA pattern scores in boys were associated with higher fitness (r = 0.3) and lower fatness (r = -0.3); however, in girls, pattern scores were only associated with higher fitness (r = 0.4) (fatness}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16711, title = {A Collaborative Analysis of Individual Participant Data from 19 Prospective Studies Assesses Circulating Vitamin D and Prostate Cancer Risk}, author = {R C Travis and A Perez-Cornago and P N Appleby and D Albanes and C E Joshu and P L Lutsey and A M Mondul and E A Platz and S J Weinstein and T M Layne and K J Helzlsouer and K Visvanathan and D Palli and P H Peeters and B Bueno-de-Mesquita and A Trichopoulou and M J Gunter and K K Tsilidis and M J Sanchez and A Olsen and H Brenner and B Schottker and L Perna and B Holleczek and P Knekt and H Rissanen and B B Yeap and L Flicker and O P Almeida and Y Y E Wong and J M Chan and E L Giovannucci and M J Stampfer and G Ursin and R E Gislefoss and T Bjorge and H E Meyer and R Blomhoff and S Tsugane and N Sawada and D R English and D W Eyles and A K Heath and E J Williamson and J Manjer and J Malm and M Almquist and L L Marchand and C A Haiman and L R Wilkens and J M Schenk and C M Tangen and A Black and M B Cook and W Y Huang and R G Ziegler and R M Martin and F C Hamdy and J L Donovan and D E Neal and M Touvier and S Hercberg and P Galan and M Deschasaux and T J Key and N E Allen}, doi = {10.1158/0008-5472.Can-18-2318}, issn = {0008-5472}, year = {2019}, date = {2019-01-01}, journal = {Cancer Res}, volume = {79}, number = {1}, pages = {274-285}, abstract = {Previous prospective studies assessing the relationship between circulating concentrations of vitamin D and prostate cancer risk have shown inconclusive results, particularly for risk of aggressive disease. In this study, we examine the association between prediagnostic concentrations of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] and the risk of prostate cancer overall and by tumor characteristics. Principal investigators of 19 prospective studies provided individual participant data on circulating 25(OH)D and 1,25(OH)2D for up to 13,462 men with incident prostate cancer and 20,261 control participants. ORs for prostate cancer by study-specific fifths of season-standardized vitamin D concentration were estimated using multivariable-adjusted conditional logistic regression. 25(OH)D concentration was positively associated with risk for total prostate cancer (multivariable-adjusted OR comparing highest vs. lowest study-specific fifth was 1.22; 95% confidence interval, 1.13-1.31; P trend \< 0.001). However, this association varied by disease aggressiveness (P heterogeneity = 0.014); higher circulating 25(OH)D was associated with a higher risk of nonaggressive disease (OR per 80 percentile increase = 1.24, 1.13-1.36) but not with aggressive disease (defined as stage 4, metastases, or prostate cancer death, 0.95, 0.78-1.15). 1,25(OH)2D concentration was not associated with risk for prostate cancer overall or by tumor characteristics. The absence of an association of vitamin D with aggressive disease does not support the hypothesis that vitamin D deficiency increases prostate cancer risk. Rather, the association of high circulating 25(OH)D concentration with a higher risk of nonaggressive prostate cancer may be influenced by detection bias. SIGNIFICANCE: This international collaboration comprises the largest prospective study on blood vitamin D and prostate cancer risk and shows no association with aggressive disease but some evidence of a higher risk of nonaggressive disease.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16689, title = {The Maastricht FFQ: Development and validation of a comprehensive food frequency questionnaire for the Maastricht study}, author = {M C Dongen and N E G Wijckmans-Duysens and L J Biggelaar and M C Ocke and S Meijboom and H A Brants and J H Vries and E J Feskens and H B Bueno-de-Mesquita and A Geelen and C D Stehouwer and P C Dagnelie and S J Eussen}, doi = {10.1016/j.nut.2018.10.015}, issn = {0899-9007}, year = {2019}, date = {2019-01-01}, journal = {Nutrition}, volume = {62}, pages = {39-46}, abstract = {OBJECTIVE: The aim of this study was to develop and validate a comprehensive food frequency questionnaire (FFQ) for The Maastricht Study, a population-based prospective cohort study in Maastricht, The Netherlands. METHODS: Item selection for the FFQ was based on explained variation and contribution to intake of energy and 24 nutrients. For validation, the FFQ was completed by 135 participants (25-70 y of age) of the Nutrition Questionnaires plus study. Per person, on average 2.8 (range 1-5) telephone-based 24-h dietary recalls (24HRs), two 24-h urinary samples, and one blood sample were available. Validity of 54 nutrients and 22 food groups was assessed by ranking agreement, correlation coefficients, attenuation factors, and ultimately deattenuated correlation coefficients (validity coefficients). RESULTS: Median correlation coefficients for energy and macronutrients, micronutrients, and food groups were 0.45, 0.36, and 0.38, respectively. Median deattenuated correlation coefficients were 0.53 for energy and macronutrients, 0.45 for micronutrients, and 0.64 for food groups, being \>0.50 for 18 of 22 macronutrients, 16 of 30 micronutrients and \>0.50 for 17 of 22 food groups. The FFQ underestimated protein and potassium intake compared with 24-h urinary nitrogen and potassium excretion by -18% and -2%, respectively. Correlation coefficients ranged from 0.50 and 0.55 for (fatty) fish intake and plasma eicosapentaenoic acid and docosahexaenoic acid, and from 0.26 to 0.42 between fruit and vegetable intake and plasma carotenoids. CONCLUSION: Overall, the validity of the 253-item Maastricht FFQ was satisfactory. The comprehensiveness of this FFQ make it well suited for use in The Maastricht Study and similar populations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16698, title = {One-carbon metabolism biomarkers and risk of urothelial cell carcinoma in the European prospective investigation into cancer and nutrition}, author = {A Vrieling and H B Bueno-De-Mesquita and M M Ros and E Kampman and K K Aben and F L Buchner and E H Jansen and N Roswall and A Tjonneland and M C Boutron-Ruault and C Cadeau and J Chang-Claude and R Kaaks and S Weikert and H Boeing and A Trichopoulou and P Lagiou and D Trichopoulos and S Sieri and D Palli and S Panico and P H Peeters and E Weiderpass and G Skeie and P Jakszyn and M D Chirlaque and E Ardanaz and M J Sanchez and R Ehrnstrom and J Malm and B Ljungberg and K T Khaw and N J Wareham and P Brennan and M Johansson and E Riboli and L A Kiemeney}, doi = {10.1002/ijc.32165}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, volume = {145}, number = {9}, pages = {2349-2359}, abstract = {Published associations between dietary folate and bladder cancer risk are inconsistent. Biomarkers may provide more accurate measures of nutrient status. This nested case-control analysis within the European Prospective Investigation into Cancer and Nutrition (EPIC) investigated associations between pre-diagnostic serum folate, homocysteine, vitamins B6 and B12 and the risk of urothelial cell carcinomas of the bladder (UCC). A total of 824 patients with newly diagnosed UCC were matched with 824 cohort members. Serum folate, homocysteine, and vitamins B6 and B12 were measured. Odds ratios (OR) and 95% confidence intervals (CI) for total, aggressive, and non-aggressive UCC were estimated using conditional logistic regression with adjustment for smoking status, smoking duration and intensity, and other potential confounders. Additionally, statistical interaction with smoking status was assessed. A halving in serum folate concentrations was moderately associated with risk of UCC (OR: 1.18; 95% CI: 0.98-1.43), in particular aggressive UCC (OR: 1.34; 95% CI: 1.02-1.75; p-heterogeneity = 0.19). Compared to never smokers in the highest quartile of folate concentrations, this association seemed only apparent among current smokers in the lowest quartile of folate concentrations (OR: 6.26; 95% CI: 3.62-10.81}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16768, title = {Agnostic Pathway/Gene Set Analysis of Genome-Wide Association Data Identifies Associations for Pancreatic Cancer}, author = {N Walsh and H Zhang and P L Hyland and Q Yang and E Mocci and M Zhang and E J Childs and I Collins and Z Wang and A A Arslan and L Beane-Freeman and P M Bracci and P Brennan and F Canzian and E J Duell and S Gallinger and G G Giles and M Goggins and G E Goodman and P J Goodman and R J Hung and C Kooperberg and R C Kurtz and N Malats and L Lemarchand and R E Neale and S H Olson and G Scelo and X O Shu and S K Van Den Eeden and K Visvanathan and E White and W Zheng and D Albanes and G Andreotti and A Babic and W R Bamlet and S I Berndt and A Borgida and M C Boutron-Ruault and L Brais and B Bueno-De-Mesquita and J Buring and K G Chaffee and S Chanock and S Cleary and M Cotterchio and L Foretova and C Fuchs and J M M Gaziano and E Giovannucci and T Hackert and C Haiman and P Hartge and M Hasan and K J Helzlsouer and J Herman and I Holcatova and E A Holly and R Hoover and V Janout and E A Klein and D Laheru and I M Lee and L Lu and S Mannisto and R L Milne and A L Oberg and I Orlow and A V Patel and U Peters and M Porta and F X Real and N Rothman and H D Sesso and G Severi and D Silverman and O Strobel and M Sund and M D Thornquist and G S Tobias and J Wactawski-Wende and N Wareham and E Weiderpass and N Wentzensen and W Wheeler and H Yu and A Zeleniuch-Jacquotte and P Kraft and D Li and E J Jacobs and G M Petersen and B M Wolpin and H A Risch and L T Amundadottir and K Yu and A P Klein and R Z Stolzenberg-Solomon}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85068554437\&doi=10.1093%2fjnci%2fdjy155\&partnerID=40\&md5=a302cf2127319a770a2ac68663096df3}, doi = {10.1093/jnci/djy155}, year = {2019}, date = {2019-01-01}, journal = {Journal of the National Cancer Institute}, volume = {111}, number = {6}, pages = {557-567}, abstract = {Background: Genome-wide association studies (GWAS) identify associations of individual single-nucleotide polymorphisms (SNPs) with cancer risk but usually only explain a fraction of the inherited variability. Pathway analysis of genetic variants is a powerful tool to identify networks of susceptibility genes. Methods: We conducted a large agnostic pathway-based meta-analysis of GWAS data using the summary-based adaptive rank truncated product method to identify gene sets and pathways associated with pancreatic ductal adenocarcinoma (PDAC) in 9040 cases and 12 496 controls. We performed expression quantitative trait loci (eQTL) analysis and functional annotation of the top SNPs in genes contributing to the top associated pathways and gene sets. All statistical tests were two-sided. Results: We identified 14 pathways and gene sets associated with PDAC at a false discovery rate of less than 0.05. After Bonferroni correction (P ≤ 1.3 × 10-5), the strongest associations were detected in five pathways and gene sets, including maturity-onset diabetes of the young, regulation of beta-cell development, role of epidermal growth factor (EGF) receptor transactivation by G protein-coupled receptors in cardiac hypertrophy pathways, and the Nikolsky breast cancer chr17q11-q21 amplicon and Pujana ATM Pearson correlation coefficient (PCC) network gene sets. We identified and validated rs876493 and three correlating SNPs (PGAP3) and rs3124737 (CASP7) from the Pujana ATM PCC gene set as eQTLs in two normal derived pancreas tissue datasets. Conclusion: Our agnostic pathway and gene set analysis integrated with functional annotation and eQTL analysis provides insight into genes and pathways that may be biologically relevant for risk of PDAC, including those not previously identified. © The Author(s) 2019.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16705, title = {Gallstones and incident colorectal cancer in a large pan-European cohort study}, author = {H A Ward and N Murphy and E Weiderpass and M F Leitzmann and E Aglago and M J Gunter and H Freisling and M Jenab and M C Boutron-Ruault and G Severi and F Carbonnel and T Kuhn and R Kaaks and H Boeing and A Tjonneland and A Olsen and K Overvad and S Merino and R Zamora-Ros and M Rodriguez-Barranco and M Dorronsoro and M D Chirlaque and A Barricarte and A Perez-Cornago and A Trichopoulou and C Bamia and P Lagiou and G Masala and S Grioni and R Tumino and C Sacerdote and A Mattiello and B Bueno-de-Mesquita and R Vermeulen and C Van Gils and H Nystrom and M Rutegard and D Aune and E Riboli and A J Cross}, doi = {10.1002/ijc.32090}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, volume = {145}, number = {6}, pages = {1510-1516}, abstract = {Gallstones, a common gastrointestinal condition, can lead to several digestive complications and can result in inflammation. Risk factors for gallstones include obesity, diabetes, smoking and physical inactivity, all of which are known risk factors for colorectal cancer (CRC), as is inflammation. However, it is unclear whether gallstones are a risk factor for CRC. We examined the association between history of gallstones and CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a prospective cohort of over half a million participants from ten European countries. History of gallstones was assessed at baseline using a self-reported questionnaire. The analytic cohort included 334,986 participants; a history of gallstones was reported by 3,917 men and 19,836 women, and incident CRC was diagnosed among 1,832 men and 2,178 women (mean follow-up: 13.6 years). Hazard ratios (HR) and 95% confidence intervals (CI) for the association between gallstones and CRC were estimated using Cox proportional hazards regression models, stratified by sex, study centre and age at recruitment. The models were adjusted for body mass index, diabetes, alcohol intake and physical activity. A positive, marginally significant association was detected between gallstones and CRC among women in multivariable analyses (HR = 1.14, 95%CI 0.99-1.31}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16688, title = {The associations of anthropometric, behavioural and sociodemographic factors with circulating concentrations of IGF-I, IGF-II, IGFBP-1, IGFBP-2 and IGFBP-3 in a pooled analysis of 16,024 men from 22 studies}, author = {E L Watts and A Perez-Cornago and P N Appleby and D Albanes and E Ardanaz and A Black and H B Bueno-de-Mesquita and J M Chan and C Chen and S A P Chubb and M B Cook and M Deschasaux and J L Donovan and D R English and L Flicker and N D Freedman and P Galan and G G Giles and E L Giovannucci and M J Gunter and L A Habel and C Haggstrom and C Haiman and F C Hamdy and S Hercberg and J M Holly and J Huang and W Y Huang and M Johansson and R Kaaks and T Kubo and J A Lane and T M Layne and L Le Marchand and R M Martin and E J Metter and K Mikami and R L Milne and H A Morris and L A Mucci and D E Neal and M L Neuhouser and S E Oliver and K Overvad and K Ozasa and V Pala and C H Pernar and M Pollak and M A Rowlands and C A Schaefer and J M Schenk and P Stattin and A Tamakoshi and E Thysell and M Touvier and A Trichopoulou and K K Tsilidis and S K Van Den Eeden and S J Weinstein and L Wilkens and B B Yeap and T J Key and N E Allen and R C Travis}, doi = {10.1002/ijc.32276}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, volume = {145}, number = {12}, pages = {3244-3256}, abstract = {Insulin-like growth factors (IGFs) and insulin-like growth factor binding proteins (IGFBPs) have been implicated in the aetiology of several cancers. To better understand whether anthropometric, behavioural and sociodemographic factors may play a role in cancer risk via IGF signalling, we examined the cross-sectional associations of these exposures with circulating concentrations of IGFs (IGF-I and IGF-II) and IGFBPs (IGFBP-1, IGFBP-2 and IGFBP-3). The Endogenous Hormones, Nutritional Biomarkers and Prostate Cancer Collaborative Group dataset includes individual participant data from 16,024 male controls (i.e. without prostate cancer) aged 22-89 years from 22 prospective studies. Geometric means of protein concentrations were estimated using analysis of variance, adjusted for relevant covariates. Older age was associated with higher concentrations of IGFBP-1 and IGFBP-2 and lower concentrations of IGF-I, IGF-II and IGFBP-3. Higher body mass index was associated with lower concentrations of IGFBP-1 and IGFBP-2. Taller height was associated with higher concentrations of IGF-I and IGFBP-3 and lower concentrations of IGFBP-1. Smokers had higher concentrations of IGFBP-1 and IGFBP-2 and lower concentrations of IGFBP-3 than nonsmokers. Higher alcohol consumption was associated with higher concentrations of IGF-II and lower concentrations of IGF-I and IGFBP-2. African Americans had lower concentrations of IGF-II, IGFBP-1, IGFBP-2 and IGFBP-3 and Hispanics had lower IGF-I, IGF-II and IGFBP-3 than non-Hispanic whites. These findings indicate that a range of anthropometric, behavioural and sociodemographic factors are associated with circulating concentrations of IGFs and IGFBPs in men, which will lead to a greater understanding of the mechanisms through which these factors influence cancer risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16759, title = {Pedometer-determined physical activity among primary schoolchildren in Kuala Lumpur}, author = {B S Wee and A Bulgiba and A T Ruzita and M N Ismail and B K Poh}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85070371762\&doi=10.1177%2f2010105818823784\&partnerID=40\&md5=60ee195ff02935227443a7ec6a50cfb1}, doi = {10.1177/2010105818823784}, year = {2019}, date = {2019-01-01}, journal = {Proceedings of Singapore Healthcare}, volume = {28}, number = {2}, pages = {115-123}, abstract = {Objective: The aim of this study was to objectively measure physical activity and its association with sociodemographic factors among Malaysian primary school-age children. Methods: A total of 111 primary school children in Kuala Lumpur were selected through random sampling. Activity pattern was determined using pedometers and differences by sex, ethnicity and body mass index categories were analysed. The relationship between pedometer-determined physical activity and sociodemographic factors were also studied. Results: Overall, boys attained significantly higher daily step counts than girls (9573 ± 4145 vs 7313 ± 2697). Significant difference in daily step counts between boys and girls were observed during weekdays (p\<0.01), weekends (p\<0.05) and total mean step counts (p\<0.01). Malay ethnicity showed higher daily step counts during weekdays than weekends (p\<0.05). Compared with boys, girls had higher odds (OR=5.58; 95% CI 1.12, 27.77) of not meeting the recommended daily step counts. Those who had low physical activity levels had higher odds (OR=15.75; 95% CI 1.78, 139.33) of not meeting recommended daily step counts than children who had moderate physical activity level. Conclusion: Boys were significantly more active than girls and physical activity was greater during weekdays than on weekends. The primary schoolchildren in Kuala Lumpur were sedentary, with minimum physical activity being observed. Differences in sexes and physical activity levels influenced pedometer step counts in children. © The Author(s) 2019.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16803, title = {Nutritional status of post-acute stroke patients during rehabilitation phase in hospital}, author = {C C Weun and N Hasnan and L A Latif and H A Majid}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85062292968\&doi=10.17576%2fjsm-2019-4801-15\&partnerID=40\&md5=3c884ade54c5b6fd03d00bcd5eef19f5}, doi = {10.17576/jsm-2019-4801-15}, year = {2019}, date = {2019-01-01}, journal = {Sains Malaysiana}, volume = {48}, number = {1}, pages = {129-135}, abstract = {Malnutrition is highly prevalent among stroke patients during post-acute rehabilitation phase and may give a negative effect on rehabilitation and impair recovery. However, to date, there is no reported study in Malaysia investigating the nutritional status of stroke patients during rehabilitation phase. Thus, this paper aims to report the preliminary results of nutritional assessment for a randomized controlled trial at baseline. All participating patients were assessed for anthropometric measurements, nutritional status using validated Mini Nutrition Assessment (MNA), 24 h diet recall, and handgrip strength. Demographic data, biochemical profiles and functional outcomes (Modified Barthel Index Score, Motor Assessment Scale) were obtained from patients’ medical record. From a total of 45 post-acute stroke patients at baseline, 24.4% of them were malnourished during admission to rehabilitation ward and 66.7% of the patients were at risk of malnutrition. Mean dietary intake and protein intake of the patients were 1489 ± 297 kcal/day and 66.1 ± 17.2 g/ day, respectively. Mean handgrip strength for the patients was 17.9 ± 8.1 kg. Weight, body mass index, serum albumin, handgrip strength, Modified Barthel Index and Motor Assessment Scale score were positively correlated with MNA score (p\<0.05), but no correlation was found for the dietary intake (r=0.163}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16696, title = {An inverse association between the Mediterranean diet and bladder cancer risk: a pooled analysis of 13 cohort studies}, author = {W J A Witlox and F H M Osch and M Brinkman and S Jochems and M E Goossens and E Weiderpass and E White and P A Brandt and G G Giles and R L Milne and I Huybrechts and H O Adami and B Bueno-de-Mesquita and A Wesselius and M P Zeegers}, doi = {10.1007/s00394-019-01907-8}, issn = {1436-6207}, year = {2019}, date = {2019-01-01}, journal = {Eur J Nutr}, abstract = {PURPOSE: The role of diet in bladder carcinogenesis has yet to be established. To date most studies have investigated dietary components individually, rather than as dietary patterns, which may provide stronger evidence for any influence of diet on bladder carcinogenesis. The Mediterranean diet has been associated with many health benefits, but few studies have investigated its association with bladder cancer risk. METHODS: We investigated the potential association between the Mediterranean diet score (MDS) and risk of developing bladder cancer by pooling 13 prospective cohort studies included in the BLadder cancer Epidemiology and Nutritional Determinants (BLEND) study and applying a Cox regression analysis. RESULTS: Dietary data from 646,222 study participants, including 3639 incident bladder cancer cases, were analysed. We observed an inverse association between Mediterranean diet and bladder cancer risk (HRhigh 0.85 [95% CI 0.77, 0.93]). When stratifying the results on non-muscle-invasive or muscle-invasive disease or sex the association remained similar and the HR estimate was consistently below 1.00 both for medium and high adherence to the Mediterranean diet. A consistent association was observed when disregarding fat or alcohol intake. CONCLUSION: We found evidence that adherence to the Mediterranean diet was associated with reduced risk of developing bladder cancer, suggesting a positive effect of the diet as a whole and not just one component.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16635, title = {The mobile-phone-based iCO(TM) Smokerlyzer((R)): Comparison with the piCO(+) Smokerlyzer((R)) among smokers undergoing methadone-maintained therapy}, author = {H Y Wong and M Subramaniyan and C Bullen and A N Amer Siddiq and M Danaee and A Yee}, doi = {10.18332/tid/111355}, issn = {1617-9625}, year = {2019}, date = {2019-01-01}, journal = {Tob Induc Dis}, volume = {17}, pages = {65}, abstract = {INTRODUCTION: The mobile-phone-based Bedfont iCO(TM) Smokerlyzer((R)) is of unknown validity and reproducibility compared to the widely-used piCO(+) Smokerlyzer((R)). We aimed to compare the validity and reproducibility of the iCO(TM) Smokerlyzer((R)) with the piCO(+) Smokerlyzer((R)) among patients reducing or quitting tobacco smoking. METHODS: Methadone-maintained therapy (MMT) users from three centers in Malaysia had their exhaled carbon monoxide (eCO) levels recorded via the piCO(+) and iCO(TM) Smokerlyzers((R)), their nicotine dependence assessed with the Malay version of the Fagerstrom Test for Nicotine Dependence (FTND-M), and daily tobacco intake measured via the Opiate Treatment Index (OTI) Tobacco Q-score. Pearson partial correlations were used to compare the eCO results of both devices, as well as the corresponding FTND-M scores. RESULTS: Among the 146 participants (mean age 47.9 years, 92.5% male, and 73.3% Malay ethnic group) most (55.5%) were moderate smokers (6-19 cigarettes/day). Mean eCO categories were significantly correlated between both devices (r=0.861, p\<0.001), and the first and second readings were significantly correlated for each device (r=0.94 for the piCO(+) Smokerlyzer((R)), p\<0.001; r=0.91 for the iCO(TM) Smokerlyzer((R)), p\<0.001). Exhaled CO correlated positively with FTND-M scores for both devices. The post hoc analysis revealed a significantly lower iCO(TM) Smokerlyzer((R)) reading of 0.82 (95% CI: 0.69-0.94, p\<0.001) compared to that of the piCO(+) Smokerlyzer((R)), and a significant intercept of -0.34 (95% CI: -0.61 - -0.07}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16806, title = {The mobile-phone-based iCOTM Smokerlyzer®: Comparison with the piCO+ Smokerlyzer® among smokers undergoing methadone-maintained therapy}, author = {H Y Wong and M Subramaniyan and C Bullen and A N Amer Siddiq and M Danaee and A Yee}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85076393878\&doi=10.18332%2ftid%2f111355\&partnerID=40\&md5=cf82b2b4c334c755a6f16c530711b2da}, doi = {10.18332/tid/111355}, year = {2019}, date = {2019-01-01}, journal = {Tobacco Induced Diseases}, volume = {17}, number = {September}, abstract = {INTRODUCTION The mobile-phone-based Bedfont iCOTM Smokerlyzer® is of unknown validity and reproducibility compared to the widely-used piCO+ Smokerlyzer®. We aimed to compare the validity and reproducibility of the iCOTM Smokerlyzer® with the piCO+ Smokerlyzer® among patients reducing or quitting tobacco smoking. METHODS Methadone-maintained therapy (MMT) users from three centers in Malaysia had their exhaled carbon monoxide (eCO) levels recorded via the piCO+ and iCOTM Smokerlyzers®, their nicotine dependence assessed with the Malay version of the Fagerstr\"{o}m Test for Nicotine Dependence (FTND-M), and daily tobacco intake measured via the Opiate Treatment Index (OTI) Tobacco Q-score. Pearson partial correlations were used to compare the eCO results of both devices, as well as the corresponding FTND-M scores. RESULTS Among the 146 participants (mean age 47.9 years, 92.5% male, and 73.3% Malay ethnic group) most (55.5%) were moderate smokers (6-19 cigarettes/day). Mean eCO categories were significantly correlated between both devices (r=0.861, p\<0.001), and the first and second readings were significantly correlated for each device (r=0.94 for the piCO+ Smokerlyzer®, p\<0.001; r=0.91 for the iCOTM Smokerlyzer®, p\<0.001). Exhaled CO correlated positively with FTND-M scores for both devices. The post hoc analysis revealed a significantly lower iCOTM Smokerlyzer® reading of 0.82 (95% CI: 0.69-0.94, p\<0.001) compared to that of the piCO+ Smokerlyzer®, and a significant intercept of -0.34 (95% CI: -0.61 - -0.07}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16712, title = {A Nationwide Study Comparing Knowledge and Beliefs about HPV among Female Students before and after HPV Vaccination}, author = {L P Wong and H Alias and I C Sam and G D Zimet}, doi = {10.1016/j.jpag.2018.10.010}, issn = {1083-3188}, year = {2019}, date = {2019-01-01}, journal = {J Pediatr Adolesc Gynecol}, volume = {32}, number = {2}, pages = {158-164}, abstract = {STUDY OBJECTIVE: To assess the knowledge and beliefs regarding human papillomavirus (HPV) and the HPV vaccine among girls before and after vaccination in the Malaysian HPV Immunisation Programme. DESIGN: A nationwide longitudinal survey. SETTING: Thirty-two randomly selected schools from 13 states and 3 federal territories in Malaysia from February to March 2013, and October to November 2013. PARTICIPANTS: Form One female students (13 years old). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Mean knowledge score of HPV infection. RESULTS: A total of 2644 students responded to the prevaccination survey, of whom 2005 (70%) completed the postvaccination survey. The mean knowledge score was 2.72 (SD +/- 2.20) of a maximum score of 10 in the prevaccination survey, which increased significantly to 3.33 (SD +/- 1.73) after the 3 doses of HPV vaccine (P = .001). Many answered incorrectly that, "Only girls can get HPV infection" (91.5%}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16665, title = {Are Boys Ready for Human Papillomavirus Vaccine? A National Study of Boys in Malaysia}, author = {L P Wong and H Alias and Rnarm Yusoff and I C Sam and G D Zimet}, doi = {10.1097/olq.0000000000001024}, issn = {0148-5717}, year = {2019}, date = {2019-01-01}, journal = {Sex Transm Dis}, volume = {46}, number = {9}, pages = {617-624}, abstract = {BACKGROUND: The aim of this study was to investigate factors associated with the willingness of boys to accept the human papillomavirus (HPV) vaccine. METHODS: A nationwide cross-sectional survey among Secondary One male students in Malaysia. RESULTS: Among 2823 respondents, knowledge about HPV infection and the HPV vaccine was extremely poor. The mean total knowledge score was only 3.17 (SD +/- 2.14), out of a possible score of 10. The majority of respondents were unaware that vaccinating boys can help protect girls against HPV infection (81.6%), and HPV is a sexually transmitted infection (70.1%). Many had the misconception that only females get HPV (78.9%). In multivariable analysis, the factors associated with the intention to receive the HPV vaccination were: agreeing boys need to be vaccinated against HPV infection (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.57-2.68), perceiving their parents might allow them to get the HPV vaccine (OR, 1.66; 95% CI, 1.18-2.34), perceived susceptibility to HPV infection (OR, 1.63; 95% CI, 1.06-2.52), and attending a rural school (OR, 1.49; 95% CI, 1.14-1.95). CONCLUSIONS: Public health educational programs that are focused and tailored on parents consenting to HPV vaccination for boys at a young age can be useful in improving HPV vaccination rates among boys. There is also a pressing need to educate boys about the benefits of HPV vaccination in males and about HPV disease susceptibility to facilitate adoption of the HPV vaccine by young adults in the future.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16678, title = {Current issues facing the introduction of human papillomavirus vaccine in China and future prospects}, author = {L P Wong and L Han and H Li and J Zhao and Q Zhao and G D Zimet}, doi = {10.1080/21645515.2019.1611157}, issn = {2164-5515}, year = {2019}, date = {2019-01-01}, journal = {Hum Vaccin Immunother}, volume = {15}, number = {7-8}, pages = {1533-1540}, abstract = {The introduction of human papillomavirus (HPV) vaccination in China aims to prevent HPV infection in all women. The issues that China might face include high cost of vaccines made in other countries, shortage in HPV vaccine supply, negative events attributed to vaccination (whether justified or not) that jeopardizes the general public's confidence in the HPV vaccine, cultural and literacy barriers, and sensitivity to receiving a vaccine for a sexually transmitted disease. Ensuring the effective delivery of the HPV vaccine in China, a country with vast economic, geographical, and cultural complexities, will require a commitment of significant resources. In light of the high price of imported vaccines, the availability of locally manufactured HPV vaccines would greatly facilitate the national HPV vaccination program. New evidence supporting the efficacy of a two-dose regime in younger adolescents would also be advantageous in terms of affordability and logistical simplicity of vaccine administration. Furthermore, it would potentially enhance the compliance and uptake, especially for hard to reach women in remote regions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16647, title = {Diagnosis of severe dengue: Challenges, needs and opportunities}, author = {P F Wong and L P Wong and S AbuBakar}, doi = {10.1016/j.jiph.2019.07.012}, issn = {1876-0341}, year = {2019}, date = {2019-01-01}, journal = {J Infect Public Health}, abstract = {BACKGROUND: Delayed diagnosis of dengue cases with increased risk for severe disease could lead to poor disease outcome. To date there is no specific laboratory diagnostic test for severe dengue. This qualitative study explored expert views regarding current issues in diagnosing severe dengue, rationale for severe dengue-specific diagnostics, future prospects and features of potential diagnostics for severe dengue. METHODS: In-depth individual interviews with thematic saturation were conducted between May and July 2018. The data was analyzed using thematic analysis. RESULTS: Based on expert opinion, diagnosis of severe dengue is challenging as it depends on astute clinical interpretation of non-dengue-specific clinical and laboratory findings. A specific test that detects impending manifestation of severe dengue could 1) overcome failure in identifying severe disease for referral or admission, 2) facilitate timely and appropriate management of plasma leakage and bleeding, 3) overcome the lack of clinical expertise and laboratory diagnosis in rural health settings. The most important feature of any diagnostics for severe dengue is the point-of-care (POC) format where it can be performed at or near the bedside. CONCLUSION: The development of diagnostics to detect impending severe dengue is warranted to reduce the morbidity and mortality rates of dengue infection and it should be prioritized.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16621, title = {Health facility use by dengue patients in the Klang Valley, Malaysia: a secondary analysis of dengue surveillance data}, author = {Y L Woon and C W Ng and R N Mudin and Z Suli}, doi = {10.5365/wpsar.2019.10.1.001}, issn = {2094-7321}, year = {2019}, date = {2019-01-01}, journal = {Western Pac Surveill Response J}, volume = {10}, number = {2}, pages = {39-45}, abstract = {Background: Dengue patients in Malaysia have the choice to seek care from either public or private sector providers. This study aims to analyse the pattern of health facility use among dengue patients to provide input for the ongoing policy discussion regarding public-private integration. The focus of this study is in the Klang Valley, which has a high dengue burden as well as a high number of private facilities. Methods: This is a cross-sectional study using an available secondary data source - the Malaysian national dengue passive surveillance system, e-Dengue registry. A total of 61 455 serologically confirmed dengue cases from the Klang Valley, registered in year 2014, were included. We retrospectively examined the relationship between demographic factors and the choice of health-care sector by logistic regression. Results: The median age of the cohort was 26 (interquartile range: 17 to 37) years. More private facilities (54.4%) were used for inpatient care; more public facilities (68.2%) were used for outpatient care. The Chinese and urban populations showed significantly higher use of the private health-care sector with an adjusted odds ratio of 4.8 [95% confidence interval (CI): 4.6-5.1] and 2.3 (95% CI: 2.2-2.4), respectively. Conclusion: Both public and private health facilities bear significant responsibilities in delivering health-care services to dengue patients. The workload of both sectors should be included in future health policy planning by public agencies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16701, title = {Risk of all-cause and CHD mortality in women versus men with type 2 diabetes: a systematic review and meta-analysis}, author = {G Xu and D You and L Wong and D Duan and F Kong and X Zhang and J Zhao and W Xing and L Han and L Li}, doi = {10.1530/eje-18-0792}, issn = {0804-4643}, year = {2019}, date = {2019-01-01}, journal = {Eur J Endocrinol}, volume = {180}, number = {4}, pages = {243-255}, abstract = {Objective: Previous studies have shown sex-specific differences in all-cause and CHD mortality in type 2 diabetes. We performed a systematic review and meta-analysis to provide a global picture of the estimated influence of type 2 diabetes on the risk of all-cause and CHD mortality in women vs men. Methods: We systematically searched PubMed, EMBASE and Web of Science for studies published from their starting dates to Aug 7, 2018. The sex-specific hazard ratios (HRs) and their pooled ratio (women vs men) of all-cause and CHD mortality associated with type 2 diabetes were obtained through an inverse variance-weighted random-effects meta-analysis. Subgroup analyses were used to explore the potential sources of heterogeneity. Results: The 35 analyzed prospective cohort studies included 2 314 292 individuals, among whom 254 038 all-cause deaths occurred. The pooled women vs men ratio of the HRs for all-cause and CHD mortality were 1.17 (95% CI: 1.12-1.23}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16723, title = {Consequences of Elder Abuse and Neglect: A Systematic Review of Observational Studies}, author = {R M Yunus and N N Hairi and W Y Choo}, doi = {10.1177/1524838017692798}, issn = {1524-8380}, year = {2019}, date = {2019-01-01}, journal = {Trauma Violence Abuse}, volume = {20}, number = {2}, pages = {197-213}, abstract = {This article presents the results of a systematic review of the consequences of elder abuse and neglect (EAN). A systematic search was conducted in seven electronic databases and three sources of gray literature up to January 8, 2016, supplemented by scanning of citation lists in relevant articles and contact with field experts. All observational studies investigating elder abuse as a risk factor for adverse health outcomes, mortality, and health-care utilization were included. Of 517 articles initially captured, 19 articles met our inclusion criteria and were analyzed. Two reviewers independently performed abstract screening, full-texts appraisal, and quality assessment using the Newcastle-Ottawa Scale. Across 19 studies, methodological heterogeneity was a prominent feature; seven definitions of EAN and nine measurement tools for abuse were employed. Summary of results reveals a wide range of EAN outcomes, from premature mortality to increased health-care consumption and various forms of physical and psychological symptoms. Higher risks of mortality emerged as the most credible outcome, while the majority of morbidity outcomes originated from cross-sectional studies. Our findings suggest that there is an underrepresentation of older adults from non-Western populations and developing countries, and there is a need for more population-based prospective studies in middle- and low-income regions. Evidence gathered from this review is crucial in upgrading current practices, formulating policies, and shaping the future direction of research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16717, title = {Does abuse in late life worsen sleep quality? A two-year prospective cohort study among rural older adults}, author = {R M Yunus and N N Hairi and C Yuen and R Sooryanarayana and F Hairi and N Ismail and S Kandiben and T N Peng and Z M Ali and S N Ahmad and I A Razak and S Othman and D Peramalah and F H M Mydin and A Bulgiba}, doi = {10.1002/gps.4986}, issn = {0885-6230}, year = {2019}, date = {2019-01-01}, journal = {Int J Geriatr Psychiatry}, volume = {34}, number = {1}, pages = {60-66}, abstract = {BACKGROUND: Elder abuse and neglect (EAN) is a growing public health problem, and numerous adverse health effects of abuse in late life have been documented. Little is known, however, about the impact of elder abuse on sleep quality. This study examines the longitudinal relationship between EAN and sleep quality. METHODS: This was a 2-year prospective cohort study involving 1927 older adults in a rural Malaysian district, Kuala Pilah. A multi-stage cluster sampling strategy was employed. After 2 years, 1189 respondents were re-assessed. EAN was determined using the modified Conflict Tactic Scale, while sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). RESULTS: The prevalence of elder abuse was 8.1% (95% CI:6.9,9.3). Longitudinal analysis using generalized estimating equations showed that elder abuse contributed to higher PSQI scores (B:0.49, 95% CI:0.17,0.58). Sub-analyses demonstrated that psychological abuse and neglect had significant longitudinal relationships with increase of PSQI scores, while other subtypes did not. CONCLUSION: Abuse in late life, particularly psychological abuse and neglect, result in greater PSQI scores. Even though this may imply decline in sleep quality, our findings were not considered clinically significant as they did not exceed the clinical cut-off score of five. Nevertheless, sleep quality is an important determinant of health and a predictor of mortality among older adults; thus, understanding its relationship with abuse is useful to health care providers and policy-makers in improving health services and upgrading preventive measures.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16661, title = {Cost of preterm birth during initial hospitalization: A care provider's perspective}, author = {H Zainal and M Dahlui and S A Soelar and T T Su}, doi = {10.1371/journal.pone.0211997}, issn = {1932-6203}, year = {2019}, date = {2019-01-01}, journal = {PLoS One}, volume = {14}, number = {6}, pages = {e0211997}, abstract = {Preterm birth incidence has risen globally and remains a major cause of neonatal mortality despite improved survival. Demand and cost of initial hospitalization has also increased. This study assessed the cost of preterm birth during initial hospitalization from care provider perspective in neonatal intensive care units (NICU) of two hospitals in the state of Kedah, Malaysia. It utilized universal sampling and prospectively followed up preterm infants till discharge. Care provider cost was assessed using mixed method of top down approach and activity based costing. A total of 112 preterm infants were recruited from intensive care (93 infants) and minimal care (19 infants) units. Majority were from the moderate (23%) and late (36%) preterm groups followed by very preterm (32%) and extreme preterm (9%). Median cost per infant increased with level of care and degree of prematurity. Cost was dominated by overhead (fixed) costs for general (hospital), intermediate (clinical support services) and final (NICU) cost centers where it constituted at least three quarters of admission cost per infant while the remainder was consumables (variable) cost. Breakdown of overhead cost showed NICU specific overhead contributing at least two thirds of admission cost per infant. Personnel salary made up three quarters of NICU specific overhead. Laboratory investigation was the cost driver for consumables. Gender, birth weight and length of stay were significant factors and cost prediction was developed with these variables. This study demonstrated the inverse relation between resource utilization, cost and prematurity and identified personnel salary as the cost driver. Cost estimates and prediction provide in-depth understanding of provider cost and are applicable for further economic evaluations. Since gender is non-modifiable and reducing LOS alone is not effective, birth weight as a cost predictive factor in this study can be addressed through measures to prevent or delay preterm birth.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16691, title = {Public perception and attitude towards dengue prevention activity and response to dengue early warning in Malaysia}, author = {R Zaki and S N Roffeei and Y L Hii and A Yahya and M Appannan and M A Said and N C Wan and N Aghamohammadi and N N Hairi and A Bulgiba and M Quam and J Rocklov}, doi = {10.1371/journal.pone.0212497}, issn = {1932-6203}, year = {2019}, date = {2019-01-01}, journal = {PLoS One}, volume = {14}, number = {2}, pages = {e0212497}, abstract = {An early warning system for dengue is meant to predict outbreaks and prevent dengue cases by aiding timely decision making and deployment of interventions. However, only a system which is accepted and utilised by the public would be sustainable in the long run. This study aimed to explore the perception and attitude of the Malaysian public towards a dengue early warning system. The sample consisted of 847 individuals who were 18 years and above and living/working in the Petaling District, an area adjacent to Kuala Lumpur, Malaysia. A questionnaire consisting of personal information and three sub-measures of; i) perception, ii) attitude towards dengue early warning and iii) response towards early warning; was distributed to participants. We found that most of the respondents know about dengue fever (97.1%) and its association with climate factors (90.6%). Most of them wanted to help reduce the number of dengue cases in their area (91.5%). A small percentage of the respondents admitted that they were not willing to be involved in public activities, and 64% of them admitted that they did not check dengue situations or hotspots around their area regularly. Despite the high awareness on the relationship between climate and dengue, about 45% of respondents do not know or are not sure how this can be used to predict dengue. Respondents would like to know more about how climate data can be used to predict a dengue outbreak (92.7%). Providing more information on how climate can influence dengue cases would increase public acceptability and improve response towards climate-based warning system. The most preferred way of communicating early warning was through the television (66.4%). This study shows that the public in Petaling District considers it necessary to have a dengue warning system to be necessary, but more education is required.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16706, title = {Coffee and tea drinking in relation to the risk of differentiated thyroid carcinoma: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) study}, author = {R Zamora-Ros and M A Alghamdi and V Cayssials and S Franceschi and M Almquist and J Hennings and M Sandstrom and K K Tsilidis and E Weiderpass and M C Boutron-Ruault and B Hammer Bech and K Overvad and A Tjonneland and K E N Petersen and F R Mancini and Y Mahamat-Saleh and F Bonnet and T Kuhn and R T Fortner and H Boeing and A Trichopoulou and C Bamia and G Martimianaki and G Masala and S Grioni and S Panico and R Tumino and F Fasanelli and G Skeie and T Braaten and C Lasheras and E Salamanca-Fernandez and P Amiano and M D Chirlaque and A Barricarte and J Manjer and P Wallstrom and H B Bueno-de-Mesquita and P H Peeters and K T Khaw and N J Wareham and J A Schmidt and D Aune and G Byrnes and A Scalbert and A Agudo and S Rinaldi}, doi = {10.1007/s00394-018-1874-z}, issn = {1436-6207}, year = {2019}, date = {2019-01-01}, journal = {Eur J Nutr}, volume = {58}, number = {8}, pages = {3303-3312}, abstract = {PURPOSE: Coffee and tea constituents have shown several anti-carcinogenic activities in cellular and animal studies, including against thyroid cancer (TC). However, epidemiological evidence is still limited and inconsistent. Therefore, we aimed to investigate this association in a large prospective study. METHODS: The study was conducted in the EPIC (European Prospective Investigation into Cancer and Nutrition) cohort, which included 476,108 adult men and women. Coffee and tea intakes were assessed through validated country-specific dietary questionnaires. RESULTS: During a mean follow-up of 14 years, 748 first incident differentiated TC cases (including 601 papillary and 109 follicular TC) were identified. Coffee consumption (per 100 mL/day) was not associated either with total differentiated TC risk (HRcalibrated 1.00, 95% CI 0.97-1.04) or with the risk of TC subtypes. Tea consumption (per 100 mL/day) was not associated with the risk of total differentiated TC (HRcalibrated 0.98, 95% CI 0.95-1.02) and papillary tumor (HRcalibrated 0.99, 95% CI 0.95-1.03), whereas an inverse association was found with follicular tumor risk (HRcalibrated 0.90, 95% CI 0.81-0.99), but this association was based on a sub-analysis with a small number of cancer cases. CONCLUSIONS: In this large prospective study, coffee and tea consumptions were not associated with TC risk.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16650, title = {Polyphenol intake and differentiated thyroid cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort}, author = {R Zamora-Ros and V Cayssials and S Franceschi and C Kyro and E Weiderpass and J Hennings and M Sandstrom and A Tjonneland and A Olsen and K Overvad and M C Boutron-Ruault and T Truong and F R Mancini and V Katzke and T Kuhn and H Boeing and A Trichopoulou and A Karakatsani and G Martimianaki and D Palli and V Krogh and S Panico and R Tumino and C Sacerdote and C Lasheras and M Rodriguez-Barranco and P Amiano and S M Colorado-Yohar and E Ardanaz and M Almquist and U Ericson and H B Bueno-de-Mesquita and R Vermeulen and J A Schmidt and G Byrnes and A Scalbert and A Agudo and S Rinaldi}, doi = {10.1002/ijc.32589}, issn = {0020-7136}, year = {2019}, date = {2019-01-01}, journal = {Int J Cancer}, abstract = {Polyphenols are bioactive compounds with several anticarcinogenic activities; however, human data regarding associations with thyroid cancer (TC) is still negligible. Our aim was to evaluate the association between intakes of total, classes and subclasses of polyphenols and risk of differentiated TC and its main subtypes, papillary and follicular, in a European population. The European Prospective Investigation into Cancer and Nutrition cohort included 476,108 men and women from 10 European countries. During a mean follow-up of 14 years, there were 748 incident differentiated TC cases, including 601 papillary and 109 follicular tumors. Polyphenol intake was estimated at baseline using validated center/country-specific dietary questionnaires and the Phenol-Explorer database. In multivariable-adjusted Cox regression models, no association between total polyphenol and the risks of overall differentiated TC (HRQ4 vs. Q1 = 0.99, 95% confidence interval [CI] 0.77-1.29), papillary (HRQ4 vs. Q1 = 1.06, 95% CI 0.80-1.41) or follicular TC (HRQ4 vs. Q1 = 1.10, 95% CI 0.55-2.22) were found. No associations were observed either for flavonoids, phenolic acids or the rest of classes and subclasses of polyphenols. After stratification by body mass index (BMI), an inverse association between the intake of polyphenols (p-trend = 0.019) and phenolic acids (p-trend = 0.007) and differentiated TC risk in subjects with BMI \>/= 25 was observed. In conclusion, our study showed no associations between dietary polyphenol intake and differentiated TC risk; although further studies are warranted to investigate the potential protective associations in overweight and obese individuals.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16627, title = {Predictors of low back pain among secondary school teachers in Malaysia: a longitudinal study}, author = {E N Zamri and V C W Hoe and F M Moy}, doi = {10.2486/indhealth.2019-0106}, issn = {0019-8366}, year = {2019}, date = {2019-01-01}, journal = {Ind Health}, abstract = {Low back pain (LBP) is prevalent among workers both in developed and developing countries. School teachers represent a high proportion of working population in Malaysia. However, there is a lack of longitudinal study on predictors and course of LBP among teachers. Therefore, this study aimed to determine the predictors and course of LBP among secondary school teachers. Longitudinal data of 701 teachers in Selangor, Malaysia were collected from May 2015 to October 2016. Associations between predictors and LBP were analysed using logistic regression and reported as odds ratio (OR) and 95% confidence interval (CI). At 12-month of follow-up, 44% (95%CI: 40.6%, 48.0%) of the participants reported to have LBP. In the regression model that included all risk factors, only LBP at baseline (OR 10.43, 95%CI: 6.19, 17.58) was associated with LBP at 12-month follow-up. When LBP at baseline was removed from the model, anxiety symptom (OR 2.51, 95%CI: 1.19, 5.30) and lifting heavy weights (OR 4.16, 95%CI: 1.40, 12.30) were found to be significantly associated with LBP at 12-month follow-up. In conclusion, issues on anxiety and lifting heavy weights should be addressed to reduce the occurrence of LBP despite the presence of health condition itself (LBP at baseline).}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16677, title = {Dietary patterns in relation to lipid profiles among Iranian adults}, author = {F Zaribaf and N Mohammadifard and N Sarrafzadegan and G Karimi and A Gholampour and L Azadbakht}, doi = {10.15171/jcvtr.2019.04}, issn = {2008-5117 (Print) 2008-5117}, year = {2019}, date = {2019-01-01}, journal = {J Cardiovasc Thorac Res}, volume = {11}, number = {1}, pages = {19-27}, abstract = {Introduction: Lipid metabolism is one of the main concerns of cardiovascular disease and atherosclerosis. Little is known about the association between dietary patterns and dyslipidemia. Therefore, the present study aimed to determine such association among Iranian adults. Methods: This cross-sectional study was conducted on 1433 Iranian adults in Isfahan Healthy Heart Program (IHHP). Usual dietary intakes were assessed with the use of a 48 items food frequency questionnaire (FFQ). Factor analysis was used to identify dietary patterns. Three major dietary patterns were identified: western, semi healthy and healthy fat patterns. Results: After adjustment, subjects in the upper quartiles of western dietary pattern were more likely to have high total cholesterol concentrations than those in the first quartile (odds ratio [OR]: 2.07; 95% CI: 1.25-3.42). Individuals with greater adherence to western dietary pattern had greater odds of having high low-density lipoprotein-cholesterol (LDL-C) levels compared with those in the lowest quartiles (2.53; 1.45-4.40). Conclusion: Semi healthy dietary pattern was not associated with cardiovascular disease (CVD) risk factors. Same trend was observed for healthy fat dietary pattern. Significant association was found between western dietary pattern and dyslipidemia among Iranian adults.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16782, title = {Low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols diet and irritable bowel syndrome in Asia}, author = {Y Zhang and Z F Ma and H Zhang and B Pan and Y Li and H A Majid and Y Y Lee}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85071703460\&doi=10.1002%2fjgh3.12125\&partnerID=40\&md5=4fd09f17177afb306c2b52db3af63a1c}, doi = {10.1002/jgh3.12125}, year = {2019}, date = {2019-01-01}, journal = {JGH Open}, volume = {3}, number = {2}, pages = {173-178}, abstract = {Functional bowel disorders, including irritable bowel syndrome (IBS), are a chronic condition that can significantly reduce patients’ quality of life. Therefore, this paper will review the roles of a low fermentable oligosaccharides, disaccharides, monosaccharides, and polypols (FODMAP) diet in treating IBS, particularly in an Asian setting. About 20% of the general population is diagnosed with IBS. However, there are limited effective medical therapies available for treating IBS. Therefore, IBS presents a major challenge to the health-care providers. Recently, there is an increasing interest in the use of a diet low in FODMAP for the treatment of IBS. A low FODMAP diet can decrease the delivery of readily fermentable substrates to the small intestine and colon, thereby improving functional gastrointestinal symptoms. © 2018 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley \& Sons Australia, Ltd.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN853, title = {Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study}, author = {S Naudin and K Li and T Jaouen and N Assi and C Kyro and A Tjonneland and K Overvad and M C Boutron-Ruault and V Rebours and A L Vedie and H Boeing and R Kaaks and V Katzke and C Bamia and A Naska and A Trichopoulou and F Berrino and G Tagliabue and D Palli and S Panico and R Tumino and C Sacerdote and P H Peeters and H B A Bueno-de-Mesquita and E Weiderpass and I T Gram and G Skeie and M D Chirlaque and M Rodriguez-Barranco and A Barricarte and J R Quiros and M Dorronsoro and I Johansson and M Sund and H Sternby and K E Bradbury and N Wareham and E Riboli and M Gunter and P Brennan and E J Duell and P Ferrari}, doi = {10.1002/ijc.31367}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, volume = {143}, number = {4}, pages = {801-812}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN882, title = {Cochrane Rehabilitation: Organization and Functioning}, author = {S Negrini and C Arienti and F Gimigliano and F Grubisic and T Howe and E Ilieva and W Levack and A Malmivaara and T Meyer and J Patrick Engkasan and F A Rathore and C Kiekens}, doi = {10.1097/phm.0000000000000832}, issn = {0894-9115}, year = {2018}, date = {2018-01-01}, journal = {Am J Phys Med Rehabil}, volume = {97}, number = {1}, pages = {68-71}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN822, title = {Cochrane Rehabilitation: report of the first year of work}, author = {S Negrini and C Arienti and J Pollet and J P Engkasan and F Gimigliano and F Grubisic and T Howe and E Ilieva and W Levack and A Malmivaara and T Meyer and A Oral and F Rathore and C Kiekens}, doi = {10.23736/s1973-9087.18.05317-0}, issn = {1973-9087}, year = {2018}, date = {2018-01-01}, journal = {Eur J Phys Rehabil Med}, volume = {54}, number = {3}, pages = {463-465}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN861, title = {Viral Load and Sequence Analysis Reveal the Symptom Severity, Diversity, and Transmission Clusters of Rhinovirus Infections}, author = {K T Ng and X Y Oong and S H Lim and J B Chook and Y Takebe and Y F Chan and K G Chan and N S Hanafi and Y K Pang and A Kamarulzaman and K K Tee}, doi = {10.1093/cid/ciy063}, issn = {1058-4838}, year = {2018}, date = {2018-01-01}, journal = {Clin Infect Dis}, volume = {67}, number = {2}, pages = {261-268}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN799b, title = {Prevalence and factors associated with the use of traditional medicines among human immunodeficiency virus and acquired immunodeficiency syndrome patients in Sokoto, Nigeria}, author = {O M Oche and U A Sadiq and R A Oladigbolu and K Chinna}, doi = {10.4103/aam.aam_39_17}, issn = {0975-5764}, year = {2018}, date = {2018-01-01}, journal = {Ann Afr Med}, volume = {17}, number = {3}, pages = {125-132}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN877, title = {Nurses' perceptions of barriers and facilitators and their associations with the quality of end-of-life care}, author = {E Omar Daw Hussin and L P Wong and M C Chong and P Subramanian}, doi = {10.1111/jocn.14130}, issn = {0962-1067}, year = {2018}, date = {2018-01-01}, journal = {J Clin Nurs}, volume = {27}, number = {3-4}, pages = {e688-e702}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN867, title = {Impact of prediagnostic smoking and smoking cessation on colorectal cancer prognosis: a meta-analysis of individual patient data from cohorts within the CHANCES consortium}, author = {J M Ordonez-Mena and V Walter and B Schottker and M Jenab and M G O'Doherty and F Kee and B Bueno-de-Mesquita and P H M Peeters and B H Stricker and R Ruiter and A Hofman and S Soderberg and P Jousilahti and K Kuulasmaa and N D Freedman and T Wilsgaard and A Wolk and L M Nilsson and A Tjonneland and J R Quiros and F J B Duijnhoven and P D Siersema and P Boffetta and A Trichopoulou and H Brenner}, doi = {10.1093/annonc/mdx761}, issn = {0923-7534}, year = {2018}, date = {2018-01-01}, journal = {Ann Oncol}, volume = {29}, number = {2}, pages = {472-483}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN794b, title = {Lactobacillus helveticus (ATCC 27558) upregulates Runx2 and Bmp2 and modulates bone mineral density in ovariectomy-induced bone loss rats}, author = {M Parvaneh and G Karimi and R Jamaluddin and M H Ng and I Zuriati and S I Muhammad}, doi = {10.2147/cia.S169223}, issn = {1176-9092}, year = {2018}, date = {2018-01-01}, journal = {Clin Interv Aging}, volume = {13}, pages = {1555-1564}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN884, title = {Is There an Association Between Ambient Air Pollution and Bladder Cancer Incidence? Analysis of 15 European Cohorts}, author = {M Pedersen and M Stafoggia and G Weinmayr and Z J Andersen and C Galassi and J Sommar and B Forsberg and D Olsson and B Oftedal and N H Krog and G Aamodt and A Pyko and G Pershagen and M Korek and U De Faire and N L Pedersen and C G Ostenson and L Fratiglioni and M Sorensen and K T Eriksen and A Tjonneland and P H Peeters and B Bueno-de-Mesquita and R Vermeulen and M Eeftens and M Plusquin and T J Key and A Jaensch and G Nagel and H Concin and M Wang and M Y Tsai and S Grioni and A Marcon and V Krogh and F Ricceri and C Sacerdote and A Ranzi and G Cesaroni and F Forastiere and I Tamayo and P Amiano and M Dorronsoro and L T Stayner and M Kogevinas and M J Nieuwenhuijsen and R Sokhi and K Hoogh and R Beelen and P Vineis and B Brunekreef and G Hoek and O Raaschou-Nielsen}, doi = {10.1016/j.euf.2016.11.008}, issn = {2405-4569}, year = {2018}, date = {2018-01-01}, journal = {Eur Urol Focus}, volume = {4}, number = {1}, pages = {113-120}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN865, title = {Clinical and economic implications of upper gastrointestinal adverse events in Asian rheumatological patients on long-term non-steroidal anti-inflammatory drugs}, author = {L S L Pok and F H Shabaruddin and M Dahlui and S Sockalingam and M S Mohamed Said and A Rosman and I S Lau and L M Isa and H Hussein and C T Ng and S Mahadeva}, doi = {10.1111/1756-185x.13256}, issn = {1756-1841}, year = {2018}, date = {2018-01-01}, journal = {Int J Rheum Dis}, volume = {21}, number = {5}, pages = {943-951}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN815b, title = {Hepatocellular Carcinoma in Malaysia and Its Changing Trend}, author = {R Raihan and A Azzeri and Shabaruddin H F and R Mohamed}, doi = {10.5005/jp-journals-10018-1259}, issn = {2231-5047 (Print) 2231-5047}, year = {2018}, date = {2018-01-01}, journal = {Euroasian J Hepatogastroenterol}, volume = {8}, number = {1}, pages = {54-56}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN869, title = {Haze and health impacts in ASEAN countries: a systematic review}, author = {L Ramakreshnan and N Aghamohammadi and C S Fong and A Bulgiba and R A Zaki and L P Wong and N M Sulaiman}, doi = {10.1007/s11356-017-0860-y}, issn = {0944-1344}, year = {2018}, date = {2018-01-01}, journal = {Environ Sci Pollut Res Int}, volume = {25}, number = {3}, pages = {2096-2111}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN833, title = {Clinical efficacy and feasibility of whey protein isolates supplementation in malnourished peritoneal dialysis patients: A multicenter, parallel, open-label randomized controlled trial}, author = {S Sahathevan and C H Se and S Ng and B H Khor and K Chinna and B L Goh and H A Gafor and S Bavanandan and G Ahmad and T Karupaiah}, doi = {10.1016/j.clnesp.2018.04.002}, issn = {2405-4577}, year = {2018}, date = {2018-01-01}, journal = {Clin Nutr ESPEN}, volume = {25}, pages = {68-77}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN808b, title = {KIM-1 as a Blood-Based Marker for Early Detection of Kidney Cancer: A Prospective Nested Case-Control Study}, author = {G Scelo and D C Muller and E Riboli and M Johansson and A J Cross and P Vineis and K K Tsilidis and P Brennan and H Boeing and P H M Peeters and R C H Vermeulen and K Overvad and H B Bueno-de-Mesquita and G Severi and V Perduca and M Kvaskoff and A Trichopoulou and C La Vecchia and A Karakatsani and D Palli and S Sieri and S Panico and E Weiderpass and T M Sandanger and T H Nost and A Agudo and J R Quiros and M Rodriguez-Barranco and M D Chirlaque and T J Key and P Khanna and J V Bonventre and V S Sabbisetti and R S Bhatt}, doi = {10.1158/1078-0432.Ccr-18-1496}, issn = {1078-0432 (Print) 1078-0432}, year = {2018}, date = {2018-01-01}, journal = {Clin Cancer Res}, volume = {24}, number = {22}, pages = {5594-5601}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN795b, title = {The 'Be Cancer Alert Campaign': protocol to evaluate a mass media campaign to raise awareness about breast and colorectal cancer in Malaysia}, author = {D Schliemann and M Donnelly and M Dahlui and S Y Loh and N S B Tamin Ibrahim and S Somasundaram and C Donnelly and T T Su}, doi = {10.1186/s12885-018-4769-8}, issn = {1471-2407}, year = {2018}, date = {2018-01-01}, journal = {BMC Cancer}, volume = {18}, number = {1}, pages = {881}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN824, title = {Association analyses of more than 140,000 men identify 63 new prostate cancer susceptibility loci}, author = {F R Schumacher and A A Al Olama and S I Berndt and S Benlloch and M Ahmed and E J Saunders and T Dadaev and D Leongamornlert and E Anokian and C Cieza-Borrella and C Goh and M N Brook and X Sheng and L Fachal and J Dennis and J Tyrer and K Muir and A Lophatananon and V L Stevens and S M Gapstur and B D Carter and C M Tangen and P J Goodman and Jr. Thompson I. M. and J Batra and S Chambers and L Moya and J Clements and L Horvath and W Tilley and G P Risbridger and H Gronberg and M Aly and T Nordstrom and P Pharoah and N Pashayan and J Schleutker and T L J Tammela and C Sipeky and A Auvinen and D Albanes and S Weinstein and A Wolk and N Hakansson and C M L West and A M Dunning and N Burnet and L A Mucci and E Giovannucci and G L Andriole and O Cussenot and G Cancel-Tassin and S Koutros and L E Beane Freeman and K D Sorensen and T F Orntoft and M Borre and L Maehle and E M Grindedal and D E Neal and J L Donovan and F C Hamdy and R M Martin and R C Travis and T J Key and R J Hamilton and N E Fleshner and A Finelli and S A Ingles and M C Stern and B S Rosenstein and S L Kerns and H Ostrer and Y J Lu and H W Zhang and N Feng and X Mao and X Guo and G Wang and Z Sun and G G Giles and M C Southey and R J MacInnis and L M FitzGerald and A S Kibel and B F Drake and A Vega and A Gomez-Caamano and R Szulkin and M Eklund and M Kogevinas and J Llorca and G Castano-Vinyals and K L Penney and M Stampfer and J Y Park and T A Sellers and H Y Lin and J L Stanford and C Cybulski and others}, doi = {10.1038/s41588-018-0142-8}, issn = {1061-4036}, year = {2018}, date = {2018-01-01}, journal = {Nat Genet}, volume = {50}, number = {7}, pages = {928-936}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN875, title = {Low Lifetime Risk of Contralateral Breast Cancer in a Middle-Income Asian Country: Evidence to Guide Post-treatment Surveillance}, author = {M H See and N Bhoo-Pathy and S Jamaris and A Kiran and D G Evans and C H Yip and N A Taib}, doi = {10.1007/s00268-017-4319-6}, issn = {0364-2313}, year = {2018}, date = {2018-01-01}, journal = {World J Surg}, volume = {42}, number = {5}, pages = {1270-1277}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN870, title = {Breast cancer survivors: return to work and wage loss in selected hospitals in Malaysia}, author = {T T Su and M Azzani and F L Tan and S Y Loh}, doi = {10.1007/s00520-017-3987-y}, issn = {0941-4355}, year = {2018}, date = {2018-01-01}, journal = {Support Care Cancer}, volume = {26}, number = {5}, pages = {1617-1624}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN778b, title = {Eating Behaviour Predicts Weight Loss Six Months after Bariatric Surgery: A Longitudinal Study}, author = {K Subramaniam and W Y Low and P C Lau and K F Chin and K Chinna and N R Kosai and M M Taher and R Rajan}, doi = {10.3390/nu10111616}, issn = {2072-6643}, year = {2018}, date = {2018-01-01}, journal = {Nutrients}, volume = {10}, number = {11}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN826, title = {Health-related quality of life and psychological distress among cancer survivors in a middle-income country}, author = {S Subramaniam and Y C Kong and K Chinna and M Kimman and Y Z Ho and N Saat and R A Malik and N A Taib and M M Abdullah and G C Lim and N I Tamin and Y L Woo and K M Chang and P P Goh and C H Yip and N Bhoo-Pathy}, doi = {10.1002/pon.4787}, issn = {1057-9249}, year = {2018}, date = {2018-01-01}, journal = {Psychooncology}, volume = {27}, number = {9}, pages = {2172-2179}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN820b, title = {Altered body composition, sarcopenia, frailty, and their clinico-biological correlates, in Parkinson's disease}, author = {A H Tan and Y C Hew and S Y Lim and N M Ramli and S B Kamaruzzaman and M P Tan and M Grossmann and B H Ang and J Y Tan and Maaa Manap and T K Tay and S L Tan and R P New and F Fadzli and E J Yee and F M Moy and S Mahadeva and A E Lang}, doi = {10.1016/j.parkreldis.2018.06.020}, issn = {1353-8020}, year = {2018}, date = {2018-01-01}, journal = {Parkinsonism Relat Disord}, volume = {56}, pages = {58-64}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN855, title = {The effectiveness of outcome based education on the competencies of nursing students: A systematic review}, author = {K Tan and M C Chong and P Subramaniam and L P Wong}, doi = {10.1016/j.nedt.2017.12.030}, issn = {0260-6917}, year = {2018}, date = {2018-01-01}, journal = {Nurse Educ Today}, volume = {64}, pages = {180-189}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN806b, title = {Individually-tailored multifactorial intervention to reduce falls in the Malaysian Falls Assessment and Intervention Trial (MyFAIT): A randomized controlled trial}, author = {P J Tan and E M Khoo and K Chinna and N I Saedon and M I Zakaria and A Z Ahmad Zahedi and N Ramli and N Khalidin and M Mazlan and K H Chee and I Zainal Abidin and N Nalathamby and S Mat and M H Jaafar and H M Khor and N M Khannas and L A Majid and K M Tan and A V Chin and S B Kamaruzzaman and P Poi and K Morgan and K D Hill and L MacKenzie and M P Tan}, doi = {10.1371/journal.pone.0199219}, issn = {1932-6203}, year = {2018}, date = {2018-01-01}, journal = {PLoS One}, volume = {13}, number = {8}, pages = {e0199219}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN873, title = {Pre-operative parameters do not reliably identify post-operative respiratory risk in children undergoing adenotonsillectomy}, author = {S Thavagnanam and S Y Cheong and K Chinna and A M Nathan and J A Bruyne}, doi = {10.1111/jpc.13789}, issn = {1034-4810}, year = {2018}, date = {2018-01-01}, journal = {J Paediatr Child Health}, volume = {54}, number = {5}, pages = {530-534}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN876, title = {Circulating concentrations of vitamin D in relation to pancreatic cancer risk in European populations}, author = {F J B Duijnhoven and M Jenab and K Hveem and P D Siersema and V Fedirko and E J Duell and E Kampman and A Halfweeg and H J Kranen and J M W Ouweland and E Weiderpass and N Murphy and A Langhammer and E Ness-Jensen and A Olsen and A Tjonneland and K Overvad and C Cadeau and M Kvaskoff and M C Boutron-Ruault and V A Katzke and T Kuhn and H Boeing and A Trichopoulou and A Kotanidou and M Kritikou and D Palli and C Agnoli and R Tumino and S Panico and G Matullo and P Peeters and M Brustad and K S Olsen and C Lasheras and M Obon-Santacana and M J Sanchez and M Dorronsoro and M D Chirlaque and A Barricarte and J Manjer and M Almquist and F Renstrom and W Ye and N Wareham and K T Khaw and K E Bradbury and H Freisling and D Aune and T Norat and E Riboli and H B A Bueno-de-Mesquita}, doi = {10.1002/ijc.31146}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, volume = {142}, number = {6}, pages = {1189-1201}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN832, title = {Circulating Metabolites Associated with Alcohol Intake in the European Prospective Investigation into Cancer and Nutrition Cohort}, author = {E H Roekel and L Trijsburg and N Assi and M Carayol and D Achaintre and N Murphy and S Rinaldi and J A Schmidt and M Stepien and R Kaaks and T Kuhn and H Boeing and K Iqbal and D Palli and V Krogh and R Tumino and F Ricceri and S Panico and P H Peeters and B Bueno-de-Mesquita and E Ardanaz and L Lujan-Barroso and J R Quiros and J M Huerta and E Molina-Portillo and M Dorronsoro and K K Tsilidis and E Riboli and A L Rostgaard-Hansen and A Tjonneland and K Overvad and E Weiderpass and M C Boutron-Ruault and G Severi and A Trichopoulou and A Karakatsani and A Kotanidou and A Hakansson and J Malm and M P Weijenberg and M J Gunter and M Jenab and M Johansson and R C Travis and A Scalbert and P Ferrari}, doi = {10.3390/nu10050654}, issn = {2072-6643}, year = {2018}, date = {2018-01-01}, journal = {Nutrients}, volume = {10}, number = {5}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN771b, title = {Agnostic Pathway/Gene Set Analysis of Genome-Wide Association Data Identifies Associations for Pancreatic Cancer}, author = {N Walsh and H Zhang and P L Hyland and Q Yang and E Mocci and M Zhang and E J Childs and I Collins and Z Wang and A A Arslan and L Beane-Freeman and P M Bracci and P Brennan and F Canzian and E J Duell and S Gallinger and G G Giles and M Goggins and G E Goodman and P J Goodman and R J Hung and C Kooperberg and R C Kurtz and N Malats and L LeMarchand and R E Neale and S H Olson and G Scelo and X O Shu and S K Van Den Eeden and K Visvanathan and E White and W Zheng and D Albanes and G Andreotti and A Babic and W R Bamlet and S I Berndt and A Borgida and M C Boutron-Ruault and L Brais and P Brennan and B Bueno-de-Mesquita and J Buring and K G Chaffee and S Chanock and S Cleary and M Cotterchio and L Foretova and C Fuchs and Gaziano M JM and E Giovannucci and M Goggins and T Hackert and C Haiman and P Hartge and M Hasan and K J Helzlsouer and J Herman and I Holcatova and E A Holly and R Hoover and R J Hung and V Janout and E A Klein and R C Kurtz and D Laheru and I M Lee and L Lu and N Malats and S Mannisto and R L Milne and A L Oberg and I Orlow and A V Patel and U Peters and M Porta and F X Real and N Rothman and H D Sesso and G Severi and D Silverman and O Strobel and M Sund and M D Thornquist and G S Tobias and J Wactawski-Wende and N Wareham and E Weiderpass and N Wentzensen and W Wheeler and H Yu and A Zeleniuch-Jacquotte and P Kraft and D Li and E J Jacobs and G M Petersen and B M Wolpin and H A Risch and L T Amundadottir and others}, doi = {10.1093/jnci/djy155}, issn = {0027-8874}, year = {2018}, date = {2018-01-01}, journal = {J Natl Cancer Inst}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN864, title = {Flow pattern analysis in type B aortic dissection patients after stent-grafting repair: Comparison between complete and incomplete false lumen thrombosis}, author = {W N Wan Ab Naim and P B Ganesan and Z Sun and J Lei and S Jansen and S A Hashim and T K Ho and E Lim}, doi = {10.1002/cnm.2961}, issn = {2040-7939}, year = {2018}, date = {2018-01-01}, journal = {Int J Numer Method Biomed Eng}, volume = {34}, number = {5}, pages = {e2961}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN852, title = {Prevention practices of vaginitis among Malaysian women and its associated factors}, author = {W M Wan Muda and L P Wong and S T Tay}, doi = {10.1080/01443615.2017.1405923}, issn = {0144-3615}, year = {2018}, date = {2018-01-01}, journal = {J Obstet Gynaecol}, volume = {38}, number = {5}, pages = {708-715}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN888, title = {Meat and haem iron intake in relation to glioma in the European Prospective Investigation into Cancer and Nutrition study}, author = {H A Ward and A Gayle and P Jakszyn and M Merritt and B Melin and H Freisling and E Weiderpass and A Tjonneland and A Olsen and C C Dahm and K Overvad and V Katzke and T Kuhn and H Boeing and A Trichopoulou and P Lagiou and A Kyrozis and D Palli and V Krogh and R Tumino and F Ricceri and A Mattiello and B Bueno-de-Mesquita and P H Peeters and J R Quiros and A Agudo and M Rodriguez-Barranco and N Larranaga and J M Huerta and A Barricarte and E Sonestedt and I Drake and M Sandstrom and R C Travis and P Ferrari and E Riboli and A J Cross}, doi = {10.1097/cej.0000000000000331}, issn = {0959-8278}, year = {2018}, date = {2018-01-01}, journal = {Eur J Cancer Prev}, volume = {27}, number = {4}, pages = {379-383}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN770b, title = {Gallstones and incident colorectal cancer in a large pan-European cohort study}, author = {H A Ward and N Murphy and E Weiderpass and M F Leitzmann and E Aglago and M J Gunter and H Freisling and M Jenab and M C Boutron-Ruault and G Severi and F Carbonnel and T Kuhn and R Kaaks and H Boeing and A Tjonneland and A Olsen and K Overvad and S Merino and R Zamora-Ros and M Rodriguez-Barranco and M Dorronsoro and M D Chirlaque and A Barricarte and A Perez-Cornago and A Trichopoulou and C Bamia and P Lagiou and G Masala and S Grioni and R Tumino and C Sacerdote and A Mattiello and B Bueno-de-Mesquita and R Vermeulen and C Van Gils and H Nystrom and M Rutegard and D Aune and E Riboli and A J Cross}, doi = {10.1002/ijc.32090}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN805b, title = {Low Free Testosterone and Prostate Cancer Risk: A Collaborative Analysis of 20 Prospective Studies}, author = {E L Watts and P N Appleby and A Perez-Cornago and H B Bueno-de-Mesquita and J M Chan and C Chen and B A Cohn and M B Cook and L Flicker and N D Freedman and G G Giles and E Giovannucci and R E Gislefoss and G J Hankey and R Kaaks and P Knekt and L N Kolonel and T Kubo and L Le Marchand and R N Luben and T Luostarinen and S Mannisto and E J Metter and K Mikami and R L Milne and K Ozasa and E A Platz and J R Quiros and H Rissanen and N Sawada and M Stampfer and F Z Stanczyk and P Stattin and A Tamakoshi and C M Tangen and I M Thompson and K K Tsilidis and S Tsugane and G Ursin and L Vatten and N S Weiss and B B Yeap and N E Allen and T J Key and R C Travis}, doi = {10.1016/j.eururo.2018.07.024}, issn = {0302-2838}, year = {2018}, date = {2018-01-01}, journal = {Eur Urol}, volume = {74}, number = {5}, pages = {585-594}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN801c, title = {Physical, Psychological, and Social Health Impact of Temperature Rise Due to Urban Heat Island Phenomenon and Its Associated Factors}, author = {L P Wong and H Alias and N Aghamohammadi and S Aghazadeh and N M Nik Sulaiman}, doi = {10.3967/bes2018.074}, issn = {0895-3988 (Print) 0895-3988}, year = {2018}, date = {2018-01-01}, journal = {Biomed Environ Sci}, volume = {31}, number = {7}, pages = {545-550}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN783b, title = {Community Needs Assessment in Relation to Urban Heat Effects: A Study in Greater Kuala Lumpur, Malaysia}, author = {L P Wong and H Alias and N Aghamohammadi and N M Nik Sulaiman}, doi = {10.3967/bes2018.095}, issn = {0895-3988 (Print) 0895-3988}, year = {2018}, date = {2018-01-01}, journal = {Biomed Environ Sci}, volume = {31}, number = {9}, pages = {705-711}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN879, title = {Awareness, perception and barriers to seeking information from online academic databases and medical journals as sources of information}, author = {L P Wong and S M Mohamad Shakir and W T Tong and H Alias and N Aghamohammadi and K Arumugam}, doi = {10.1080/17538157.2017.1364248}, issn = {1753-8157}, year = {2018}, date = {2018-01-01}, journal = {Inform Health Soc Care}, volume = {43}, number = {4}, pages = {335-347}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN848, title = {Evaluating the quality of antenatal care and pregnancy outcomes using content and utilization assessment}, author = {P L Yeoh and K Hornetz and N I A Shauki and M Dahlui}, doi = {10.1093/intqhc/mzy041}, issn = {1353-4505}, year = {2018}, date = {2018-01-01}, journal = {Int J Qual Health Care}, volume = {30}, number = {6}, pages = {466-471}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN854, title = {Overall and Central Obesity and Risk of Lung Cancer: A Pooled Analysis}, author = {D Yu and W Zheng and M Johansson and Q Lan and Y Park and E White and C E Matthews and N Sawada and Y T Gao and K Robien and R Sinha and A Langhammer and R Kaaks and E L Giovannucci and L M Liao and Y B Xiang and D Lazovich and U Peters and X Zhang and B Bueno-de-Mesquita and W C Willett and S Tsugane and Y Takata and S A Smith-Warner and W Blot and X O Shu}, doi = {10.1093/jnci/djx286}, issn = {0027-8874}, year = {2018}, date = {2018-01-01}, journal = {J Natl Cancer Inst}, volume = {110}, number = {8}, pages = {831-842}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN886, title = {Coexistence of Colorectal Adenomas and Coronary Calcification in Asymptomatic Men and Women}, author = {K E Yun and Y Chang and S Rampal and Y Zhang and J Cho and H S Jung and C W Kim and C Jeong and M Cainzos-Achirica and D Zhao and R Pastor-Barriuso and H Shin and E Guallar and S Ryu}, doi = {10.1097/mcg.0000000000000824}, issn = {0192-0790}, year = {2018}, date = {2018-01-01}, journal = {J Clin Gastroenterol}, volume = {52}, number = {6}, pages = {508-514}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN847, title = {Elder Abuse and Chronic Pain: Cross-Sectional and Longitudinal Results from the Preventing Elder Abuse and Neglect Initiative}, author = {R M Yunus and N N Hairi and W Y Choo and M P Tan and F Hairi and R Sooryanarayana and N Ismail and S Kandiben and D Peramalah and Z M Ali and S N Ahmad and I A Razak and S Othman and F H Mydin and K Chinna and A Bulgiba}, doi = {10.1111/jgs.15370}, issn = {0002-8614}, year = {2018}, date = {2018-01-01}, journal = {J Am Geriatr Soc}, volume = {66}, number = {6}, pages = {1165-1171}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN835, title = {Non-Synonymous Single-Nucleotide Polymorphisms and Physical Activity Interactions on Adiposity Parameters in Malaysian Adolescents}, author = {N L Zaharan and N H Muhamad and M Y Jalaludin and T T Su and Z Mohamed and M N A Mohamed and Majid A H}, doi = {10.3389/fendo.2018.00209}, issn = {1664-2392 (Print) 1664-2392}, year = {2018}, date = {2018-01-01}, journal = {Front Endocrinol (Lausanne)}, volume = {9}, pages = {209}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN772b, title = {Coffee and tea drinking in relation to the risk of differentiated thyroid carcinoma: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) study}, author = {R Zamora-Ros and M A Alghamdi and V Cayssials and S Franceschi and M Almquist and J Hennings and M Sandstrom and K K Tsilidis and E Weiderpass and M C Boutron-Ruault and B Hammer Bech and K Overvad and A Tjonneland and K E N Petersen and F R Mancini and Y Mahamat-Saleh and F Bonnet and T Kuhn and R T Fortner and H Boeing and A Trichopoulou and C Bamia and G Martimianaki and G Masala and S Grioni and S Panico and R Tumino and F Fasanelli and G Skeie and T Braaten and C Lasheras and E Salamanca-Fernandez and P Amiano and M D Chirlaque and A Barricarte and J Manjer and P Wallstrom and H B Bueno-de-Mesquita and P H Peeters and K T Khaw and N J Wareham and J A Schmidt and D Aune and G Byrnes and A Scalbert and A Agudo and S Rinaldi}, doi = {10.1007/s00394-018-1874-z}, issn = {1436-6207}, year = {2018}, date = {2018-01-01}, journal = {Eur J Nutr}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN834, title = {Dietary intake of total polyphenol and polyphenol classes and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort}, author = {R Zamora-Ros and V Cayssials and M Jenab and J A Rothwell and V Fedirko and K Aleksandrova and A Tjonneland and C Kyro and K Overvad and M C Boutron-Ruault and F Carbonnel and Y Mahamat-Saleh and R Kaaks and T Kuhn and H Boeing and A Trichopoulou and E Valanou and E Vasilopoulou and G Masala and V Pala and S Panico and R Tumino and F Ricceri and E Weiderpass and M Lukic and T M Sandanger and C Lasheras and A Agudo and M J Sanchez and P Amiano and C Navarro and E Ardanaz and E Sonestedt and B Ohlsson and L M Nilsson and M Rutegard and B Bueno-de-Mesquita and P H Peeters and K T Khaw and N J Wareham and K Bradbury and H Freisling and I Romieu and A J Cross and P Vineis and A Scalbert}, doi = {10.1007/s10654-018-0408-6}, issn = {0393-2990}, year = {2018}, date = {2018-01-01}, journal = {Eur J Epidemiol}, volume = {33}, number = {11}, pages = {1063-1075}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN821, title = {Prevalence and correlates of chronic diseases in an elderly population: A community-based survey in Haikou}, author = {C Zhao and L Wong and Q Zhu and H Yang}, doi = {10.1371/journal.pone.0199006}, issn = {1932-6203}, year = {2018}, date = {2018-01-01}, journal = {PLoS One}, volume = {13}, number = {6}, pages = {e0199006}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN860, title = {The association between obesity and dengue severity among pediatric patients: A systematic review and meta-analysis}, author = {M S Zulkipli and M Dahlui and N Jamil and D Peramalah and H V C Wai and A Bulgiba and S Rampal}, doi = {10.1371/journal.pntd.0006263}, issn = {1935-2727}, year = {2018}, date = {2018-01-01}, journal = {PLoS Negl Trop Dis}, volume = {12}, number = {2}, pages = {e0006263}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN878, title = {Results from the European Prospective Investigation into Cancer and Nutrition Link Vitamin B6 Catabolism and Lung Cancer Risk}, author = {H Zuo and P M Ueland and O Midttun and S E Vollset and G S Tell and D Theofylaktopoulou and R C Travis and M C Boutron-Ruault and A Fournier and G Severi and M Kvaskoff and H Boeing and M M Bergmann and R T Fortner and R Kaaks and A Trichopoulou and A Kotanidou and P Lagiou and D Palli and S Sieri and S Panico and H B Bueno-de-Mesquita and P H Peeters and K Grankvist and M Johansson and A Agudo and J R Q Garcia and N Larranaga and M J Sanchez and M D Chirlaque and E Ardanaz and S C Chuang and V Gallo and P Brennan and M Johansson and A Ulvik}, doi = {10.1158/0008-5472.Can-17-1923}, issn = {0008-5472}, year = {2018}, date = {2018-01-01}, journal = {Cancer Res}, volume = {78}, number = {1}, pages = {302-308}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15553b, title = {Cochrane Rehabilitation: Organization and Functioning}, author = {S Negrini and C Arienti and F Gimigliano and F Grubisic and T Howe and E Ilieva and W Levack and A Malmivaara and T Meyer and J Patrick Engkasan and F A Rathore and C Kiekens}, doi = {10.1097/phm.0000000000000832}, issn = {0894-9115}, year = {2018}, date = {2018-01-01}, journal = {Am J Phys Med Rehabil}, volume = {97}, number = {1}, pages = {68-71}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15527b, title = {Flow pattern analysis in Type B aortic dissection patients after stent-grafting repair: Comparison between complete and incomplete false lumen thrombosis}, author = {Wnwa Naim and P B Ganesan and Z Sun and J Lei and S Jansen and S A Hashim and T K Ho and E Lim}, url = {http://onlinelibrary.wiley.com/doi/10.1002/cnm.2961/abstract?systemMessage=Please+be+advised+that+we+experienced+an+unexpected+issue+that+occurred+on+Saturday+and+Sunday+January+20th+and+21st+that+caused+the+site+to+be+down+for+an+extended+period+of+time+and+affected+the+ability+of+users+to+access+content+on+Wiley+Online+Library.+This+issue+has+now+been+fully+resolved.++We+apologize+for+any+inconvenience+this+may+have+caused+and+are+working+to+ensure+that+we+can+alert+you+immediately+of+any+unplanned+periods+of+downtime+or+disruption+in+the+future.}, doi = {10.1002/cnm.2961}, issn = {2040-7939}, year = {2018}, date = {2018-01-01}, journal = {Int J Numer Method Biomed Eng}, abstract = {Endovascular stent graft repair has become a common treatment for complicated Stanford Type B aortic dissection in order to restore true lumen flow and induce false lumen thrombosis. Using computational fluid dynamics, this study reports the differences in flow patterns and wall shear stress distribution in complicated Stanford Type B aortic dissection patients after endovascular stent graft repair. Five patients were included in this study: two having more than 80% false lumen thrombosis (Group 1), while three others had less than 80% false lumen thrombosis (Group 2) within one year following endovascular repair. Group 1 patients had concentrated re-entry tears around the abdominal branches only, while Group 2 patients had re-entry tears that spread along the dissection line. Blood flow inside the false lumen which affected thrombus formation, increased with the number of re-entry tears and when only small amounts of blood that entered the false lumen exited through the branches. In those cases where dissection extended below the abdominal branches (Group 2), patients with fewer re-entry tears and longer distance between the tears had low wall shear stress contributing to thrombosis. This work provides an insight into predicting the development of complete or incomplete false lumen thrombosis and, has implications for patient selection for treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15583b, title = {Quantitative assessment of wound healing using high-frequency ultrasound image analysis}, author = {H Mohafez and S A Ahmad and M Hadizadeh and S Moghimi and S A Roohi and M H Marhaban and M I Saripan and S Rampal}, doi = {10.1111/srt.12388}, issn = {0909-752x}, year = {2018}, date = {2018-01-01}, journal = {Skin Res Technol}, volume = {24}, number = {1}, pages = {45-53}, abstract = {PURPOSE: We aimed to develop a method for quantitative assessment of wound healing in ulcerated diabetic feet. METHODS: High-frequency ultrasound (HFU) images of 30 wounds were acquired in a controlled environment on post-debridement days 7, 14, 21, and 28. Meaningful features portraying changes in structure and intensity of echoes during healing were extracted from the images, their relevance and discriminatory power being verified by analysis of variance. Relative analysis of tissue healing was conducted by developing a features-based healing function, optimised using the pattern-search method. Its performance was investigated through leave-one-out cross-validation technique and reconfirmed using principal component analysis. RESULTS: The constructed healing function could depict tissue changes during healing with 87.8% accuracy. The first principal component derived from the extracted features demonstrated similar pattern to the constructed healing function, accounting for 86.3% of the data variance. CONCLUSION: The developed wound analysis technique could be a viable tool in quantitative assessment of diabetic foot ulcers during healing.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15544c, title = {Results from the European Prospective Investigation into Cancer and Nutrition Link Vitamin B6 Catabolism and Lung Cancer Risk}, author = {H Zuo and P M Ueland and O Midttun and S E Vollset and G S Tell and D Theofylaktopoulou and R C Travis and M C Boutron-Ruault and A Fournier and G Severi and M Kvaskoff and H Boeing and M M Bergmann and R T Fortner and R Kaaks and A Trichopoulou and A Kotanidou and P Lagiou and D Palli and S Sieri and S Panico and H B Bueno-de-Mesquita and P H Peeters and K Grankvist and M Johansson and A Agudo and J R Q Garcia and N Larranaga and M J Sanchez and M D Chirlaque and E Ardanaz and S C Chuang and V Gallo and P Brennan and M Johansson and A Ulvik}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29070616}, doi = {10.1158/0008-5472.CAN-17-1923}, issn = {1538-7445 (Electronic) 0008-5472 (Linking)}, year = {2018}, date = {2018-01-01}, journal = {Cancer Res}, volume = {78}, number = {1}, pages = {302-308}, abstract = {Circulating pyridoxal-5'-phosphate (PLP) has been linked to lung cancer risk. The PAr index, defined as the ratio 4-pyridoxic acid/(pyridoxal + PLP), reflects increased vitamin B6 catabolism during inflammation. PAr has been defined as a marker of lung cancer risk in a prospective cohort study, but analysis of a larger numbers of cases are needed to deepen the significance of this study. Here, we conducted a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15541c, title = {Circulating concentrations of vitamin D in relation to pancreatic cancer risk in European populations}, author = {F J B Duijnhoven and M Jenab and K Hveem and P D Siersema and V Fedirko and E J Duell and E Kampman and A Halfweeg and H J Kranen and J M W Ouweland and E Weiderpass and N Murphy and A Langhammer and E Ness-Jensen and A Olsen and A Tjonneland and K Overvad and C Cadeau and M Kvaskoff and M C Boutron-Ruault and V A Katzke and T Kuhn and H Boeing and A Trichopoulou and A Kotanidou and M Kritikou and D Palli and C Agnoli and R Tumino and S Panico and G Matullo and P Peeters and M Brustad and K S Olsen and C Lasheras and M Obon-Santacana and M J Sanchez and M Dorronsoro and M D Chirlaque and A Barricarte and J Manjer and M Almquist and F Renstrom and W Ye and N Wareham and K T Khaw and K E Bradbury and H Freisling and D Aune and T Norat and E Riboli and H B A Bueno-de-Mesquita}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29114875}, doi = {10.1002/ijc.31146}, issn = {1097-0215 (Electronic) 0020-7136 (Linking)}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, volume = {142}, number = {6}, pages = {1189-1201}, abstract = {Evidence from in vivo, in vitro and ecological studies are suggestive of a protective effect of vitamin D against pancreatic cancer (PC). However, this has not been confirmed by analytical epidemiological studies. We aimed to examine the association between pre-diagnostic circulating vitamin D concentrations and PC incidence in European populations. We conducted a pooled nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) and the Nord-Trondelag Health Study's second survey (HUNT2) cohorts. In total, 738 primary incident PC cases (EPIC n = 626; HUNT2 n = 112; median follow-up = 6.9 years) were matched to 738 controls. Vitamin D [25(OH)D2 and 25(OH)D3 combined] concentrations were determined using isotope-dilution liquid chromatography-tandem mass spectrometry. Conditional logistic regression models with adjustments for body mass index and smoking habits were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (95%CI). Compared with a reference category of \>50 to 75 nmol/L vitamin D, the IRRs (95% CIs) were 0.71 (0.42-1.20); 0.94 (0.72-1.22); 1.12 (0.82-1.53) and 1.26 (0.79-2.01) for clinically pre-defined categories of \</=25; \>25 to 50; \>75 to 100; and \>100 nmol/L vitamin D, respectively (p for trend = 0.09). Corresponding analyses by quintiles of season-standardized vitamin D concentrations also did not reveal associations with PC risk (p for trend = 0.23). Although these findings among participants from the largest combination of European cohort studies to date show increasing effect estimates of PC risk with increasing pre-diagnostic concentrations of vitamin D, they are not statistically significant.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15532c, title = {Haze and health impacts in ASEAN countries: a systematic review}, author = {L Ramakreshnan and N Aghamohammadi and C S Fong and A Bulgiba and R A Zaki and L P Wong and N M Sulaiman}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29209970}, doi = {10.1007/s11356-017-0860-y}, issn = {1614-7499 (Electronic) 0944-1344 (Linking)}, year = {2018}, date = {2018-01-01}, journal = {Environ Sci Pollut Res Int}, volume = {25}, number = {3}, pages = {2096-2111}, abstract = {Seasonal haze episodes and the associated inimical health impacts have become a regular crisis among the ASEAN countries. Even though many emerging experimental and epidemiological studies have documented the plausible health effects of the predominating toxic pollutants of haze, the consistency among the reported findings by these studies is poorly understood. By addressing such gap, this review aimed to critically highlight the evidence of physical and psychological health impacts of haze from the available literature in ASEAN countries. Systematic literature survey from six electronic databases across the environmental and medical disciplines was performed, and 20 peer-reviewed studies out of 384 retrieved articles were selected. The evidence pertaining to the health impacts of haze based on field survey, laboratory tests, modelling and time-series analysis were extracted for expert judgement. In specific, no generalization can be made on the reported physical symptoms as no specific symptoms recorded in all the reviewed studies except for throat discomfort. Consistent evidence was found for the increase in respiratory morbidity, especially for asthma, whilst the children and the elderly are deemed to be the vulnerable groups of the haze-induced respiratory ailments. A consensual conclusion on the association between the cardiovascular morbidity and haze is unfeasible as the available studies are scanty and geographically limited albeit of some reported increased cases. A number of modelling and simulation studies demonstrated elevating respiratory mortality rates due to seasonal haze exposures over the years. Besides, evidence on cancer risk is inconsistent where industrial and vehicular emissions are also expected to play more notable roles than mere haze exposure. There are insufficient regional studies to examine the association between the mental health and haze. Limited toxicological studies in ASEAN countries often impede a comprehensive understanding of the biological mechanism of haze-induced toxic pollutants on human physiology. Therefore, the lack of consistent evidence among the reported haze-induced health effects as highlighted in this review calls for more intensive longitudinal and toxicological studies with greater statistical power to disseminate more reliable and congruent findings to empower the institutional health planning among the ASEAN countries.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15528c, title = {Clinical and economic implications of upper gastrointestinal adverse events in Asian rheumatological patients on long-term non-steroidal anti-inflammatory drugs}, author = {L S L Pok and F H Shabaruddin and M Dahlui and S Sockalingam and M S Mohamed Said and A Rosman and I S Lau and L M Isa and H Hussein and C T Ng and S Mahadeva}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29314744}, doi = {10.1111/1756-185X.13256}, issn = {1756-185X (Electronic) 1756-1841 (Linking)}, year = {2018}, date = {2018-01-01}, journal = {Int J Rheum Dis}, abstract = {AIM: To determine the incidence and direct costs of NSAID-induced upper GI adverse events in Malaysian rheumatology patients. METHODS: A retrospective, multi-centre, cohort study of rheumatology patients on long-term NSAIDs was conducted. Clinical data of patients treated between 2010 and 2013 were collected for a 24-month follow-up period. The costs of managing upper GI adverse events were based on patient level resource use data. RESULTS: Six hundred and thirty-four patients met the inclusion criteria: mean age 53.4 years, 89.9% female, diagnosis of rheumatoid arthritis (RA; 59.3%), osteoarthritis (OA; 10.3%) and both RA and OA (30.3%). Three hundred and seventy-one (58.5%) patients were prescribed non-selective NSAIDs and 263 (41.5%) had cyclo-oxygenase-2 inhibitors. Eighty-four upper GI adverse events occurred, translating into a risk of 13.2% and an incidence rate of 66.2 per 1000 person-years. GI adverse events comprised: dyspepsia n = 78 (12.3%), peptic ulcer disease (PUD) n = 5 (0.79%) and upper GI bleeding (UGIB) n = 1 (0.16%). The total direct healthcare cost of managing adverse events was Malaysian Ringgit (MR) 37 352 (US dollars [USD] 11 419) with a mean cost of MR 446.81 +/- 534.56 (USD 136.60 +/- 163.42) per patient, consisting mainly of GI pharmacotherapy (33.8%), oesophagoduodenoscopies (23.1%) and outpatient clinic visits (18.2%). Mean cost per patient by GI events were: dyspepsia, MR 408.98 +/- 513.29 (USD125.03 +/- 156.92); PUD, MR 805.93 +/- 578.80 (USD 246.39 +/- 176.95); UGIB, MR 1601.94 (USD 489.74}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15523c, title = {Viral load and sequence analysis reveal the symptom severity, diversity and transmission clusters of rhinovirus infections}, author = {K T Ng and X Y Oong and S H Lim and J B Chook and Y Takebe and Y F Chan and K G Chan and N S Hanafi and Y K Pang and A Kamarulzaman and K K Tee}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29385423}, doi = {10.1093/cid/ciy063}, issn = {1537-6591 (Electronic) 1058-4838 (Linking)}, year = {2018}, date = {2018-01-01}, journal = {Clin Infect Dis}, abstract = {Background: Rhinovirus (RV) is one of the main viral etiologic agents of acute respiratory illnesses. Despite the heightened disease burden caused by RV, the viral factors that increase the severity of RV infection, the transmission pattern and seasonality of RV infections remain unclear. Methods: An observational study was conducted among 3,935 patients presenting with acute upper respiratory illnesses in the ambulatory settings between 2012 and 2014. Results: The VP4/VP2 gene was genotyped from all 976 RV-positive specimens, where the predominance of RV-A (49%) was observed, followed by RV-C (38%) and RV-B (13%). A significant regression in median nasopharyngeal viral load (p\<0.001) was observed; from 883 viral copies/microl at 1-2 days after symptoms onset to 312 viral copies/microl at 3-4 days and 158 viral copies/microl at 5-7 days, before declining to 35 viral copies/microl at \>/= 8 days. In comparison with RV-A (median viral load: 217 copies/microl) and -B (275 copies/microl), RV-C-infected subjects produced higher viral load (505 copies/microl; p\<0.001). Importantly, higher RV viral load (median: 348 copies/microl) was associated with more severe respiratory symptoms (TSSS \>/= 17}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15525c, title = {Seroprevalence of Q Fever Among the Indigenous People (Orang Asli) of Peninsular Malaysia}, author = {C S Khor and N F Mohd-Rahim and H Hassan and J R Chandren and S S Nore and J Johari and S K Loong and J Abd-Jamil and J J Khoo and H Y Lee and B L Pike and L P Wong and Y A Lim and K Zandi and S AbuBakar}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29336685}, doi = {10.1089/vbz.2017.2153}, issn = {1557-7759 (Electronic) 1530-3667 (Linking)}, year = {2018}, date = {2018-01-01}, journal = {Vector Borne Zoonotic Dis}, abstract = {Q fever is a disease caused by Coxiella burnetii. It is a disease of public health concern in many parts of the world. In this study, we described the seroprevalence of Q fever among selected populations of Orang Asli (OA), indigenous people, many of whom live within the forest fringe areas of Peninsular Malaysia. Serum samples were obtained from 887 OA participants from selected villages. Samples were analyzed for the presence of IgG antibodies reactive against C. burnetii by enzyme-linked immunosorbent assay. Statistical methods were used to identify possible associations between seropositivity for C. burnetii and a number of demographic variables obtained from the questionnaires. In total, 9.6% (n = 85/887) of the serum samples were reactive to C. burnetii. Statistical results suggest that elderly male OA residing in OA village, Bukit Payung, were most likely to be tested seropositive for C. burnetii. This study suggests that OA are at a significant risk of contracting C. burnetii infection, and both demographic and geographic factors are important contributors to this risk. Further prospective studies are needed to establish the true burden of C. burnetii infection within the indigenous population as well as within Peninsular Malaysia as a whole.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15552b, title = {Awareness of cervical cancer and socio-demographic variations among women in Libya: An exploratory study in Az-Zawiya city}, author = {N A Hweissa and T T Su}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28960640}, doi = {10.1111/ecc.12750}, issn = {1365-2354 (Electronic) 0961-5423 (Linking)}, year = {2018}, date = {2018-01-01}, journal = {Eur J Cancer Care (Engl)}, volume = {27}, number = {1}, abstract = {Cervical cancer is still a public health problem worldwide, and almost 80% of cervical cancer cases occur in developing countries. In Libya, cervical cancer ranks as the third most frequent cancer among women. This paper presents the results of a study conducted to assess women's awareness of the symptoms and risk factors of cervical cancer and to identify socio-demographic variations in their level of awareness. A population-based cross-sectional survey was carried out in the city of Az-Zawiya, Libya from 1 January 2014 to 31 August 2014. A total of 412 adult women of the reproductive age (18-50 years) were selected randomly from the population registry. A face-to-face interview was conducted, using a validated Arabic version of the Cervical Cancer Awareness Measure (CAM) questionnaire. More than 63% of respondents were unable to recall any warning signs and 66.7% were unable to recall any risk factors. Respondents scored considerably higher on recognition rather than on recall for both the warning signs and the risk factors of cervical cancer. Recall and recognition of cervical cancer symptoms and risk factors were higher in women who had a higher level of education and who earned a higher income. However, overall awareness of cervical cancer symptoms and risk factors among women in the city Az-Zawiya in Libya was low. The findings underline the need to improve public awareness of cervical cancer and its prevention by using several health promotion strategies.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15556c, title = {Do pancreatic cancer and chronic pancreatitis share the same genetic risk factors? A PANcreatic Disease ReseArch (PANDoRA) consortium investigation}, author = {D Campa and M Pastore and G Capurso and T Hackert and M Di Leo and J R Izbicki and K T Khaw and D Gioffreda and J Kupcinskas and C Pasquali and P Macinga and R Kaaks and S Stigliano and P H Peeters and T J Key and R Talar-Wojnarowska and P Vodicka and R Valente and Y K Vashist and R Salvia and I Papaconstantinou and Y Shimizu and C Valsuani and C F Zambon and M Gazouli and I Valantiene and W Niesen and B Mohelnikova-Duchonova and K Hara and P Soucek and E Malecka-Panas and H B A Bueno-de-Mesquita and T Johnson and H Brenner and F Tavano and P Fogar and H Ito and C Sperti and K Butterbach and A Latiano and A Andriulli and G M Cavestro and O R C Busch and F Dijk and W Greenhalf and K Matsuo and C Lombardo and O Strobel and A K Konig and K Cuk and H Strothmann and V Katzke and M Cantore and A Mambrini and M Oliverius and R Pezzilli and S Landi and F Canzian}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28913878}, doi = {10.1002/ijc.31047}, issn = {1097-0215 (Electronic) 0020-7136 (Linking)}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, volume = {142}, number = {2}, pages = {290-296}, abstract = {Pancreatic ductal adenocarcinoma (PDAC) is a very aggressive tumor with a five-year survival of less than 6%. Chronic pancreatitis (CP), an inflammatory process in of the pancreas, is a strong risk factor for PDAC. Several genetic polymorphisms have been discovered as susceptibility loci for both CP and PDAC. Since CP and PDAC share a consistent number of epidemiologic risk factors, the aim of this study was to investigate whether specific CP risk loci also contribute to PDAC susceptibility. We selected five common SNPs (rs11988997, rs379742, rs10273639, rs2995271 and rs12688220) that were identified as susceptibility markers for CP and analyzed them in 2,914 PDAC cases, 356 CP cases and 5,596 controls retrospectively collected in the context of the international PANDoRA consortium. We found a weak association between the minor allele of the PRSS1-PRSS2-rs10273639 and an increased risk of developing PDAC (ORhomozygous = 1.19, 95% CI 1.02-1.38}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15524c, title = {Prospective evaluation of antibody response to Streptococcus gallolyticus and risk of colorectal cancer}, author = {J Butt and M Jenab and M Willhauck-Fleckenstein and A Michel and M Pawlita and C Kyro and A Tjonneland and M C Boutron-Ruault and F Carbonnel and G Severi and R Kaaks and T Kuhn and H Boeing and A Trichopoulou and C Vecchia and A Karakatsani and S Panico and R Tumino and C Agnoli and D Palli and C Sacerdote and B Bueno-de-Mesquita and E Weiderpass and M J Sanchez and C Bonet Bonet and J Huerta and E Ardanaz and K Bradbury and M Gunter and N Murphy and H Freisling and E Riboli and K Tsilidis and D Aune and T Waterboer and D Hughes}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29377173}, doi = {10.1002/ijc.31283}, issn = {1097-0215 (Electronic) 0020-7136 (Linking)}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, abstract = {The gut microbiome is increasingly implicated in colorectal cancer (CRC) development. A subgroup of patients diagnosed with CRC show high antibody responses to Streptococcus gallolyticus subspecies gallolyticus (SGG). However, it is unclear whether the association is also present pre-diagnostically. We assessed the association of antibody responses to SGG proteins in pre-diagnostic serum samples with CRC risk in a case-control study nested within a prospective cohort. Pre-diagnostic serum samples from 485 first incident CRC cases (mean time between blood draw and diagnosis 3.4 years) and 485 matched controls in the European Prospective Investigation into Nutrition and Cancer (EPIC) study were analyzed for antibody responses to eleven SGG proteins using multiplex serology. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable conditional logistic regression models. Antibody positivity for any of the eleven SGG proteins was significantly associated with CRC risk with 56% positive controls compared to 63% positive cases (OR: 1.36, 95% CI: 1.04-1.77). Positivity for two or more proteins of a previously identified SGG 6-marker panel with greater CRC-specificity was also observed among 9% of controls compared to 17% of CRC cases, corresponding to a significantly increased CRC risk (OR: 2.17, 95% CI: 1.44-3.27). In this prospective nested case-control study we observed a positive association between antibody responses to SGG and CRC development in serum samples taken pre-diagnostically. Further work is required to establish the possibly etiological significance of these observations and whether SGG serology may be applicable for CRC risk stratification. This article is protected by copyright. All rights reserved.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN16664, title = {Generic Cost-Effectiveness Models: A Proof of Concept of a Tool for Informed Decision-Making for Public Health Precision Medicine}, author = {S R Snyder and J Hao and L H Cavallari and Z Geng and A Elsey and J A Johnson and Z Mohamed and N Chaiyakunapruk and H Y Chong and M Dahlui and F H Shabaruddin and G P Patrinos and C Mitropoulou and M S Williams}, doi = {10.1159/000500725}, issn = {1662-4246}, year = {2018}, date = {2018-01-01}, journal = {Public Health Genomics}, volume = {21}, number = {5-6}, pages = {217-227}, abstract = {BACKGROUND/AIMS: Economic evaluation is integral to informed public health decision-making in the rapidly growing field of precision and personalized medicine (PM); however, this research requires specialized expertise and significant resources. Generic models are a novel innovation to efficiently address a critical PM evidence shortage and implementation barrier by enabling use of population-specific input values. This is a generic PM economic evaluation model proof-of-concept study for a pharmacogenomic use case. METHODS: An 8-step generic economic model development process was applied to the use case of human leukocyte antigen (HLA)-B*15:02genotyping for prediction of carbamazepine-induced cutaneous reactions, with a user-friendly decision-making tool relying on user-provided input values. This generic model was transparently documented and validated, including cross-validation comparing cost-effectiveness results with 3 country-specific models. RESULTS: A generic pharmacogenomic use case cost-effectiveness model with decision-making tool was successfully developed and cross-validated using input values for 6 populations which produced consistent results for HLA-B*15:02 screening at country-specific cost-effectiveness threshold values. Differences between the generic and country-specific model results were largely due to differences in model structure and assumptions. CONCLUSION: This proof on concept demonstrates the feasibility of generic models to provide useful PM economic evidence, supporting their use as a pragmatic and timely approach to address a growing need.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN844, title = {Inflammatory potential of the diet and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) study}, author = {A Agudo and V Cayssials and C Bonet and A Tjonneland and K Overvad and M C Boutron-Ruault and A Affret and G Fagherazzi and V Katzke and R Schubel and A Trichopoulou and A Karakatsani and C La Vecchia and D Palli and S Grioni and R Tumino and F Ricceri and S Panico and B Bueno-de-Mesquita and P H Peeters and E Weiderpass and G Skeie and T H Nost and C Lasheras and M Rodriguez-Barranco and P Amiano and M D Chirlaque and E Ardanaz and B Ohlsson and J A Dias and L M Nilsson and R Myte and K T Khaw and A Perez-Cornago and M Gunter and I Huybrechts and A J Cross and K Tsilidis and E Riboli and P Jakszyn}, doi = {10.1093/ajcn/nqy002}, issn = {0002-9165}, year = {2018}, date = {2018-01-01}, journal = {Am J Clin Nutr}, volume = {107}, number = {4}, pages = {607-616}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN781b, title = {Prevalence, transitions and factors predicting transition between frailty states among rural community-dwelling older adults in Malaysia}, author = {N S Ahmad and N N Hairi and M A Said and S B Kamaruzzaman and W Y Choo and F Hairi and S Othman and N Ismail and D Peramalah and S Kandiben and Z Mohd Ali and S N Ahmad and I Abdul Razak and A Bulgiba}, doi = {10.1371/journal.pone.0206445}, issn = {1932-6203}, year = {2018}, date = {2018-01-01}, journal = {PLoS One}, volume = {13}, number = {11}, pages = {e0206445}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN812b, title = {Cross-sectional analysis of ethnic differences in fall prevalence in urban dwellers aged 55 years and over in the Malaysian Elders Longitudinal Research study}, author = {D Alex and H M Khor and A V Chin and N N Hairi and S Othman and S P K Khoo and S Bahyah Kamaruzzaman and M P Tan}, doi = {10.1136/bmjopen-2017-019579}, issn = {2044-6055}, year = {2018}, date = {2018-01-01}, journal = {BMJ Open}, volume = {8}, number = {7}, pages = {e019579}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN813b, title = {Care Recipient Multimorbidity and Health Impacts on Informal Caregivers: A Systematic Review}, author = {A Amer Nordin and F Mohd Hairi and W Y Choo and N N Hairi}, doi = {10.1093/geront/gny072}, issn = {0016-9013}, year = {2018}, date = {2018-01-01}, journal = {Gerontologist}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN880, title = {Long-term exposure to ambient air pollution and incidence of brain tumor: the European Study of Cohorts for Air Pollution Effects (ESCAPE)}, author = {Z J Andersen and M Pedersen and G Weinmayr and M Stafoggia and C Galassi and J T Jorgensen and J N Sommar and B Forsberg and D Olsson and B Oftedal and G M Aasvang and P Schwarze and A Pyko and G Pershagen and M Korek and U Faire and C G Ostenson and L Fratiglioni and K T Eriksen and A H Poulsen and A Tjonneland and E V Brauner and P H Peeters and B Bueno-de-Mesquita and A Jaensch and G Nagel and A Lang and M Wang and M Y Tsai and S Grioni and A Marcon and V Krogh and F Ricceri and C Sacerdote and E Migliore and R Vermeulen and R Sokhi and M Keuken and K Hoogh and R Beelen and P Vineis and G Cesaroni and B Brunekreef and G Hoek and O Raaschou-Nielsen}, doi = {10.1093/neuonc/nox163}, issn = {1522-8517}, year = {2018}, date = {2018-01-01}, journal = {Neuro Oncol}, volume = {20}, number = {3}, pages = {420-432}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN831, title = {Pancreatic Cancer Risk is Modulated by Inflammatory Potential of Diet and ABO Genotype: A Consortia-based Evaluation and Replication Study}, author = {S O Antwi and W R Bamlet and K S Pedersen and K G Chaffee and H A Risch and N Shivappa and S E Steck and K E Anderson and P M Bracci and J Polesel and D Serraino and C La Vecchia and C Bosetti and D Li and A L Oberg and A A Arslan and D Albanes and E J Duell and I Huybrechts and L T Amundadottir and R Hoover and S Mannisto and S Chanock and W Zheng and X O Shu and M Stepien and F Canzian and B Bueno-de-Mesquita and J R Quiros and A Zeleniuch-Jacquotte and F Bruinsma and R L Milne and G G Giles and J R Hebert and R Z Stolzenberg-Solomon and G M Petersen}, doi = {10.1093/carcin/bgy072}, issn = {0143-3334}, year = {2018}, date = {2018-01-01}, journal = {Carcinogenesis}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN856, title = {Does a low-income urban population practise healthy dietary habits?}, author = {N A Azizan and N Thangiah and T T Su and H A Majid}, doi = {10.1093/inthealth/ihy001}, issn = {1876-3405}, year = {2018}, date = {2018-01-01}, journal = {Int Health}, volume = {10}, number = {2}, pages = {108-115}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN804b, title = {Long-term exposure to insulin and volumetric mammographic density: observational and genetic associations in the Karma study}, author = {S Borgquist and A H Rosendahl and K Czene and N Bhoo-Pathy and M Dorkhan and P Hall and J S Brand}, doi = {10.1186/s13058-018-1026-7}, issn = {1465-5411}, year = {2018}, date = {2018-01-01}, journal = {Breast Cancer Res}, volume = {20}, number = {1}, pages = {93}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN862, title = {Prospective evaluation of antibody response to Streptococcus gallolyticus and risk of colorectal cancer}, author = {J Butt and M Jenab and M Willhauck-Fleckenstein and A Michel and M Pawlita and C Kyro and A Tjonneland and M C Boutron-Ruault and F Carbonnel and G Severi and R Kaaks and T Kuhn and H Boeing and A Trichopoulou and C Vecchia and A Karakatsani and S Panico and R Tumino and C Agnoli and D Palli and C Sacerdote and H B A Bueno-de-Mesquita and E Weiderpass and M J Sanchez and C Bonet Bonet and J M Huerta and E Ardanaz and K Bradbury and M Gunter and N Murphy and H Freisling and E Riboli and K Tsilidis and D Aune and T Waterboer and D J Hughes}, doi = {10.1002/ijc.31283}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, volume = {143}, number = {2}, pages = {245-252}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN842, title = {Mitochondrial DNA copy number variation, leukocyte telomere length, and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study}, author = {D Campa and M Barrdahl and A Santoro and G Severi and L Baglietto and H Omichessan and R Tumino and H B A Bueno-de-Mesquita and P H Peeters and E Weiderpass and M D Chirlaque and M Rodriguez-Barranco and A Agudo and M Gunter and L Dossus and V Krogh and G Matullo and A Trichopoulou and R C Travis and F Canzian and R Kaaks}, doi = {10.1186/s13058-018-0955-5}, issn = {1465-5411}, year = {2018}, date = {2018-01-01}, journal = {Breast Cancer Res}, volume = {20}, number = {1}, pages = {29}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN883, title = {Do pancreatic cancer and chronic pancreatitis share the same genetic risk factors? A PANcreatic Disease ReseArch (PANDoRA) consortium investigation}, author = {D Campa and M Pastore and G Capurso and T Hackert and M Di Leo and J R Izbicki and K T Khaw and D Gioffreda and J Kupcinskas and C Pasquali and P Macinga and R Kaaks and S Stigliano and P H Peeters and T J Key and R Talar-Wojnarowska and P Vodicka and R Valente and Y K Vashist and R Salvia and I Papaconstantinou and Y Shimizu and C Valsuani and C F Zambon and M Gazouli and I Valantiene and W Niesen and B Mohelnikova-Duchonova and K Hara and P Soucek and E Malecka-Panas and H B A Bueno-de-Mesquita and T Johnson and H Brenner and F Tavano and P Fogar and H Ito and C Sperti and K Butterbach and A Latiano and A Andriulli and G M Cavestro and O R C Busch and F Dijk and W Greenhalf and K Matsuo and C Lombardo and O Strobel and A K Konig and K Cuk and H Strothmann and V Katzke and M Cantore and A Mambrini and M Oliverius and R Pezzilli and S Landi and F Canzian}, doi = {10.1002/ijc.31047}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, volume = {142}, number = {2}, pages = {290-296}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN839, title = {Epigenome-wide association study of adiposity and future risk of obesity-related diseases}, author = {G Campanella and M J Gunter and S Polidoro and V Krogh and D Palli and S Panico and C Sacerdote and R Tumino and G Fiorito and S Guarrera and L Iacoviello and I A Bergdahl and B Melin and P Lenner and Tmcm Kok and P Georgiadis and J C S Kleinjans and S A Kyrtopoulos and H B Bueno-de-Mesquita and K A Lillycrop and A M May and N C Onland-Moret and R Murray and E Riboli and M Verschuren and E Lund and N Mode and T M Sandanger and V Fiano and M Trevisan and G Matullo and P Froguel and P Elliott and P Vineis and M Chadeau-Hyam}, doi = {10.1038/s41366-018-0064-7}, issn = {0307-0565}, year = {2018}, date = {2018-01-01}, journal = {Int J Obes (Lond)}, volume = {42}, number = {12}, pages = {2022-2035}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN866, title = {Quantitative analysis of intraventricular flow-energetics and vortex in ischaemic hearts}, author = {B T Chan and H K Yeoh and Y M Liew and S Dokos and A Al Abed and K H Chee and Y F Abdul Aziz and G S Sridhar and K Chinna and E Lim}, doi = {10.1097/mca.0000000000000596}, issn = {0954-6928}, year = {2018}, date = {2018-01-01}, journal = {Coron Artery Dis}, volume = {29}, number = {4}, pages = {316-324}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN887, title = {Awareness, Facilitators, and Barriers to Policy Implementation Related to Obesity Prevention for Primary School Children in Malaysia}, author = {C Chan and F M Moy and J N W Lim and M Dahlui}, doi = {10.1177/0890117117695888}, issn = {0890-1171}, year = {2018}, date = {2018-01-01}, journal = {Am J Health Promot}, volume = {32}, number = {3}, pages = {806-811}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN828, title = {What influences student nurses' intention to work with older people? A cross-sectional study}, author = {C C Che and M C Chong and N N Hairi}, doi = {10.1016/j.ijnurstu.2018.05.007}, issn = {0020-7489}, year = {2018}, date = {2018-01-01}, journal = {Int J Nurs Stud}, volume = {85}, pages = {61-67}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN889, title = {Prevalence of oral cancer, oral potentially malignant disorders and other oral mucosal lesions in Cambodia}, author = {T Chher and S Hak and T G Kallarakkal and C Durward and A Ramanathan and W M N Ghani and I A Razak and M H Harun and N A M Ashar and R K Rajandram and P Prak and H M Hussaini and R B Zain}, doi = {10.1080/13557858.2016.1246431}, issn = {1355-7858}, year = {2018}, date = {2018-01-01}, journal = {Ethn Health}, volume = {23}, number = {1}, pages = {1-15}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN823, title = {Fine-mapping of prostate cancer susceptibility loci in a large meta-analysis identifies candidate causal variants}, author = {T Dadaev and E J Saunders and P J Newcombe and E Anokian and D A Leongamornlert and M N Brook and C Cieza-Borrella and M Mijuskovic and S Wakerell and A A A Olama and F R Schumacher and S I Berndt and S Benlloch and M Ahmed and C Goh and X Sheng and Z Zhang and K Muir and K Govindasami and A Lophatananon and V L Stevens and S M Gapstur and B D Carter and C M Tangen and P Goodman and Jr. Thompson I. M. and J Batra and S Chambers and L Moya and J Clements and L Horvath and W Tilley and G Risbridger and H Gronberg and M Aly and T Nordstrom and P Pharoah and N Pashayan and J Schleutker and T L J Tammela and C Sipeky and A Auvinen and D Albanes and S Weinstein and A Wolk and N Hakansson and C West and A M Dunning and N Burnet and L Mucci and E Giovannucci and G Andriole and O Cussenot and G Cancel-Tassin and S Koutros and L E B Freeman and K D Sorensen and T F Orntoft and M Borre and L Maehle and E M Grindedal and D E Neal and J L Donovan and F C Hamdy and R M Martin and R C Travis and T J Key and R J Hamilton and N E Fleshner and A Finelli and S A Ingles and M C Stern and B Rosenstein and S Kerns and H Ostrer and Y J Lu and H W Zhang and N Feng and X Mao and X Guo and G Wang and Z Sun and G G Giles and M C Southey and R J MacInnis and L M FitzGerald and A S Kibel and B F Drake and A Vega and A Gomez-Caamano and L Fachal and R Szulkin and M Eklund and M Kogevinas and J Llorca and G Castano-Vinyals and K L Penney and M Stampfer and J Y Park and T A Sellers and others}, doi = {10.1038/s41467-018-04109-8}, issn = {2041-1723}, year = {2018}, date = {2018-01-01}, journal = {Nat Commun}, volume = {9}, number = {1}, pages = {2256}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN796b, title = {Handgrip Strength and Its Associated Factors among Community-dwelling Elderly in Sri Lanka: A Cross-sectional Study}, author = {Hdwt Damayanthi and F M Moy and K L Abdullah and S D Dharmaratne}, doi = {10.1016/j.anr.2018.08.008}, issn = {1976-1317}, year = {2018}, date = {2018-01-01}, journal = {Asian Nurs Res (Korean Soc Nurs Sci)}, volume = {12}, number = {3}, pages = {231-236}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN851, title = {Health related quality of life and its associated factors among community-dwelling older people in Sri Lanka: A cross-sectional study}, author = {Hdwt Damayanthi and F M Moy and K L Abdullah and S D Dharmaratne}, doi = {10.1016/j.archger.2018.03.009}, issn = {0167-4943}, year = {2018}, date = {2018-01-01}, journal = {Arch Gerontol Geriatr}, volume = {76}, pages = {215-220}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN800b, title = {Prevalence of malnutrition and associated factors among community-dwelling older persons in Sri Lanka: a cross-sectional study}, author = {Hdwt Damayanthi and F M Moy and K L Abdullah and S D Dharmaratne}, doi = {10.1186/s12877-018-0892-2}, issn = {1471-2318}, year = {2018}, date = {2018-01-01}, journal = {BMC Geriatr}, volume = {18}, number = {1}, pages = {199}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN793b, title = {Nutritional quality of food as represented by the FSAm-NPS nutrient profiling system underlying the Nutri-Score label and cancer risk in Europe: Results from the EPIC prospective cohort study}, author = {M Deschasaux and I Huybrechts and N Murphy and C Julia and S Hercberg and B Srour and E Kesse-Guyot and P Latino-Martel and C Biessy and C Casagrande and M Jenab and H Ward and E Weiderpass and C C Dahm and K Overvad and C Kyro and A Olsen and A Affret and M C Boutron-Ruault and Y Mahamat-Saleh and R Kaaks and T Kuhn and H Boeing and L Schwingshackl and C Bamia and E Peppa and A Trichopoulou and G Masala and V Krogh and S Panico and R Tumino and C Sacerdote and B Bueno-de-Mesquita and P H Peeters and A Hjartaker and C Rylander and G Skeie and J Ramon Quiros and P Jakszyn and E Salamanca-Fernandez and J M Huerta and E Ardanaz and P Amiano and U Ericson and E Sonestedt and E Huseinovic and I Johansson and K T Khaw and N Wareham and K E Bradbury and A Perez-Cornago and K K Tsilidis and P Ferrari and E Riboli and M J Gunter and M Touvier}, doi = {10.1371/journal.pmed.1002651}, issn = {1549-1277}, year = {2018}, date = {2018-01-01}, journal = {PLoS Med}, volume = {15}, number = {9}, pages = {e1002651}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN874, title = {Adipokines and inflammation markers and risk of differentiated thyroid carcinoma: The EPIC study}, author = {L Dossus and S Franceschi and C Biessy and A S Navionis and R C Travis and E Weiderpass and A Scalbert and I Romieu and A Tjonneland and A Olsen and K Overvad and M C Boutron-Ruault and F Bonnet and A Fournier and R T Fortner and R Kaaks and K Aleksandrova and A Trichopoulou and C La Vecchia and E Peppa and R Tumino and S Panico and D Palli and C Agnoli and P Vineis and H B A Bueno-de-Mesquita and P H Peeters and G Skeie and R Zamora-Ros and M D Chirlaque and E Ardanaz and M J Sanchez and J Ramon Quiros and M Dorronsoro and M Sandstrom and L M Nilsson and J A Schmidt and K T Khaw and K K Tsilidis and D Aune and E Riboli and S Rinaldi}, doi = {10.1002/ijc.31172}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, volume = {142}, number = {7}, pages = {1332-1342}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN811b, title = {The effect of educational intervention on nurses' knowledge, attitude, intention, practice and incidence rate of physical restraint use}, author = {F Eskandari and K L Abdullah and N Z Zainal and L P Wong}, doi = {10.1016/j.nepr.2018.07.007}, issn = {1471-5953}, year = {2018}, date = {2018-01-01}, journal = {Nurse Educ Pract}, volume = {32}, pages = {52-57}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN885, title = {Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study}, author = {H Freisling and H Noh and N Slimani and V Chajes and A M May and P H Peeters and E Weiderpass and A J Cross and G Skeie and M Jenab and F R Mancini and M C Boutron-Ruault and G Fagherazzi and V A Katzke and T Kuhn and A Steffen and H Boeing and A Tjonneland and C Kyro and C P Hansen and K Overvad and E J Duell and D Redondo-Sanchez and P Amiano and C Navarro and A Barricarte and A Perez-Cornago and K K Tsilidis and D Aune and H Ward and A Trichopoulou and A Naska and P Orfanos and G Masala and C Agnoli and F Berrino and R Tumino and C Sacerdote and A Mattiello and H B Bueno-de-Mesquita and U Ericson and E Sonestedt and A Winkvist and T Braaten and I Romieu and J Sabate}, doi = {10.1007/s00394-017-1513-0}, issn = {1436-6207}, year = {2018}, date = {2018-01-01}, journal = {Eur J Nutr}, volume = {57}, number = {7}, pages = {2399-2408}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN776b, title = {Exploring causality of the association between smoking and Parkinson's disease}, author = {V Gallo and P Vineis and M Cancellieri and P Chiodini and R A Barker and C Brayne and N Pearce and R Vermeulen and S Panico and B Bueno-de-Mesquita and N Vanacore and L Forsgren and S Ramat and E Ardanaz and L Arriola and J Peterson and O Hansson and D Gavrila and C Sacerdote and S Sieri and T Kuhn and V A Katzke and Y T Schouw and A Kyrozis and G Masala and A Mattiello and R Perneczky and L Middleton and R Saracci and E Riboli}, doi = {10.1093/ije/dyy230}, issn = {0300-5771}, year = {2018}, date = {2018-01-01}, journal = {Int J Epidemiol}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN819b, title = {Development and validation of the Evidence Based Medicine Questionnaire (EBMQ) to assess doctors' knowledge, practice and barriers regarding the implementation of evidence-based medicine in primary care}, author = {R Hisham and C J Ng and S M Liew and P S M Lai and Y C Chia and E M Khoo and N S Hanafi and S Othman and P Y Lee and K L Abdullah and K Chinna}, doi = {10.1186/s12875-018-0779-5}, issn = {1471-2296}, year = {2018}, date = {2018-01-01}, journal = {BMC Fam Pract}, volume = {19}, number = {1}, pages = {98}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN784b, title = {Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers}, author = {V C Hoe and D M Urquhart and H L Kelsall and E N Zamri and M R Sim}, doi = {10.1002/14651858.CD008570.pub3}, issn = {1361-6137}, year = {2018}, date = {2018-01-01}, journal = {Cochrane Database Syst Rev}, volume = {10}, pages = {Cd008570}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN817, title = {Latest Updates in Dengue Fever Therapeutics: Natural, Marine, and Synthetic Drugs}, author = {S Hosseini and R B Munoz-Soto and J Oliva-Ramirez and P Vazquez-Villegas and N Aghamohammadi and A Rodriguez-Garcia and S O Martinez-Chapa}, doi = {10.2174/0929867325666180629124709}, issn = {0929-8673}, year = {2018}, date = {2018-01-01}, journal = {Curr Med Chem}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN782b, title = {Dengue Fever: A Worldwide Threat An Overview of the Infection Process, Environmental Factors for a Global Outbreak, Diagnostic Platforms and Vaccine Developments}, author = {S Hosseini and J Oliva-Ramirez and P Vazquez-Villegas and A Rodriguez-Garcia and R B Munoz-Soto and N Aghamohammadi and S O Martinez-Chapa}, doi = {10.2174/1568026618666181105130000}, issn = {1568-0266}, year = {2018}, date = {2018-01-01}, journal = {Curr Top Med Chem}, volume = {18}, number = {18}, pages = {1531-1549}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN858, title = {Factors associated with nurses' perceptions about quality of end-of-life care}, author = {E O D Hussin and L P Wong and M C Chong and P Subramanian}, doi = {10.1111/inr.12428}, issn = {0020-8132}, year = {2018}, date = {2018-01-01}, journal = {Int Nurs Rev}, volume = {65}, number = {2}, pages = {200-208}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN881, title = {Awareness of cervical cancer and socio-demographic variations among women in Libya: An exploratory study in Az-Zawiya city}, author = {N A Hweissa and T T Su}, doi = {10.1111/ecc.12750}, issn = {0961-5423}, year = {2018}, date = {2018-01-01}, journal = {Eur J Cancer Care (Engl)}, volume = {27}, number = {1}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN791b, title = {Outcomes of STEMI patients with chronic kidney disease treated with percutaneous coronary intervention: the Malaysian National Cardiovascular Disease Database - Percutaneous Coronary Intervention (NCVD-PCI) registry data from 2007 to 2014}, author = {M D Ismail and M Jalalonmuhali and Z Azhari and J Mariapun and Z V Lee and I Zainal Abidin and W A Wan Ahmad and A S M Zuhdi}, doi = {10.1186/s12872-018-0919-9}, issn = {1471-2261}, year = {2018}, date = {2018-01-01}, journal = {BMC Cardiovasc Disord}, volume = {18}, number = {1}, pages = {184}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN798b, title = {A systematic review of financial implications of air pollution on health in Asia}, author = {H Jaafar and N A Razi and A Azzeri and M Isahak and M Dahlui}, doi = {10.1007/s11356-018-3049-0}, issn = {0944-1344}, year = {2018}, date = {2018-01-01}, journal = {Environ Sci Pollut Res Int}, volume = {25}, number = {30}, pages = {30009-30020}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN872, title = {Efficacy of Rebamipide in Organic and Functional Dyspepsia: A Systematic Review and Meta-Analysis}, author = {M H Jaafar and S Z Safi and M P Tan and S Rampal and S Mahadeva}, doi = {10.1007/s10620-017-4871-9}, issn = {0163-2116}, year = {2018}, date = {2018-01-01}, journal = {Dig Dis Sci}, volume = {63}, number = {5}, pages = {1250-1260}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN837, title = {High rate treatment of hospital wastewater using activated sludge process induced by high-frequency ultrasound}, author = {N Karami and P Mohammadi and A Zinatizadeh and F Falahi and N Aghamohammadi}, doi = {10.1016/j.ultsonch.2018.04.009}, issn = {1350-4177}, year = {2018}, date = {2018-01-01}, journal = {Ultrason Sonochem}, volume = {46}, pages = {89-98}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN850, title = {Efficacy of Nutritional Interventions on Inflammatory Markers in Haemodialysis Patients: A Systematic Review and Limited Meta-Analysis}, author = {B H Khor and S S Narayanan and S Sahathevan and A H A Gafor and Z A M Daud and P Khosla and A Sabatino and E Fiaccadori and K Chinna and T Karupaiah}, doi = {10.3390/nu10040397}, issn = {2072-6643}, year = {2018}, date = {2018-01-01}, journal = {Nutrients}, volume = {10}, number = {4}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN863, title = {Seroprevalence of Q Fever Among the Indigenous People (Orang Asli) of Peninsular Malaysia}, author = {C S Khor and N F Mohd-Rahim and H Hassan and J R Chandren and S S Nore and J Johari and S K Loong and J Abd-Jamil and J J Khoo and H Y Lee and B L Pike and L P Wong and Y A Lim and K Zandi and S AbuBakar}, doi = {10.1089/vbz.2017.2153}, issn = {1530-3667}, year = {2018}, date = {2018-01-01}, journal = {Vector Borne Zoonotic Dis}, volume = {18}, number = {3}, pages = {131-137}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN859, title = {Genome-wide meta-analysis identifies five new susceptibility loci for pancreatic cancer}, author = {A P Klein and B M Wolpin and H A Risch and R Z Stolzenberg-Solomon and E Mocci and M Zhang and F Canzian and E J Childs and J W Hoskins and A Jermusyk and J Zhong and F Chen and D Albanes and G Andreotti and A A Arslan and A Babic and W R Bamlet and L Beane-Freeman and S I Berndt and A Blackford and M Borges and A Borgida and P M Bracci and L Brais and P Brennan and H Brenner and B Bueno-de-Mesquita and J Buring and D Campa and G Capurso and G M Cavestro and K G Chaffee and C C Chung and S Cleary and M Cotterchio and F Dijk and E J Duell and L Foretova and C Fuchs and N Funel and S Gallinger and Gaziano M JM and M Gazouli and G G Giles and E Giovannucci and M Goggins and G E Goodman and P J Goodman and T Hackert and C Haiman and P Hartge and M Hasan and P Hegyi and K J Helzlsouer and J Herman and I Holcatova and E A Holly and R Hoover and R J Hung and E J Jacobs and K Jamroziak and V Janout and R Kaaks and K T Khaw and E A Klein and M Kogevinas and C Kooperberg and M H Kulke and J Kupcinskas and R J Kurtz and D Laheru and S Landi and R T Lawlor and I M Lee and L LeMarchand and L Lu and N Malats and A Mambrini and S Mannisto and R L Milne and B Mohelnikova-Duchonova and R E Neale and J P Neoptolemos and A L Oberg and S H Olson and I Orlow and C Pasquali and A V Patel and U Peters and R Pezzilli and M Porta and F X Real and N Rothman and G Scelo and H D Sesso and G Severi and X O Shu and D Silverman and J P Smith and P Soucek and others}, doi = {10.1038/s41467-018-02942-5}, issn = {2041-1723}, year = {2018}, date = {2018-01-01}, journal = {Nat Commun}, volume = {9}, number = {1}, pages = {556}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN871, title = {Ehrlichia and Anaplasma Infections: Serological Evidence and Tick Surveillance in Peninsular Malaysia}, author = {F X Koh and K L Kho and M G Kisomi and L P Wong and A Bulgiba and P E Tan and Y A L Lim and Q N H Nizam and C Panchadcharam and S T Tay}, doi = {10.1093/jme/tjx204}, issn = {0022-2585}, year = {2018}, date = {2018-01-01}, journal = {J Med Entomol}, volume = {55}, number = {2}, pages = {269-276}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN825, title = {Coffee and Tea Consumption and the Contribution of Their Added Ingredients to Total Energy and Nutrient Intakes in 10 European Countries: Benchmark Data from the Late 1990s}, author = {E Landais and A Moskal and A Mullee and G Nicolas and M J Gunter and I Huybrechts and K Overvad and N Roswall and A Affret and G Fagherazzi and Y Mahamat-Saleh and V Katzke and T Kuhn and C La Vecchia and A Trichopoulou and E Valanou and C Saieva and M Santucci Magistris and S Sieri and T Braaten and G Skeie and E Weiderpass and E Ardanaz and M D Chirlaque and J R Garcia and P Jakszyn and M Rodriguez-Barranco and L Brunkwall and E Huseinovic and L Nilsson and P Wallstrom and B Bueno-de-Mesquita and P H Peeters and D Aune and T Key and M Lentjes and E Riboli and N Slimani and H Freisling}, doi = {10.3390/nu10060725}, issn = {2072-6643}, year = {2018}, date = {2018-01-01}, journal = {Nutrients}, volume = {10}, number = {6}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN857, title = {Elements of the complete blood count associated with cardiovascular disease incidence: Findings from the EPIC-NL cohort study}, author = {C Lassale and A Curtis and I Abete and Y T Schouw and W M M Verschuren and Y Lu and H B A Bueno-de-Mesquita}, doi = {10.1038/s41598-018-21661-x}, issn = {2045-2322}, year = {2018}, date = {2018-01-01}, journal = {Sci Rep}, volume = {8}, number = {1}, pages = {3290}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN775, title = {Risk prediction for estrogen receptor-specific breast cancers in two large prospective cohorts}, author = {K Li and G Anderson and V Viallon and P Arveux and M Kvaskoff and A Fournier and V Krogh and R Tumino and M J Sanchez and E Ardanaz and M D Chirlaque and A Agudo and D C Muller and T Smith and I Tzoulaki and T J Key and B Bueno-de-Mesquita and A Trichopoulou and C Bamia and P Orfanos and R Kaaks and A Husing and R T Fortner and A Zeleniuch-Jacquotte and M Sund and C C Dahm and K Overvad and D Aune and E Weiderpass and I Romieu and E Riboli and M J Gunter and L Dossus and R Prentice and P Ferrari}, doi = {10.1186/s13058-018-1073-0}, issn = {1465-5411}, year = {2018}, date = {2018-01-01}, journal = {Breast Cancer Res}, volume = {20}, number = {1}, pages = {147}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN836, title = {A Novel Calculator for Estimating Prostate Volume in Daily Urology Services}, author = {J Lim and S Rampal and A H A Razack and R Malek and M Sundram and N A Nasuha and C C Ooi and T A Ong and S Sothilingam}, doi = {10.1016/j.urology.2018.02.055}, issn = {0090-4295}, year = {2018}, date = {2018-01-01}, journal = {Urology}, volume = {118}, pages = {145-151}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN849, title = {Is BRCA Mutation Testing Cost Effective for Early Stage Breast Cancer Patients Compared to Routine Clinical Surveillance? The Case of an Upper Middle-Income Country in Asia}, author = {K K Lim and S Y Yoon and N A Mohd Taib and F H Shabaruddin and M Dahlui and Y L Woo and M K Thong and S H Teo and N Chaiyakunapruk}, doi = {10.1007/s40258-018-0384-8}, issn = {1175-5652}, year = {2018}, date = {2018-01-01}, journal = {Appl Health Econ Health Policy}, volume = {16}, number = {3}, pages = {395-406}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN846, title = {The management of methamphetamine use in sexual settings among men who have sex with men in Malaysia}, author = {S H Lim and M Akbar and J A Wickersham and A Kamarulzaman and F L Altice}, doi = {10.1016/j.drugpo.2018.02.019}, issn = {0955-3959}, year = {2018}, date = {2018-01-01}, journal = {Int J Drug Policy}, volume = {55}, pages = {256-262}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN787b, title = {"You Have to Keep Yourself Hidden": Perspectives From Malaysian Malay-Muslim Men Who Have Sex With Men on Policy, Network, Community, and Individual Influences on HIV Risk}, author = {S H Lim and S E Brown and S A Shaw and A Kamarulzaman and F L Altice and C Beyrer}, doi = {10.1080/00918369.2018.1525946}, issn = {0091-8369}, year = {2018}, date = {2018-01-01}, journal = {J Homosex}, pages = {1-23}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN809b, title = {Association between night-shift work, sleep quality and metabolic syndrome}, author = {Y C Lim and V C W Hoe and A Darus and N Bhoo-Pathy}, doi = {10.1136/oemed-2018-105104}, issn = {1351-0711}, year = {2018}, date = {2018-01-01}, journal = {Occup Environ Med}, volume = {75}, number = {10}, pages = {716-723}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN814b, title = {Pre-diagnostic circulating insulin-like growth factor-I and bladder cancer risk in the European Prospective Investigation into Cancer and Nutrition}, author = {C Lin and R C Travis and P N Appleby and S Tipper and E Weiderpass and J Chang-Claude and I T Gram and R Kaaks and L A Kiemeney and B Ljungberg and R Tumino and A Tjonneland and N Roswall and K Overvad and M C Boutron-Ruault and F R Manciniveri and G Severi and A Trichopoulou and G Masala and C Sacerdote and C Agnoli and S Panico and B Bueno-de-Mesquita and P H Peeters and E Salamanca-Fernandez and M D Chirlaque and E Ardanaz and M Dorronsoro and V Menendez and L Lujan-Barroso and F Liedberg and H Freisling and M Gunter and D Aune and A J Cross and E Riboli and T J Key and A Perez-Cornago}, doi = {10.1002/ijc.31650}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, volume = {143}, number = {10}, pages = {2351-2358}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN785b, title = {Adult diphtheria in Malaysia: A case report}, author = {T Loganathan and P Y Mohamed}, issn = {0300-5283 (Print) 0300-5283}, year = {2018}, date = {2018-01-01}, journal = {Med J Malaysia}, volume = {73}, number = {5}, pages = {340-341}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN868, title = {Thresholds for decision-making: informing the cost-effectiveness and affordability of rotavirus vaccines in Malaysia}, author = {T Loganathan and C W Ng and W S Lee and R C W Hutubessy and S Verguet and M Jit}, doi = {10.1093/heapol/czx166}, issn = {0268-1080}, year = {2018}, date = {2018-01-01}, journal = {Health Policy Plan}, volume = {33}, number = {2}, pages = {204-214}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN827, title = {Corrigendum re "Genetic Variants Related to Longer Telomere Length are Associated with Increased Risk of Renal Cell Carcinoma" [Eur Urol 2017;72:747-54]}, author = {M J Machiela and J N Hofmann and R Carreras-Torres and K M Brown and M Johansson and Z Wang and M Foll and P Li and N Rothman and S A Savage and V Gaborieau and J D McKay and Y Ye and M Henrion and F Bruinsma and S Jordan and G Severi and K Hveem and L J Vatten and T Fletcher and K Koppova and S C Larsson and A Wolk and R E Banks and P J Selby and D F Easton and P Pharoah and G Andreotti and L E B Freeman and S Koutros and D Albanes and S Mannisto and S Weinstein and P E Clark and T E Edwards and L Lipworth and S M Gapstur and V L Stevens and H Carol and M L Freedman and M M Pomerantz and E Cho and P Kraft and M A Preston and K M Wilson and J M Gaziano and H S Sesso and A Black and N D Freedman and W Y Huang and J G Anema and R J Kahnoski and B R Lane and S L Noyes and D Petillo and L M Colli and J N Sampson and C Besse and H Blanche and A Boland and L Burdette and E Prokhortchouk and K G Skryabin and M Yeager and M Mijuskovic and M Ognjanovic and L Foretova and I Holcatova and V Janout and D Mates and A Mukeriya and S Rascu and D Zaridze and V Bencko and C Cybulski and E Fabianova and V Jinga and J Lissowska and J Lubinski and M Navratilova and P Rudnai and N Szeszenia-Dabrowska and S Benhamou and G Cancel-Tassin and O Cussenot and H B A Bueno-de-Mesquita and F Canzian and E J Duell and B Ljungberg and R T Sitaram and U Peters and E White and G L Anderson and L Johnson and J Luo and J Buring and I M Lee and W H Chow and L E Moore and C Wood and others}, doi = {10.1016/j.eururo.2018.05.017}, issn = {0302-2838}, year = {2018}, date = {2018-01-01}, journal = {Eur Urol}, volume = {74}, number = {3}, pages = {e85-e86}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN790b, title = {Socioeconomic Differences In Smoking And Cessation Across a Period Of Rapid Economic Growth in an Upper-Middle-Income Country}, author = {J Mariapun and N N Hairi and C W Ng}, doi = {10.1093/ntr/nty203}, issn = {1462-2203}, year = {2018}, date = {2018-01-01}, journal = {Nicotine Tob Res}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN843, title = {The Gradual Shift of Overweight, Obesity, and Abdominal Obesity Towards the Poor in a Multi-ethnic Developing Country: Findings From the Malaysian National Health and Morbidity Surveys}, author = {J Mariapun and C W Ng and N N Hairi}, doi = {10.2188/jea.JE20170001}, issn = {0917-5040}, year = {2018}, date = {2018-01-01}, journal = {J Epidemiol}, volume = {28}, number = {6}, pages = {279-286}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN845, title = {Vitamin D deficiency is associated with ethnicity and knee pain in a multi-ethnic South-East Asian nation: Results from Malaysian Elders Longitudinal Research (MELoR)}, author = {S Mat and M H Jaafar and S Sockalingam and J Raja and S B Kamaruzzaman and A V Chin and A A Abbas and C K Chan and N N Hairi and S Othman and R Cumming and M P Tan}, doi = {10.1111/1756-185x.13279}, issn = {1756-1841}, year = {2018}, date = {2018-01-01}, journal = {Int J Rheum Dis}, volume = {21}, number = {5}, pages = {930-936}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN803b, title = {Circulating plasma phospholipid fatty acids and risk of pancreatic cancer in a large European cohort}, author = {M Matejcic and F Lesueur and C Biessy and A L Renault and N Mebirouk and S Yammine and P Keski-Rahkonen and K Li and B Hemon and E Weiderpass and V Rebours and M C Boutron-Ruault and F Carbonnel and R Kaaks and V Katzke and T Kuhn and H Boeing and A Trichopoulou and D Palli and C Agnoli and S Panico and R Tumino and C Sacerdote and J R Quiros and E J Duell and M Porta and M J Sanchez and M D Chirlaque and A Barricarte and P Amiano and W Ye and P H Peeters and K T Khaw and A Perez-Cornago and T J Key and H B Bueno-de-Mesquita and E Riboli and P Vineis and I Romieu and M J Gunter and V Chajes}, doi = {10.1002/ijc.31797}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, volume = {143}, number = {10}, pages = {2437-2448}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN779b, title = {Germline variation at 8q24 and prostate cancer risk in men of European ancestry}, author = {M Matejcic and E J Saunders and T Dadaev and M N Brook and K Wang and X Sheng and A A A Olama and F R Schumacher and S A Ingles and K Govindasami and S Benlloch and S I Berndt and D Albanes and S Koutros and K Muir and V L Stevens and S M Gapstur and C M Tangen and J Batra and J Clements and H Gronberg and N Pashayan and J Schleutker and A Wolk and C West and L Mucci and P Kraft and G Cancel-Tassin and K D Sorensen and L Maehle and E M Grindedal and S S Strom and D E Neal and F C Hamdy and J L Donovan and R C Travis and R J Hamilton and B Rosenstein and Y J Lu and G G Giles and A S Kibel and A Vega and J T Bensen and M Kogevinas and K L Penney and J Y Park and J L Stanford and C Cybulski and B G Nordestgaard and H Brenner and C Maier and J Kim and M R Teixeira and S L Neuhausen and K De Ruyck and A Razack and L F Newcomb and D Lessel and R Kaneva and N Usmani and F Claessens and P A Townsend and M Gago-Dominguez and M J Roobol and F Menegaux and K T Khaw and L A Cannon-Albright and H Pandha and S N Thibodeau and D J Schaid and F Wiklund and S J Chanock and D F Easton and R A Eeles and Z Kote-Jarai and D V Conti and C A Haiman}, doi = {10.1038/s41467-018-06863-1}, issn = {2041-1723}, year = {2018}, date = {2018-01-01}, journal = {Nat Commun}, volume = {9}, number = {1}, pages = {4616}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN802b, title = {Projections of the Healthcare Costs and Disease Burden due to Hepatitis C Infection under Different Treatment Policies in Malaysia, 2018-2040}, author = {S A McDonald and A Azzeri and F H Shabaruddin and M Dahlui and S S Tan and A Kamarulzaman and R Mohamed}, doi = {10.1007/s40258-018-0425-3}, issn = {1175-5652}, year = {2018}, date = {2018-01-01}, journal = {Appl Health Econ Health Policy}, volume = {16}, number = {6}, pages = {847-857}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN788b, title = {Associations of clothing size, adiposity and weight change with risk of postmenopausal breast cancer in the UK Women's Cohort Study (UKWCS)}, author = {F M Moy and D C Greenwood and J E Cade}, doi = {10.1136/bmjopen-2018-022599}, issn = {2044-6055}, year = {2018}, date = {2018-01-01}, journal = {BMJ Open}, volume = {8}, number = {9}, pages = {e022599}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN830, title = {Prediction of cause of death from forensic autopsy reports using text classification techniques: A comparative study}, author = {G Mujtaba and L Shuib and R G Raj and R Rajandram and K Shaikh}, doi = {10.1016/j.jflm.2017.07.001}, issn = {1752-928x}, year = {2018}, date = {2018-01-01}, journal = {J Forensic Leg Med}, volume = {57}, pages = {41-50}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN838, title = {Classification of forensic autopsy reports through conceptual graph-based document representation model}, author = {G Mujtaba and L Shuib and R G Raj and R Rajandram and K Shaikh and M A Al-Garadi}, doi = {10.1016/j.jbi.2018.04.013}, issn = {1532-0464}, year = {2018}, date = {2018-01-01}, journal = {J Biomed Inform}, volume = {82}, pages = {88-105}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN840, title = {A prospective evaluation of plasma polyphenol levels and colon cancer risk}, author = {N Murphy and D Achaintre and R Zamora-Ros and M Jenab and M C Boutron-Ruault and F Carbonnel and I Savoye and R Kaaks and T Kuhn and H Boeing and K Aleksandrova and A Tjonneland and C Kyro and K Overvad and J R Quiros and M J Sanchez and J M Altzibar and J Maria Huerta and A Barricarte and K T Khaw and K E Bradbury and A Perez-Cornago and A Trichopoulou and A Karakatsani and E Peppa and D Palli and S Grioni and R Tumino and C Sacerdote and S Panico and H B A Bueno-de-Mesquita and P H Peeters and M Rutegard and I Johansson and H Freisling and H Noh and A J Cross and P Vineis and K Tsilidis and M J Gunter and A Scalbert}, doi = {10.1002/ijc.31563}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN829, title = {Prevalence and factors associated with poor sleep quality among secondary school teachers in a developing country}, author = {N A Musa and F M Moy and L P Wong}, doi = {10.2486/indhealth.2018-0052}, issn = {0019-8366}, year = {2018}, date = {2018-01-01}, journal = {Ind Health}, volume = {56}, number = {5}, pages = {407-418}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN841, title = {Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE)}, author = {G Nagel and M Stafoggia and M Pedersen and Z J Andersen and C Galassi and J Munkenast and A Jaensch and J Sommar and B Forsberg and D Olsson and B Oftedal and N H Krog and G Aamodt and A Pyko and G Pershagen and M Korek and U De Faire and N L Pedersen and C G Ostenson and L Fratiglioni and M Sorensen and A Tjonneland and P H Peeters and B Bueno-de-Mesquita and R Vermeulen and M Eeftens and M Plusquin and T J Key and H Concin and A Lang and M Wang and M Y Tsai and S Grioni and A Marcon and V Krogh and F Ricceri and C Sacerdote and A Ranzi and G Cesaroni and F Forastiere and I Tamayo-Uria and P Amiano and M Dorronsoro and K Hoogh and R Beelen and P Vineis and B Brunekreef and G Hoek and O Raaschou-Nielsen and G Weinmayr}, doi = {10.1002/ijc.31564}, issn = {0020-7136}, year = {2018}, date = {2018-01-01}, journal = {Int J Cancer}, keywords = {}, pubstate = {published}, tppubtype = {article} } @book{RN749, title = {Breast Cancer Survivor Cookbook}, author = {H Abdul Majid}, url = {http://www.umpress.com.my/index.php?route=product/product\&product_id=705\&search=breast+cancer}, isbn = {978-983-100-929-1}, year = {2017}, date = {2017-01-01}, publisher = {University of Malaya Press}, address = {Kuala Lumpur, Malaysia}, keywords = {}, pubstate = {published}, tppubtype = {book} } @inbook{RN752, title = {Climate change and air pollution in Malaysia}, author = {N Agha Mohammadi and M Isahak}, editor = {Rais Akhtar and Cosimo Palagiano}, url = {http://www.springer.com/gp/book/9783319613451}, isbn = {978-3-319-61346-8}, year = {2017}, date = {2017-01-01}, booktitle = {ClimateChange and Air Pollution: The Impact on Human Health in Developed and Developing Countries}, publisher = {Springer}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } @article{RN15607b, title = {Association of psychological distress and work psychosocial factors with self-reported musculoskeletal pain among secondary school teachers in Malaysia}, author = {E N Zamri and F M Moy and V C Hoe}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28234933}, doi = {10.1371/journal.pone.0172195}, issn = {1932-6203 (Electronic) 1932-6203 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {PLoS One}, volume = {12}, number = {2}, pages = {e0172195}, abstract = {BACKGROUND: Musculoskeletal pain is common among teachers. Work-related psychosocial factors are found to be associated with the development of musculoskeletal pain, however psychological distress may also play an important role. OBJECTIVES: To assess the prevalence of self-reported low back pain (LBP), and neck and/or shoulder pain (NSP) among secondary school teachers; and to evaluate the association of LBP and NSP with psychological distress and work-related psychosocial factors. METHODS: This was a cross-sectional study conducted among teachers in the state of Penang, Malaysia. The participants were recruited via a two stage sampling method. Information on demographic, psychological distress, work-related psychosocial factors, and musculoskeletal pain (LBP and NSP) in the past 12 months was collected using a self-administered questionnaire. Poisson regression was used to estimate the prevalence ratio (PR) for the associations between psychological distress and work-related psychosocial factors with LBP and NSP. RESULTS: The prevalence of self-reported LBP and NSP among 1482 teachers in the past 12 months was 48.0% (95% Confidence Interval (CI) 45.2%, 50.9%) and 60.1% (95% CI 57.4%, 62.9%) respectively. From the multivariate analysis, self-reported LBP was associated with teachers who reported severe to extremely severe depression (PR: 1.71, 95% CI 1.25, 2.32), severe to extremely severe anxiety (1.46, 95% CI 1.22, 1.75), high psychological job demand (1.29, 95% CI 1.06, 1.57), low skill discretion (1.28, 95% CI 1.13, 1.47) and poorer mental health (0.98, 95% CI 0.97, 0.99). Self-reported NSP was associated with mild to moderate anxiety (1.18, 95% CI 1.06, 1.33), severe to extremely severe anxiety (1.25, 95% CI 1.09, 1.43), low supervisory support (1.13, 95% CI 1.03, 1.25) and poorer mental health (0.98, 95% CI 0.97, 0.99). CONCLUSIONS: Self-reported LBP and NSP were common among secondary school teachers. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce musculoskeletal pain among school teachers.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15578b, title = {Consumption of Fish Is Not Associated with Risk of Differentiated Thyroid Carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study}, author = {R Zamora-Ros and J Castaneda and S Rinaldi and V Cayssials and N Slimani and E Weiderpass and K K Tsilidis and M C Boutron-Ruault and K Overvad and A K Eriksen and A Tjonneland and T Kuhn and V Katzke and H Boeing and A Trichopoulou and C La Vecchia and A Kotanidou and D Palli and S Grioni and A Mattiello and R Tumino and V Sciannameo and E Lund and S Merino and E Salamanca-Fernandez and P Amiano and J M Huerta and A Barricarte and U Ericson and M Almquist and J Hennings and M Sandstrom and H B Bueno-de-Mesquita and P H Peeters and K T Khaw and N J Wareham and J A Schmidt and A J Cross and E Riboli and A Scalbert and I Romieu and A Agudo and S Franceschi}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28592517}, doi = {10.3945/jn.117.247874}, issn = {1541-6100 (Electronic) 0022-3166 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {J Nutr}, volume = {147}, number = {7}, pages = {1366-1373}, abstract = {Background: Differentiated thyroid cancer (TC) is the most common endocrine cancer. Fish can be an important source of iodine and other micronutrients and contaminants that may affect the thyroid gland and TC risk.Objective: We prospectively evaluated the relations between the consumption of total fish and different fish types and shellfish and TC risk in the EPIC (European Prospective Investigation into Cancer and Nutrition) study.Methods: EPIC is a cohort of \>500,000 men and women, mostly aged 35-70 y, who were recruited in 10 European countries. After a mean follow-up of 14 y, 748 primary differentiated TC cases were diagnosed; 666 were in women and 601 were papillary TC. Data on intakes of lean fish, fatty fish, fish products, and shellfish were collected by using country-specific validated dietary questionnaires at recruitment. Multivariable Cox regression was used to calculate HRs and 95% CIs adjusted for many potential confounders, including dietary and nondietary factors.Results: No significant association was observed between total fish consumption and differentiated TC risk for the highest compared with the lowest quartile (HR: 1.03; 95% CI: 0.81, 1.32; P-trend = 0.67). Likewise, no significant association was observed with the intake of any specific type of fish, fish product, or shellfish. No significant heterogeneity was found by TC subtype (papillary or follicular tumors), by sex, or between countries with low and high TC incidence.Conclusion: This large study shows that the intake of fish and shellfish was not associated with differentiated TC risk in Europe, a region in which iodine deficiency or excess is rare.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15622b, title = {Dietary flavonoid intake and colorectal cancer risk in the European prospective investigation into cancer and nutrition (EPIC) cohort}, author = {R Zamora-Ros and D K Barupal and J A Rothwell and M Jenab and V Fedirko and I Romieu and K Aleksandrova and K Overvad and C Kyro and A Tjonneland and A Affret and M His and M C Boutron-Ruault and V Katzke and T Kuhn and H Boeing and A Trichopoulou and A Naska and M Kritikou and C Saieva and C Agnoli and M Santucci Magistris and R Tumino and F Fasanelli and E Weiderpass and G Skeie and S Merino and P Jakszyn and M J Sanchez and M Dorronsoro and C Navarro and E Ardanaz and E Sonestedt and U Ericson and L Maria Nilsson and S Boden and H B Bueno-de-Mesquita and P H Peeters and A Perez-Cornago and N J Wareham and K T Khaw and H Freisling and A J Cross and E Riboli and A Scalbert}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28006847}, doi = {10.1002/ijc.30582}, issn = {1097-0215 (Electronic) 0020-7136 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Int J Cancer}, volume = {140}, number = {8}, pages = {1836-1844}, abstract = {Flavonoids have been shown to inhibit colon cancer cell proliferation in vitro and protect against colorectal carcinogenesis in animal models. However, epidemiological evidence on the potential role of flavonoid intake in colorectal cancer (CRC) development remains sparse and inconsistent. We evaluated the association between dietary intakes of total flavonoids and their subclasses and risk of development of CRC, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cohort of 477,312 adult men and women were recruited in 10 European countries. At baseline, dietary intakes of total flavonoids and individual subclasses were estimated using centre-specific validated dietary questionnaires and composition data from the Phenol-Explorer database. During an average of 11 years of follow-up, 4,517 new cases of primary CRC were identified, of which 2,869 were colon (proximal = 1,298 and distal = 1,266) and 1,648 rectal tumours. No association was found between total flavonoid intake and the risk of overall CRC (HR for comparison of extreme quintiles 1.05, 95% CI 0.93-1.18; p-trend = 0.58) or any CRC subtype. No association was also observed with any intake of individual flavonoid subclasses. Similar results were observed for flavonoid intake expressed as glycosides or aglycone equivalents. Intake of total flavonoids and flavonoid subclasses, as estimated from dietary questionnaires, did not show any association with risk of CRC development.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15631b, title = {Mortality among elder abuse victims in rural Malaysia: A two-year population-based descriptive study}, author = {Mph R M Yunus and PhD N N Hairi and PhD W Y Choo and PhD F M Hairi and Mph R Sooryanarayana and Md S N Ahmad and Md I Abdul Razak and BSc D Peramalah and Mph S Abdul Aziz and Mph Z L Mohammad and Md R Mohamad and Mph Z Mohd Ali and PhD A Bulgiba}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27841737}, doi = {10.1080/08946566.2016.1260083}, issn = {1540-4129 (Electronic) 0894-6566 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {J Elder Abuse Negl}, volume = {29}, number = {1}, pages = {59-71}, abstract = {Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15571b, title = {Association between elder abuse and poor sleep: A cross-sectional study among rural older Malaysians}, author = {R M Yunus and S W Wazid and N N Hairi and W Y Choo and F M Hairi and R Sooryanarayana and S N Ahmad and I A Razak and D Peramalah and S A Aziz and Z L Mohamad and R Mohamad and Z M Ali and A Bulgiba}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28686603}, doi = {10.1371/journal.pone.0180222}, issn = {1932-6203 (Electronic) 1932-6203 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {PLoS One}, volume = {12}, number = {7}, pages = {e0180222}, abstract = {OBJECTIVES: To examine the association between elder abuse and poor sleep using a Malay validated version of Pittsburgh Sleep Quality Index (PSQI). DESIGN: This study was divided into two phases. Phase I tested the construct validity and reliability of the Malay version of PSQI. Phase II was a population-based, cross-sectional study with a multi-stage cluster sampling method. Home-based interviews were conducted by trained personnel using a structured questionnaire, to determine exposure and outcome. SETTING: Kuala Pilah, a district in Negeri Sembilan which is one of the fourteen states in Malaysia. PARTICIPANTS: 1648 community-dwelling older Malaysians. RESULTS: The Malay version of PSQI had significant test re-test reliability with intra-class correlation coefficients of 0.62. Confirmatory factor analyses revealed that one factor PSQI scale with three components (subjective sleep quality, sleep latency, and sleep disturbances) was most suitable. Cronbach's Alpha was 0.60 and composite reliability was 0.63. PSQI scores were highest among neglect (4.11), followed by physical (4.10), psychological (3.96) and financial abuse (3.60). There was a dose-response relationship between clustering of abuse and PSQI scores; 3.41, 3.50 and 3.84 for "no abuse", "1 type of abuse" and "2 types or more". Generalized linear models revealed six variables as significant determinants of sleep quality-abuse, co-morbidities, self-rated health, income, social support and gait speed. Among abuse subtypes, only neglect was significantly associated with poor sleep. CONCLUSION: The Malay PSQI was valid and reliable. Abuse was significantly associated with poor sleep. As sleep is essential for health and is a good predictor for mortality among older adults, management of abuse victims should entail sleep assessment. Interventions or treatment modalities which focus on improving sleep quality among abuse victims should be designed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15526b, title = {Consequences of Elder Abuse and Neglect: A Systematic Review of Observational Studies}, author = {R M Yunus and N N Hairi and W Y Choo}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29333999}, doi = {10.1177/1524838017692798}, issn = {1552-8324 (Electronic) 1524-8380 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Trauma Violence Abuse}, pages = {1524838017692798}, abstract = {This article presents the results of a systematic review of the consequences of elder abuse and neglect (EAN). A systematic search was conducted in seven electronic databases and three sources of gray literature up to January 8, 2016, supplemented by scanning of citation lists in relevant articles and contact with field experts. All observational studies investigating elder abuse as a risk factor for adverse health outcomes, mortality, and health-care utilization were included. Of 517 articles initially captured, 19 articles met our inclusion criteria and were analyzed. Two reviewers independently performed abstract screening, full-texts appraisal, and quality assessment using the Newcastle-Ottawa Scale. Across 19 studies, methodological heterogeneity was a prominent feature; seven definitions of EAN and nine measurement tools for abuse were employed. Summary of results reveals a wide range of EAN outcomes, from premature mortality to increased health-care consumption and various forms of physical and psychological symptoms. Higher risks of mortality emerged as the most credible outcome, while the majority of morbidity outcomes originated from cross-sectional studies. Our findings suggest that there is an underrepresentation of older adults from non-Western populations and developing countries, and there is a need for more population-based prospective studies in middle- and low-income regions. Evidence gathered from this review is crucial in upgrading current practices, formulating policies, and shaping the future direction of research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15588b, title = {Coexistence of Colorectal Adenomas and Coronary Calcification in Asymptomatic Men and Women}, author = {K E Yun and Y Chang and S Rampal and Y Zhang and J Cho and H S Jung and C W Kim and C Jeong and M Cainzos-Achirica and D Zhao and R Pastor-Barriuso and H Shin and E Guallar and S Ryu}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28471937}, doi = {10.1097/MCG.0000000000000824}, issn = {1539-2031 (Electronic) 0192-0790 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {J Clin Gastroenterol}, abstract = {GOALS: Because of shared risk factors between clinically manifest cardiovascular disease and colorectal cancer, we hypothesized the coexistence of subclinical atherosclerosis measured by coronary artery calcium (CAC) and colorectal adenoma (CRA) and that these 2 processes would also share common risk factors. BACKGROUND: No study has directly compared the risk factors associated with subclinical coronary atherosclerosis and CRA. STUDY: This was a cross-sectional study using multinomial logistic regression analysis of 4859 adults who participated in a health screening examination (2010 to 2011; analysis 2014 to 2015). CAC scores were categorized as 0, 1 to 100, or \>100. Colonoscopy results were categorized as absent, low-risk, or high-risk CRA. RESULTS: The prevalence of CAC\>0, CAC 1 to 100 and \>100 was 13.0%, 11.0%, and 2.0%, respectively. The prevalence of any CRA, low-risk CRA, and high-risk CRA was 15.1%, 13.0%, and 2.1%, respectively. The adjusted odds ratios (95% confidence interval) for CAC\>0 comparing participants with low-risk and high-risk CRA with those without any CRA were 1.35 (1.06-1.71) and 2.09 (1.29-3.39), respectively. Similarly, the adjusted odds ratios (95% confidence interval) for any CRA comparing participants with CAC 1 to 100 and CAC\>100 with those with no CAC were 1.26 (1.00-1.6) and 2.07 (1.31-3.26), respectively. Age, smoking, diabetes, and family history of CRC were significantly associated with both conditions. CONCLUSIONS: We observed a graded association between CAC and CRA in apparently healthy individuals. The coexistence of both conditions further emphasizes the need for more evidence of comprehensive approaches to screening and the need to consider the impact of the high risk of coexisting disease in individuals with CAC or CRA, instead of piecemeal approaches restricted to the detection of each disease independently.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15546b, title = {Awareness, perception and barriers to seeking information from online academic databases and medical journals as sources of information}, author = {L P Wong and S M Mohamad Shakir and W T Tong and H Alias and N Aghamohammadi and K Arumugam}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29035606}, doi = {10.1080/17538157.2017.1364248}, issn = {1753-8165 (Electronic) 1753-8157 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {Inform Health Soc Care}, pages = {1-13}, abstract = {Medical students' use of online medical journals as a source of information is crucial in the learning pathway to become medical doctors. We conducted a cross-sectional survey study among University medical students between December 2012 and March 2013 to assess their awareness, perceived usefulness, practices, and barriers to seeking information from online academic databases and medical journals. The response rate was 67.53%. The majority of the students knew of the availability of online academic databases and medical journals. The mean score for awareness (4.25 of possible 11.0), perceived usefulness (13.95 of possible 33.0), and practice (10.67 of possible 33.0) were low. The mean barrier score toward using online academic databases and medical journals was 25.41 (of possible 45.0). Multivariate findings showed that significant barriers associated with overall usage of online databases and medical journals were 1) not knowing where or how to locate databases and 2) unsureness of using the Boolean operators. Availability of full text subscriptions was found to be an important factor in using online databases. Study findings highlighted the need to increase awareness of academic databases' availability and increase training on ways to search online academic databases and medical journals.}, keywords = {}, pubstate = {published}, tppubtype = {article} } @article{RN15575b, title = {A study of physicians' experiences with recommending HPV vaccines to adolescent boys}, author = {L P Wong and Z Edib and H Alias and S M Mohamad Shakir and R N A Raja Muhammad Yusoff and I C Sam and G D Zimet}, url = {https://www.ncbi.nlm.nih.gov/pubmed/28641049}, doi = {10.1080/01443615.2017.1317239}, issn = {1364-6893 (Electronic) 0144-3615 (Linking)}, year = {2017}, date = {2017-01-01}, journal = {J Obstet Gynaecol}, volume = {37}, number = {7}, pages = {937-943}, abstract = {Assessing physicians' experiences in HPV vaccine recommendation and delivery to adolescent boys is essential to providing an understanding of the issues of vaccine acceptance and an insight for policymakers to enhance HPV vaccinations among adolescent boys. Between J